The COVID-19 global pandemic forced healthcare facilities to put special isolation measures in place to limit nosocomial transmission. Cohorting is such a measure and refers to placing infected patients (or under investigation) together in a designated area. This report describes the physical reorganisation of the emergency centre at Khayelitsha Hospital, a district level hospital in Cape Town, South Africa in preparation to the COVID-19 pandemic. The preparation included the identification of a person under investigation (PUI) room, converting short stay wards into COVID-19 isolation areas, and relocating the paediatric section to an area outside the emergency centre. Finally, we had to divide the emergency centre into a respiratory and non-respiratory side by utilising part of the hospital’s main reception. We are positive that the preparation and reorganization of the emergency centre will limit nosocomial transmission during the expected COVID-19 surge. Our experience in adapting to COVID-19 may have useful implications for ECs throughout South Africa and in low-and-middle income countries that are preparing for this pandemic.

HEALTHCARE DELIVERYPurpose-orientated stocking of procedure trolleys saves time in busy emergency centres P Furstenburg, MB ChB, Dip PEC (SA); A Oosthuizen, MB ChB, Dip PEC (SA), FCEM, MMed; L Wallis, MB ChB, MD, FRCEM, FCEM (SA) Background. Inefficient storage and sourcing of routinely required consumables located on procedure trolleys result in time wasted when preparing for common procedures in emergency centres (ECs), contributing to poor efficiency and quality of care. Objectives. We designed a novel purpose-orientated procedure trolley and evaluated its impact on time spent on procedure preparation and efficiency. Methods. In an urban EC, eight participants were measured each day over 24 days, once using the standard setup and once using the modified procedure setup. During each simulation, efficiency markers were assessed (time spent on procedure preparation, steps taken, stops made, and time spent opening drawers to locate required items). Results. The mean (standard deviation) time required to collect the required items for intravenous cannulation and blood sampling from the purpose-orientated trolley was 22.7 (3.66) seconds, compared with 49.2 (15.45) seconds using the standard trolley. There was a significant difference between the two trolleys in mean collection time (p<0.0005) and in all the other categories: steps taken, stops made and drawer opening (p<0.0005). Conclusions. In our setting, stocking procedure trolleys in a purpose-orientated manner has the potential to improve efficiency by reducing time spent on procedure preparation.