Adaptation and restructuring of an academic anesthesiology department during the COVID-19 pandemic in New York City: Challenges and lessons learned

Shaparin, Naum; Mann, Glenn E.; Streiff, Agathe; Kiyatkin, Michael E.; Choice, Curtis; Ramachandran, Sujatha; Delphin, Ellise; Adams, David C.

doi:10.1016/j.bpa.2020.12.010

Cited by 5 publications

(9 citation statements)

References 12 publications

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“…A summary of the key characteristics of the included papers can be found in Table 2 . Of the 15 papers included, two were based on empirical data, ten were based on data from case studies, commentary articles or letters to the editor, 16 , 17 , 18 , 19 , 20 , 21 , 22 , 24 , 29 and three were guidelines on how to manage the de-escalation of ICUs. 25 , 26 , 28 The included papers were from the UK ( n = 6), the USA ( n = 4), Singapore ( n = 2), China ( n = 1), Iran ( n = 1), and Australia ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“… 28 Guidelines Australia Medical staff Wellbeing and operational strategies for workforce AACODS: 5/6 Shaparin et al. 21 Case study Montefiore Medical Centre, New York, USA Anaesthesiology staff Operational strategies for facilities AACODS: 4.5/6 …”

Section: Resultsmentioning

confidence: 99%

“…Shaparin et al. 21 discussed how the anaesthesiology team were planning to prepare for the future closure of Ambulatory Surgery Centre to enable its transformation into ICUs should a resurgence of COVID-19 occur. Yau et al.…”

Section: Resultsmentioning

confidence: 99%

“…This approach for separating the ICU was also experienced in the setting described by Lord et al 17 A common theme in the management of ICU facilities is that some of the healthcare settings were wary of future COVID-19 surges. Shaparin et al 21 discussed how the anaesthesiology team were planning to prepare for the future closure of Ambulatory Surgery Centre to enable its transformation into ICUs should a resurgence of COVID-19 occur. Yau et al 29 and Lum et al 19 both shared that the teams kept oversight of ICU supplies and equipment, and the team in the Lum et al paper ringfenced 10% of the remaining ICU beds.…”

Section: Training Strategiesmentioning

confidence: 99%

“…15 With the decline in ICU patients, many of the redeployed workforce and temporary ICUs could return to usual functions, and numerous publications have documented how these processes have occurred in different hospital settings. 8 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 Since the initial decline, many countries have faced recuring waves of COVID-19 infections and ICU admissions. 15 This repetitive surge in need for ICU capacity followed by de-escalation is likely to continue for some time whilst variants of SARS-CoV-2 continue to circulate throughout the globe.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of de-escalation strategies for redeployed staff and repurposed facilities in COVID-19 intensive care units (ICUs) during the pandemic

2022

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Background Intensive care units (ICUs) experienced a surge in patient cases during the COVID-19 pandemic. Demand was managed by redeploying healthcare workers (HCWs) and restructuring facilities. The rate of ICU admissions has subsided in many regions, with the redeployed workforce and facilities returning to usual functions. Previous literature has focused on the escalation of ICUs, limited research exists on de-escalation. This study aimed to identify the supportive and operational strategies used for the flexible de-escalation of ICUs in the context of COVID-19. Methods The systematic review was developed by searching eight databases in April and November 2021. Papers discussing the return of redeployed staff and facilities and the training, wellbeing, and operational strategies were included. Excluded papers were non-English and unrelated to ICU de-escalation. Quality was assessed using the mixed methods appraisal tool (MMAT) and authority, accuracy, coverage, objectivity, date, and significance (AACODS) checklist, findings were developed using narrative synthesis and thematic analysis. Findings Fifteen papers were included from six countries covering wellbeing and training themes encompassing; time off, psychological follow-up, gratitude, identification of training needs, missed training catch-up, and continuation of ICU and disaster management training. Operational themes included management of rotas, retainment of staff, division of ICU facilities, leadership changes, traffic light systems, and preparation for re-expansion. Interpretation The review provided an overview of the landscape of de-escalation strategies that have taken place in six countries. Limited empirical evidence was available that evaluated the effectiveness of such strategies. Empirical and evaluative research from a larger array of countries is needed to be able to make global recommendations on ICU de-escalation practices.

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