Less social emergency departments: implementation of workplace contact reduction during COVID-19

Abstract

The COVID-19 pandemic has led to rapid changes in community and healthcare delivery policies creating new and unique challenges to managing ED pandemic response efforts. One example is the practice of social distancing in the workplace as an internationally recommended non-pharmaceutical intervention to reduce transmission. While attention has been focused on public health measures, healthcare workers cannot overlook the transmission risk they present to their colleagues and patients. Our network of three EDs are all high traffic areas for both patients and staff, which makes the limitation of close person-to-person contact particularly difficult to achieve. To design, implement and communicate contact reduction changes in the ED workplace, our COVID-19 task force formalised a set of multidisciplinary recommendations that enumerated concrete ways to reduce healthcare worker transmission to coworkers and to patients from ED patient arrival to discharge. We also addressed staff-to-staff contact reduction strategies when not performing direct patient care. We describe our conceptual approach and successful implementation of workplace distancing.

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…The second, the topics and references. Category Topic and references Change to medical practice Mental health care [254] , [257] , [261] , [273] , [274] , [275] ; Emergency care [276] , [277] ; Substance abuse [253] , [263] , [278] , [279] , [280] ; Oncological care [264] , [281] Health care practices [255] , [259] , [262] , [282] , [283] , [284] ; Pediatric care [283] , [285] Other care [256] , [260] , [268] , [286] , [287] , [288] Modeling Modeling approaches [28] , [265] , [289] , [290] , [291] , [292] , [293] ; Transmission dynamics [294] , [295] , [296] , [297] , [298] Mobile phone data [29] ; estimation [258] Effect of NPIs Effects on: children ...…”

“…This is the largest group of comments and/or perspectives. We find articles focused on a range of medical specialities: mental health care [254] , [257] , [261] , [273] , [274] , [275] , emergency care [276] , [277] , substance abuse [253] , [263] , [278] , [279] , [280] , oncological care [264] , [281] , health care practices [255] , [259] , [262] , [282] , [283] , [284] , pediatric care [283] , [285] , and other care [256] , [260] , [268] , [286] , [287] , [288] .…”

“…Authors in Ref. [277] tackle the practical issues of social distancing in the challenging context of emergency departments. A wide range of standard procedures and workflows have been drastically changed to limit the changes of transmission between patients and health workers.…”

The Backward Art of Slowing the Spread? Congregation Efficiencies during COVID-19

“…A pandemic may still distort individual behavior toward households even when, as in Figure 1, they are less safe than larger organizations because the latter impose prevention costs on members that households do not. Hospitals intentionally rid themselves of opportunities for employees to socialize (Sangal, et al 2020), which from an employee perspective makes work less attractive at the same time that it likely contributes to the low infection rate in hospitals compared to the community. A number of University of Chicago students chose not to return to a campus with remarkably low infection rates because on-campus living quarters were more heavily regulated than before the pandemic with no commensurate reduction in residential fees.…”

“…(Seidelman, et al 2020, Paltansing, et al 2021. Yale University's Emergency Department described "structure[ing] into distinct pods...staggering breaks or using portable computers…taping off or removing chairs" and "individually packaged meals" (Sangal, et al 2020 Although households likely did not implement many of the prevention protocols cited in Table 2, they did reduce their geographic mobility (Chetty, et al 2020). 14 Measures of infection rates in the household sector are therefore equilibrium rates that reflect reduced mobility.…”