Managing COVID-19 from the epicenter: adaptations and suggestions based on experience

Burnett, Garrett; Katz, Daniel; Park, Chang H.; Hyman, Jaime B.; Dickstein, Elisha; Levin, Matthew A.; Sim, Alan; Salter, Benjamin; Owen, Robert M.; Leibowitz, Andrew B.; Hamburger, Joshua

doi:10.1007/s00540-020-02860-1

Cited by 14 publications

(12 citation statements)

References 7 publications

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“…Finally, all staff should be given the opportunity to opt-out of redeployment and self-isolate without divulging any personal information (Burnett et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…For this reason, redeployment implementation strategies have started to focus on facilitating de-escalating and escalating redeployment when necessary. Examples of practices which allowed for greater flexibility were the stepwise approach to redeployment, or only redeploying discrete teams based on skills (as described in the theme Redeployment: Implementation strategies and learnings ) (Burnett et al, 2020; Doyle et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

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Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

Juan

Camilleri

Jeans³

et al. 2021

Preprint

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BackgroundA rapid influx of patients to intensive care and infection control measures during the COVID-19 pandemic required the rapid development of innovative redeployment and training strategies.MethodsWe conducted a systematic search of 9 databases including key terms related to intensive care AND training AND redeployment AND healthcare workers. Analysis consisted of a narrative synthesis of quantitative study outputs, and a framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis.ResultsTwenty papers were analysed. These took place primarily in the UK (N=8, 40%) and USA (N=5, 25%). Themes included in the results are Redeployment: Implementation strategies and learnings; Redeployed staff experience and strategies to address their needs; Redeployed staff learning needs; Training formats offered and training evaluations; and Future redeployment and training concerns. Some of the redeployment implementation and training strategies documented in this review are: Skills-based redeployment, buddy support systems, and agreeing on locally-specific principles, rather than strict procedures.ConclusionThe COVID-19 pandemic presented unique challenges to deliver training promptly while following infection control recommendations and develop flexible redeployment strategies. This study synthesises original approaches to tackle these challenges which are relevant to inform the development of targeted and adaptative training and redeployment plans.

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“…Finally, all staff should be given the opportunity to opt-out of redeployment and self-isolate without divulging any personal information (Burnett et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

Juan

Camilleri

Jeans³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…A large majority of admitted were COVID-19 positive and many required ICU care. Adaptations to handle this volume included redefining staff prioritization, expanding capacity of isolation rooms and ICU beds, utilizing technology such as video visits to communicate with hospitalized patients, and stockpiling equipment such as ventilators, medications and PPEs (26)(27)(28). Inpatient units were specifically converted and designated as COVID-19 units.…”

Section: Systems Responses To Covid-19mentioning

confidence: 99%

“…New strategies had to be instituted to manage patients under care for other ailments and chronic illnesses, both in outpatient and inpatient settings. These included risk minimizations, care prioritization, health care team management, and applying new technology (26,27,29,33). One major change has been to institute Telehealth and COVID-19 pandemic has accelerated its advancement significantly, maybe by a decade.…”

Section: Technology Is Not Enoughmentioning

confidence: 99%

Organizational learning—COVID-19 experience: innovative global practices for improving patient care in crisis response

Muskopf¹,

Sudan²,

Verdooner³

et al. 2021

J Hosp Manag Health Policy

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Across human history, civilizations have responded to disasters and outbreaks of disease with increasingly complex, systematic approaches as a means of organizing chaos and protecting human life. The SARS-CoV-2 coronavirus (COVID-19) pandemic provides a unique opportunity to learn from the practice of disaster management and crisis-driven changes to patient care processes in hospital and emergent care environments worldwide. COVID-19 acts as an accelerant for process change and the need for redesign in systems where classical, linear evaluation methods most often inform carefully implemented service improvements. Strikingly, many innovative approaches and valuable lessons come from all over the globe where technology and access to resources have been most limited. This article answers the question, what can we learn about how to respond to future disasters from the evolution of disaster management as performed by helping professionals and policymakers during the past hundred-plus years and best practices seen today?Macro practitioners have co-created unique approaches within several global communities to help cope with COVID-19 and other disasters despite limited resources and seemingly unlimited needs. Referencing existing case studies of patient care responses during COVID-19 in Italy, Nigeria, South Africa, South Korea, and the United States, the authors document innovative practices and use of diverse technologies in local patient care systems. The article concludes by suggesting best practices for designing more robust, adaptive, and crisis ready responses to patient care, as well as the use of developmental evaluation as an agile approach to evaluating and improving patient services. It also suggests roles that helping professionals can play in the translation of big data systems of disaster management from organizations such as the Center for Disease Control, World Health Organization, non-governmental organizations (NGOs), and selected think tanks, among others.

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“…This entailed a fast adjustment of the location to ICU needs, for example technical facilities for gas delivery, room ventilation and availability of all the other medical equipment needed in ICU setting. 5 , 11 – 14 …”

Section: Introductionmentioning

confidence: 99%

Comparing Ventilation Parameters for COVID-19 Patients Using Both Long-Term ICU and Anesthetic Ventilators in Times of Shortage

Dijkman

Acht

Akkeren

et al. 2021

J Intensive Care Med

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In the first months of the COVID-19 pandemic in Europe, many patients were treated in hospitals using mechanical ventilation. However, due to a shortage of ICU ventilators, hospitals worldwide needed to deploy anesthesia machines for ICU ventilation (which is off-label use). A joint guidance was written to apply anesthesia machines for long-term ventilation. The goal of this research is to retrospectively evaluate the differences in measurable ventilation parameters between the ICU ventilator and the anesthesia machine as used for COVID-19 patients. In this study, we included 32 patients treated in March and April 2020, who had more than 3 days of mechanical ventilation, either in the regular ICU with ICU ventilators (Hamilton S1), or in the temporary emergency ICU with anesthetic ventilators (Aisys, GE). The data acquired during regular clinical treatment was collected from the Patient Data Management Systems. Available ventilation parameters (pressures and volumes: PEEP, Ppeak, Pinsp, Vtidal), monitored parameters EtCO2, SpO2, derived compliance C, and resistance R were processed and analyzed. A sub-analysis was performed to compare closed-loop ventilation (INTELLiVENT-ASV) to other ventilation modes. The results showed no major differences in the compared parameters, except for Pinsp. PEEP was reduced over time in the with Hamilton treated patients. This is most likely attributed to changing clinical protocol as more clinical experience and literature became available. A comparison of compliance between the 2 ventilators could not be made due to variances in the measurement of compliance. Closed loop ventilation could be used in 79% of the time, resulting in more stable EtCO2. From the analysis it can be concluded that the off-label usage of the anesthetic ventilator in our hospital did not result in differences in ventilation parameters compared to the ICU treatment in the first 4 days of ventilation.

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Managing COVID-19 from the epicenter: adaptations and suggestions based on experience

Cited by 14 publications

References 7 publications

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

Organizational learning—COVID-19 experience: innovative global practices for improving patient care in crisis response

Comparing Ventilation Parameters for COVID-19 Patients Using Both Long-Term ICU and Anesthetic Ventilators in Times of Shortage

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