The need for safe, stable and sustainable resumption of planned surgery in an era of COVID‐19

Price, James; Sheraton, T.; Self, Rob; Cook, Tim

doi:10.1111/anae.15470

Cited by 6 publications

(21 citation statements)

References 11 publications

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“…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%

“… 23 Qualitative study Various hospitals, Iran Nurses based on interviews from 15 nurse managers Wellbeing strategies MMAT: 4/5 Price et al. 26 Editorial based on guidelines NHS, UK Surgical staff Training, wellbeing, and operational strategies for workforce AACODS: 5.5/6 Marshall et al. 28 Guidelines Australia Medical staff Wellbeing and operational strategies for workforce AACODS: 5/6 Shaparin et al.…”

Section: Resultsmentioning

confidence: 99%

“…A common strategy implemented to improve the wellbeing of the returning redeployed staff was to provide time off to rest and recuperate. 18 , 23 , 26 , 27 , 28 Leng et al. 27 shared that following the redeployment period, the nurses received a three week holiday and Panayiotou et al.…”

Section: Resultsmentioning

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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…However, emergent research shows that healthcare workers are struggling to maintain their functioning as they continue to experience adverse psychological consequences ( Lai et al, 2020 ; Pappa et al, 2021 ) and physical illness ( Dzau et al, 2020 ) due to the crisis. We know that these strenuous conditions threaten organizations' abilities to remain responsive to the demands spurred by the COVID-19 crisis ( Gifford et al, 2021 ; Lasater et al, 2021 ; Price et al, 2021 ), and may have an effect on staff's workplace commitments ( Jain et al, 2013 ). Yet, it remains unclear how the ongoing situation has affected staff's commitment to the crisis response, in particular their willingness to provide COVID-19 care, and studies are lacking that investigate how employees' workplace commitments evolve over time (see Klein, Brinsfield, & Cooper, 2020 for a notable exception).…”

Section: Introductionmentioning

confidence: 99%

There and back again. Examining the development of employee commitment during a prolonged crisis

Gifford

Baan

Westra

et al. 2022

SSM - Qualitative Research in Health

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To effectively function and adapt in crises, healthcare organizations rely on the skills and commitment of their workforce. Yet, our current understanding of how employees’ workplace commitment is affected by and evolves throughout the course of a crisis remains limited. In this paper, we explore the commitment of hospital staff to an important workplace target, the COVID-19 crisis response, and show how this commitment develops over time. We report on an exploratory case study of hospital staff in a heavily hit region of the Netherlands. We conducted interviews with hospital executives, management, medical and support staff to uncover the issues hospitals faced in recruiting staff to provide COVID-19 care throughout the first and second wave of the crisis. Our findings suggest that while staff initially exhibited high levels of commitment to aiding in the crisis effort, staff were perceived to exhibit lower levels of commitment in the second wave, complicating the provision of COVID-19 care. We unveil three contributing factors to this shift, namely: competing demands, energy depletion and a lack of support and appreciation. Our findings suggest that while staff were initially willing to dedicate themselves and take responsibility for the crisis effort, as their other more stable commitments became more salient in the second wave, their willingness to dedicate limited resources to the crisis effort decreased. In our discussion, we examine the implications of our findings for the literature on workplace commitment, and advance our understanding of employee workplace commitment during crises.

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The impact of COVID‐19 on anaesthesia and critical care services in the UK: a serial service evaluation*

et al. 2021

Self Cite

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Summary Between October 2020 and January 2021, we conducted three national surveys to track anaesthetic, surgical and critical care activity during the second COVID‐19 pandemic wave in the UK. We surveyed all NHS hospitals where surgery is undertaken. Response rates, by round, were 64%, 56% and 51%. Despite important regional variations, the surveys showed increasing systemic pressure on anaesthetic and peri‐operative services due to the need to support critical care pandemic demands. During Rounds 1 and 2, approximately one in eight anaesthetic staff were not available for anaesthetic work. Approximately one in five operating theatres were closed and activity fell in those that were open. Some mitigation was achieved by relocation of surgical activity to other locations. Approximately one‐quarter of all surgical activity was lost, with paediatric and non‐cancer surgery most impacted. During January 2021, the system was largely overwhelmed. Almost one‐third of anaesthesia staff were unavailable, 42% of operating theatres were closed, national surgical activity reduced to less than half, including reduced cancer and emergency surgery. Redeployed anaesthesia staff increased the critical care workforce by 125%. Three‐quarters of critical care units were so expanded that planned surgery could not be safely resumed. At all times, the greatest resource limitation was staff. Due to lower response rates from the most pressed regions and hospitals, these results may underestimate the true impact. These findings have important implications for understanding what has happened during the COVID‐19 pandemic, planning recovery and building a system that will better respond to future waves or new epidemics.

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The need for safe, stable and sustainable resumption of planned surgery in an era of COVID‐19

Abstract: Critical care capacity was necessarily expanded in response to the pandemic, but this took place without any increase in substantive staffing numbers. During January 2021, the Intensive Care Society reported an increase in intensive care

Cited by 6 publications

References 11 publications

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

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

There and back again. Examining the development of employee commitment during a prolonged crisis

The impact of COVID‐19 on anaesthesia and critical care services in the UK: a serial service evaluation*

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