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. 2020 Jun;230(6):1064-1073.
doi: 10.1016/j.jamcollsurg.2020.04.007. Epub 2020 Apr 9.

Rapid Response of an Academic Surgical Department to the COVID-19 Pandemic: Implications for Patients, Surgeons, and the Community

Elizabeth M Lancaster  1 , Julie A Sosa  1 , Amanda Sammann  2 , Logan Pierce  3 , Wen Shen  1 , Michael C Conte  4 , Elizabeth C Wick  5
Affiliations

Rapid Response of an Academic Surgical Department to the COVID-19 Pandemic: Implications for Patients, Surgeons, and the Community

Elizabeth M Lancaster et al. J Am Coll Surg. 2020 Jun.

Abstract

Background: As the coronavirus disease 2019 (COVID-19) pandemic continues to spread, swift actions and preparation are critical for ensuring the best outcomes for patients and providers. We aim to describe our hospital and Department of Surgery's experience in preparing for the COVID-19 pandemic and caring for surgical patients during this unprecedented time.

Study design: This is a descriptive study outlining the strategy of a single academic health system for addressing the following 4 critical issues facing surgical departments during the COVID-19 pandemic: developing a cohesive leadership team and system for frequent communication throughout the department; ensuring adequate hospital capacity to care for an anticipated influx of COVID-19 patients; safeguarding supplies of blood products and personal protective equipment to protect patients and providers; and preparing for an unstable workforce due to illness and competing personal priorities, such as childcare.

Results: Through collaborative efforts within the Department of Surgery and hospital, we provided concise and regular communication, reduced operating room volume by 80%, secured a 4-week supply of personal protective equipment, and created reduced staffing protocols with back-up staffing plans.

Conclusions: By developing an enabling infrastructure, a department can nimbly respond to crises like COVID-19 by promoting trust among colleagues and emphasizing an unwavering commitment to excellent patient care. Sharing principles and practical applications of these changes is important to optimize responses across the country and the world.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Coronavirus disease 2019 (COVID-19) timeline. DOS, Department of Surgery; OR, operating room; PPE, personal protective equipment; SF, San Francisco.
Figure 2
Figure 2
Surge-level operating room (OR) protocols. appy/chole/hip fx, appendectomy, cholecystectomy, hip fracture; COVID+, coronavirus disease-positive; ED, emergency department; MB, Mission Bay; MZ, Mt Zion; periop, perioperative; pts, patients; PUI, person under investigation; UCSF, University of California, San Francisco.
Figure 3
Figure 3
(A) Operating room case volume last 30 days and (B) cases waiting to be scheduled.
Figure 4
Figure 4
Changes to university hospital general surgery teams in response to coronavirus disease 2019 (COVID-19). R, resident; NP, nurse practitioner.
See this image and copyright information in PMC

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