Strategic planning and response to COVID-19 in a London emergency department

Abstract

For many of us in emergency medicine, rising to the challenge of the COVID-19 crisis will be the single most exciting and challenging episode of our careers. Lessons have been learnt on how to make quick and effective changes without being hindered by the normal restraints of bureaucracy. Changes that would normally have taken months to years to implement have been successfully introduced over a period of several weeks. Although we have managed these changes largely by command and control, compassionate leadership has identified leaders within our team and paved the way for the future. This article covers the preparation and changes made in response to COVID-19 in a London teaching hospital.

Keywords: disaster planning and response; effectiveness; emergency care systems, emergency departments; emergency department; emergency department operations.

Figure 1

Timeline to show the speed at which change was required in response to COVID-19. ED, emergency department. A&E, accident and emergency; POD, outdoor hut; ID infectious diseases.

Figure 2

Map of the emergency department (ED) to show pre-COVID-19 and post-COVID-19 layout.

Figure 3

Structure of the day. ED, emergency department. OT, occupational therapy; CD, clinical director; PPE, personal protective equipment.

Figure 4

Graph to show staff sickness over time. RFH, Royal Free Hospital

Figure 5

An example of one of the checklist stickers.CXR, chest x-ray; CRP, C reactive protein; Sats, saturation level; Fi02, fraction of inspired oxygen; ITU, intensive therapy unit; DTA, decision to admit.