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. 2021 Feb 22;11(2):e043837.
doi: 10.1136/bmjopen-2020-043837.

Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

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Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

Usha Dutta et al. BMJ Open. .

Abstract

Objectives: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.

Setting: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.

Participants: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.

Results: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.

Conclusion: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.

Keywords: clinical governance; health & safety; health policy; human resource management; international health services; organisation of health services.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Healthcare welfare team playing a pivotal role in coordinating collaborating and communicating with administrators, opinion makers and policy makers HCP training team and COVID-19 patient care team to provide a multidimensional HCP-centric care. (B) Finding an optimal solution of each of the HCP concerns and converting it into an HCP-centric policy. (C) Holistic training of the HCP before being deployed on COVID-19 duty regarding patient care, laboratory protocols, biomedical waste disposal, PPE training, breach protocols and personal healthcare. HCP, healthcare personnel; PPE, personal protective equipment.
Figure 2
Figure 2
Standard operating policy for healthcare personnel recruitment, training, support, postduty isolation/quarantine and postduty COVID-19 testing. PPE, personal protective equipment; SOP, standard operating protocol.
Figure 3
Figure 3
Three tiers of COVID-19 care zones—red (high-risk zone), orange (medium-risk zone) and green (low-risk zone) with the appropriate PPE in the respective areas to optimise and streamline resources. *PCR turnaround time (8–12 hours)—stable patents; GENE Expert turnaround time (2 hours)—critical patents. HCP, healthcare personnel; ICU, intensive care unit; ILI, influenza like illness; PPE, personal protective equipment; SARI, severe acute respiratory infection.
Figure 4
Figure 4
Empowerment of healthcare personnel (HCP). We empowered the HCP by providing all the contact helplines/services/web portal access/entertainment/standard operating protocols for personal and patient care on their mobile platform to keep all communication efficient and fomite free. MDT, multidisciplinary team.

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References

    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA 2020;323:1239–42. 10.1001/jama.2020.2648 - DOI - PubMed
    1. Guan W-J, Ni Z-Y, Hu Y, W-j G, Z-y N, et al. . Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708–20. 10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Sohrabi C, Alsafi Z, O'Neill N, O’Neill N, et al. . World Health organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020;76:71–6. 10.1016/j.ijsu.2020.02.034 - DOI - PMC - PubMed
    1. WHO WHO Dashboard, 2020. Available: https://www.who.int/redirect-pages/page/novel-coronavirus-(COVID-19)-sit...
    1. Government of India COVID-19 statewise status, 2020. Available: https://www.mygov.in/COVID-19

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