Mobilising a workforce to combat COVID-19: An account, reflections, and lessons learned

Abstract

With the declaration of coronavirus 2019 (COVID-19) as a pandemic, intensive care units across the globe began to prepare for large numbers of patients. For many years, UK Intensive Care Units (ICUs) have been at high capacity, while facing staffing shortages. In order to prepare for the predicted increased work caring for large numbers with COVID-19, staff were redeployed from other clinical areas to help. Many of these staff had no previous ICU experience. In this article, we share our experiences redeploying medical staff from an extensive range of backgrounds, and how we utilised those staff to maximise use of their existing skills, together with reflections from a variety of redeployed staff members.

Keywords: Covid; ICU; coronavirus; critical care; redeployment.

Figure 1.

COVID-19 capacity planning with escalation capacity. Dedicated capacity included general Adult Intensive Care unit (AICU) with 20 beds and Cardiothoracic ICU (CTICU) with 40 beds. Escalation was possible to the paediatric ICU (PICU) and theatre recovery. Our non-COVID-19 patients requiring intensive care were placed in the neuro ICU (NICU) which had a capacity of 25 beds.

Figure 2.

Admissions pathway for patients under normal (top) and pandemic (bottom) conditions. Note the uncoupling of patient and doctor movement and the use of the redeployed doctors to enable greater utilisation of an intensivist’s specialist skills, whilst other teams take over task-specific aspects of management.

Figure 3.

Total hospital admissions, per day, with confirmed COVID-19.

Figure 4.

Total critical care occupancy of suspected or confirmed COVID-19 cases across the critical care areas, with deployment and step-down dates of various staff groups. “Surge staffing” refers to an additional airway trained registrar on every shift. The AICU was filled to near-capacity first, and then the CTICU was used.