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J Laryngol Otol ; 134(8): 670-679, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1049931

ABSTRACT

BACKGROUND: Coronavirus disease 2019 has demanded enormous adjustments to National Health Service provisions. Non-urgent out-patient work was initially postponed or performed virtually, but is now being re-established. In ENT surgery, aerosol-generating procedures pose a particular challenge in out-patient settings. OBJECTIVE: A rapid restructuring of ENT out-patient services is required, to safely accommodate aerosol-generating procedures and increase in-person attendances, whilst coronavirus disease 2019 persists. METHODS: Data were collected prospectively over four consecutive cycles. Two surveys were conducted. Results were analysed and disseminated, with recommendations for service restructuring implemented at cycle end-points. RESULTS: Out-patient activity increased four-fold, associated with a significant rise in aerosol-generating procedures during the study period. Mean aerosol-generating procedure duration dropped weekly, implying a learning curve. Service restructuring occurred at cycle end-points. CONCLUSION: Iterative data gathering, results analysis and outcome dissemination enabled a swift, data-driven approach to the restructuring of ENT out-patient services. Patient and staff safety was ensured, whilst out-patient capacity was optimised.


Subject(s)
Coronavirus Infections/transmission , Otolaryngology/standards , Otorhinolaryngologic Surgical Procedures/statistics & numerical data , Outpatients/statistics & numerical data , Pneumonia, Viral/transmission , Aerosols , Betacoronavirus/isolation & purification , Body Fluids/virology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Hospital Restructuring/organization & administration , Humans , Incidence , National Health Programs/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Prospective Studies , Quality Improvement , SARS-CoV-2 , Surveys and Questionnaires , United Kingdom/epidemiology
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