ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has confronted the U.S. health care system with unprecedented challenges amidst a tenuous economic environment. As inpatient hospitals across the country prepare for an overwhelming influx of highly contagious COVID-19 cases, many nonemergent procedures have been cancelled or indefinitely postponed without guidance regarding eventual safe accommodation of these procedures in the future. Given the potentially prolonged impact of the COVID-19 pandemic on health care use, it is imperative for plastic surgeons to collaborate with other medical and surgical specialties to develop surge capacity protocols that allow continuation of safe, high-quality, nonemergent procedures. The purpose of this article is to provide necessary and timely public health information relevant to plastic surgery and also share a conceptual framework to guide surge capacity protocols for nonemergent surgery.
Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Regional Health Planning/organization & administration , Surge Capacity/organization & administration , Surgery, Plastic/organization & administration , Ambulatory Surgical Procedures/standards , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Elective Surgical Procedures/standards , Humans , Infection Control/standards , Intersectoral Collaboration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Practice Guidelines as Topic , Plastic Surgery Procedures/standards , Regional Health Planning/standards , SARS-CoV-2 , Surgery, Plastic/standards , Surgicenters/organization & administration , Surgicenters/standards , Telemedicine/organization & administration , Telemedicine/standards , United StatesSubject(s)
Coronavirus Infections/epidemiology , Elective Surgical Procedures , Pneumonia, Viral/epidemiology , Surgery Department, Hospital/organization & administration , Surgicenters/organization & administration , Betacoronavirus , COVID-19 , Decision Making , Humans , Infection Control/organization & administration , Pandemics , SARS-CoV-2 , United States/epidemiologySubject(s)
Betacoronavirus , Breast Neoplasms/surgery , Coronavirus Infections/epidemiology , Medical Oncology , Pandemics , Pneumonia, Viral/epidemiology , Societies, Medical , Surgicenters/organization & administration , Breast Neoplasms/epidemiology , COVID-19 , Comorbidity , Female , Humans , Italy/epidemiology , Mastectomy/methods , SARS-CoV-2ABSTRACT
The current health care environment is complex. Systems often cross US state boundaries to provide care to patients with a wide variety of medical needs. The coronavirus disease 2019 pandemic is challenging health care systems across the globe. Systems face varying levels of complexity as they adapt to the new reality. This pandemic continues to escalate in hot spots nationally and internationally, and the worst strain on health care systems may be yet to come. The purpose of this article is to provide a road map developed from lessons learned from the experience in the Department of Surgery at the University of Wisconsin School of Medicine and Public Health and University of Wisconsin Health, based on past experience with incident command structures in military combat operations and Federal Emergency Management Agency responses. We will discuss administrative restructuring leveraging a team-of-teams approach, provide a framework for deploying the workforce needed to deliver all necessary urgent health care and critical care to patients in the system, and consider implications for the future.