Subject(s)
Change Management , Coronavirus Infections , Critical Pathways , Hemodialysis Units, Hospital , Infection Control , Kidney Failure, Chronic , Pandemics , Pneumonia, Viral , Renal Dialysis , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Critical Pathways/organization & administration , Critical Pathways/trends , Hemodialysis Units, Hospital/organization & administration , Hemodialysis Units, Hospital/trends , Hospital Restructuring/methods , Humans , Infection Control/methods , Infection Control/organization & administration , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Renal Dialysis/methods , Renal Dialysis/trends , SARS-CoV-2 , Workforce/organization & administrationABSTRACT
BACKGROUND/OBJECTIVE: The unprecedented pandemic spread of the novel coronavirus has severely impacted the delivery of healthcare services in the United States and around the world, and has exposed a variety of inefficiencies in healthcare infrastructure. Some states have been disproportionately affected such as New York and Michigan. In fact, Detroit and its surrounding areas have been named as the initial Midwest epicenter where over 106,000 cases have been confirmed in April 2020. METHOD, RESULTS AND CONCLUSIONS: Facilities in Southeast Michigan have served as the frontline of the pandemic in the Midwest and in order to cope with the surge, rapid, and in some cases, complete restructuring of care was mandatory to effect change and attempt to deal with the emerging crisis. We describe the initial experience and response of 4 large vascular surgery health systems in Michigan to COVID-19.
Subject(s)
COVID-19 , Health Care Rationing , Hospital Restructuring , Infection Control , Resource Allocation , Vascular Diseases , Vascular Surgical Procedures , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Civil Defense/standards , Hospital Restructuring/methods , Hospital Restructuring/organization & administration , Humans , Infection Control/methods , Infection Control/organization & administration , Michigan/epidemiology , Organizational Innovation , Patient Selection , SARS-CoV-2 , Telemedicine/organization & administration , Vascular Diseases/diagnosis , Vascular Diseases/epidemiology , Vascular Diseases/surgery , Vascular Surgical Procedures/organization & administration , Vascular Surgical Procedures/statistics & numerical dataSubject(s)
COVID-19/transmission , Emergency Service, Hospital/statistics & numerical data , Hospital Restructuring/standards , Iatrogenic Disease/epidemiology , COVID-19/prevention & control , Emergency Service, Hospital/organization & administration , Hospital Restructuring/methods , Hospital Restructuring/statistics & numerical data , Humans , Iatrogenic Disease/prevention & control , Infection Control/methods , Infection Control/standards , Infection Control/statistics & numerical data , Mass Screening/methods , Prospective StudiesABSTRACT
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Subject(s)
Coronavirus Infections , Critical Pathways/trends , Disease Transmission, Infectious/prevention & control , Endoscopy, Digestive System , Infection Control , Organizational Innovation , Pandemics , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Endoscopy, Digestive System/instrumentation , Endoscopy, Digestive System/methods , Endoscopy, Digestive System/trends , Hospital Restructuring/methods , Humans , Incidence , Infection Control/methods , Infection Control/organization & administration , Italy/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Telemedicine/methodsABSTRACT
Emergence of the Covid-19 pandemic resulted in dramatic changes in global healthcare provision. Resources were redirected across all healthcare sectors to support the treatment of viral pneumonia with resultant effects on other essential services. We describe the impact of this on the provision of major trauma care in a major capital city.
Subject(s)
Coronavirus Infections , Health Care Rationing , Hospital Restructuring/methods , Infection Control , Musculoskeletal Diseases , Pandemics , Pneumonia, Viral , Trauma Centers , Wounds and Injuries , Betacoronavirus , COVID-19 , Change Management , Civil Defense/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Critical Pathways/trends , Efficiency, Organizational , Health Care Rationing/organization & administration , Health Care Rationing/trends , Humans , Infection Control/methods , Infection Control/organization & administration , London/epidemiology , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2 , Social Environment , Trauma Centers/organization & administration , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Wounds and Injuries/therapySubject(s)
COVID-19/epidemiology , Health Services for the Aged/organization & administration , Homes for the Aged/organization & administration , Pandemics , Age Factors , Aged , Aged, 80 and over , COVID-19/mortality , France/epidemiology , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Health Services Accessibility/trends , Health Services for the Aged/standards , Homes for the Aged/standards , Hospital Restructuring/methods , Hospital Restructuring/organization & administration , Hospital Restructuring/standards , Hospital Restructuring/trends , Humans , Nursing Homes/organization & administration , Nursing Homes/standards , SARS-CoV-2/physiologySubject(s)
Change Management , Coronavirus Infections , Infection Control , Mental Disorders , Pandemics , Pneumonia, Viral , Psychiatric Department, Hospital , Aged , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Hospital Restructuring/methods , Humans , Infection Control/methods , Infection Control/organization & administration , Mental Disorders/epidemiology , Mental Disorders/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Psychiatric Department, Hospital/organization & administration , Psychiatric Department, Hospital/trends , Psychosocial Support Systems , SARS-CoV-2ABSTRACT
The coronavirus disease 2019 crisis is a global pandemic of a novel infectious disease with far-ranging public health implications. With regard to cardiac electrophysiology (EP) services, we discuss the "real-world" challenges and solutions that have been essential for efficient and successful (1) ramping down of standard clinical practice patterns and (2) pivoting of workflow processes to meet the demands of this pandemic. The aims of these recommendations are to outline: (1) essential practical steps to approaching procedures, as well as outpatient and inpatient care of EP patients, with relevant examples, (2) successful strategies to minimize exposure risk to patients and clinical staff while also balancing resource utilization, (3) challenges related to redeployment and restructuring of clinical and support staff, and (4) considerations regarding continued collaboration with clinical and administrative colleagues to implement these changes. While process changes will vary across practices and hospital systems, we believe that these experiences from 4 different EP sections in a large New York City hospital network currently based in the global epicenter of the coronavirus disease 2019 pandemic will prove useful for other EP practices adapting their own practices in preparation for local surges.