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Adaptation of an Obstetric Anesthesia Service for the Severe Acute Respiratory Syndrome Coronavirus-2 Pandemic: Description of Checklists, Workflows, and Development Tools.
Li, Yunping; Ciampa, Erin J; Zucco, Liana; Levy, Nadav; Colella, Meredith; Golen, Toni; Shainker, Scott A; Lunderberg, J Mark; Ramachandran, Satya Krishna; Hess, Philip E.
  • Li Y; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Ciampa EJ; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Zucco L; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Levy N; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Colella M; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Golen T; Gynecology and Reproductive Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
  • Shainker SA; Gynecology and Reproductive Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
  • Lunderberg JM; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Ramachandran SK; From the Departments of Anesthesia, Critical Care and Pain Medicine.
  • Hess PE; From the Departments of Anesthesia, Critical Care and Pain Medicine.
Anesth Analg ; 132(1): 31-37, 2021 01.
Article in English | MEDLINE | ID: covidwho-1124783
ABSTRACT

BACKGROUND:

Care of the pregnant patient during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic presents many challenges, including creating parallel workflows for infected and noninfected patients, minimizing waste of materials, and ensuring that clinicians can seamlessly transition between types of anesthesia. The exponential community spread of disease limited the time for development and training.

METHODS:

The goals of our workflow and process development were to maximize safety for staff and patients, minimize the risk of contamination, and reduce the waste of unused supplies and materials. We used a cyclical improvement system and the plus/delta debriefing method to rapidly develop workflows consisting of sequential checklists and procedure-specific packs.

RESULTS:

We designed independent workflows for labor analgesia, neuraxial anesthesia for cesarean delivery, conversion of labor analgesia to cesarean anesthesia, and general anesthesia. In addition, we created procedure-specific material packs to optimize supplies and prevent wastage. Finally, we generated sequential checklists to allow staff to perform standard operating procedures without extensive training.

CONCLUSIONS:

Collectively, these workflows and tools allowed our staff to urgently care for patients in high-risk situations without prior experience. Over time, we refined the workflows using a cyclical improvement system. We present our checklists and workflows as well as the system we used for their development, so that others may use them to their benefit.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Infection Control / Delivery of Health Care / Workflow / Checklist / COVID-19 / Anesthesia Department, Hospital / Anesthesia, Obstetrical Type of study: Prognostic study / Qualitative research Limits: Female / Humans / Pregnancy Language: English Journal: Anesth Analg Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infection Control / Delivery of Health Care / Workflow / Checklist / COVID-19 / Anesthesia Department, Hospital / Anesthesia, Obstetrical Type of study: Prognostic study / Qualitative research Limits: Female / Humans / Pregnancy Language: English Journal: Anesth Analg Year: 2021 Document Type: Article