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Rapid Modification of Workflows and Fellow Staffing at a Single Transplant Center to Address the COVID-19 Crisis.
Thiessen, Carrie; Wisel, Steven A; Yamaguchi, Seiji; Dietch, Zachary C; Feng, Sandy; Freise, Chris E.
  • Thiessen C; Division of Transplantation, University of California, San Francisco, San Francisco, California. Electronic address: carrie.thiessen@ucsf.edu.
  • Wisel SA; Division of Transplantation, University of California, San Francisco, San Francisco, California. Electronic address: steven.wisel@ucsf.edu.
  • Yamaguchi S; Division of Transplantation, University of California, San Francisco, San Francisco, California.
  • Dietch ZC; Division of Transplantation, University of California, San Francisco, San Francisco, California.
  • Feng S; Division of Transplantation, University of California, San Francisco, San Francisco, California.
  • Freise CE; Division of Transplantation, University of California, San Francisco, San Francisco, California.
Transplant Proc ; 52(9): 2596-2600, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-431194
ABSTRACT

BACKGROUND:

Although hospital systems have largely halted elective surgical practices in preparing their response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, transplantation remains an essential and lifesaving surgical practice. To continue transplantation while protecting immunocompromised patients and health care workers, significant restructuring of normal patient care practice habits is required.

METHODS:

This is a nonrandomized, descriptive study of the abdominal transplant program at 1 academic center (University of California, San Francisco) and the programmatic changes undertaken to safely continue transplantations. Patient transfers, fellow use, and patient discharge education were identified as key areas requiring significant reorganization.

RESULTS:

The University of California, San Francisco abdominal transplant program took an early and aggressive approach to restructuring inpatient workflows and health care worker staffing. The authors formalized a coronavirus disease 2019 (COVID-19) transfer system to address patients in need of services at their institution while minimizing the risk of SARS-CoV-2 in their transplant ward and used technological approaches to provide virtual telehealth where possible. They also modified their transplant fellow staffing and responsibilities to develop an adequate backup system in case of potential exposures.

CONCLUSION:

Every transplant program is unique, and an individualized plan to adapt and modify standard clinical practices will be required to continue providing essential transplantation services. The authors' experience highlights areas of attention specific to transplant programs and may provide generalizable solutions to support continued transplantation in the COVID-19 era.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Transplantation / Coronavirus Infections / Workflow / Pandemics Type of study: Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Transplant Proc Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Transplantation / Coronavirus Infections / Workflow / Pandemics Type of study: Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Transplant Proc Year: 2020 Document Type: Article