BRAVE: A Point of Care Adaptive Leadership Approach to Providing Patient-Centric Care in the Emergency Department.

The practice of emergency medicine has reached its cross roads. Emergency physicians (EPs) are managing many more time-dependent conditions, initiating complex treatments in the emergency department (ED), handling ethical and end of life care discussions upfront, and even performing procedures which used to be done only in critical care settings, in the resuscitation room. EPs manage a wide spectrum of patients, 24 h a day, which reflects the community and society they practice in. Besides the medical and "technical" issues to handle, they have to learn how to resolve confounding elements which their patients can present with. These may include social, financial, cultural, ethical, relationship, and even employment matters. EPs cannot overlook these, in order to provide holistic care. More and more emphasis is also now given to the social determinants of health. We, from the emergency medicine fraternity, are proposing a unique "BRAVE model," as a mnemonic to assist in the provision of point of care, adaptive leadership at the bedside in the ED. This represents another useful tool for use in the current climate of the ED, where patients have higher expectations, need more patient-centric resolution and handling of their issues, looming against the background of a more complex society and world.

COVID-19 in Singapore: Our Experience as a Country, and at Singapore General Hospital's Department of Emergency Medicine.

COVID-19 has changed our lives as we knew it. The world is not naive to infectious disease outbreaks, having experienced pandemics such as the H1N1 outbreak in 2009 with up to 400,000 deaths, and the "Spanish flu" in 1919 with up to 50 million deaths worldwide respectively (https://www.euro.who.int/en/health-topics/communicable-diseases/influenza/pandemic-influenza/past-pandemics). However, this outbreak caused by the severe acute respiratory syndrome coronavirus-2 has taken the world by storm since it was first reported in end 2019. With the numbers of confirmed cases of COVID-19 and death toll rising every day, it raises the question of when will we be fully equipped to handle a pandemic of such a mammoth scale. A multi-pronged approach has to be undertaken by not only healthcare organisations and pharmaceuticals, but also government agencies and legislation in order to overcome the repercussions and mitigate the effects of an infectious disease outbreak. In this article, we share our experience in Singapore and Singapore General Hospital against COVID-19 and our ongoing efforts to keep the virus at bay.