Collaborative Multidisciplinary Incident Command at Seattle Children’s Hospital for Rapid Preparatory Pediatric Surgery Countermeasures to the COVID-19 Pandemic - 20/07/20

Doi : 10.1016/j.jamcollsurg.2020.04.012

Sanjay R. Parikh, MD, FACS ^a,^f,^⁎ , Jeffrey R. Avansino, MD, MBA, FACS ^a,^g, Andre AS. Dick, MD, MPH, FACS ^a,^g, Brianna K. Enriquez, MD ^c,^h, Jeremy M. Geiduschek, MD ^b,ⁱ, Lynn D. Martin, MD ^b,ⁱ, Ruth A. McDonald, MD ^d,^h, Suzanne M. Yandow, MD, FACS ^a,^j, Danielle M. Zerr, MD, MPH ^e,^h, Jeffrey G. Ojemann, MD ^a,^k
^a Departments of Surgery, Seattle Children’s Hospital, Seattle, WA
^b Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA
^c Divisions of Emergency Medicine, Seattle Children’s Hospital, Seattle, WA
^d Nephrology, Seattle Children’s Hospital, Seattle, WA
^e Infectious Diseases, Seattle Children’s Hospital, Seattle, WA
^f Departments of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA
^g Surgery, University of Washington, Seattle, WA
^h Pediatrics, University of Washington, Seattle, WA
ⁱ Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
^j Orthopedic Surgery, University of Washington, Seattle, WA
^k Neurosurgery, University of Washington, Seattle, WA

^∗Correspondence address: Sanjay R Parikh, MD, FACS, Seattle Children’s Hospital, OA.9.329, Seattle, WA 98145-5005.Seattle Children’s HospitalOA.9.329SeattleWA98145-5005

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Abstract

Washington was the first US state to have a patient test positive for COVID-19. Before this, our children’s hospital proactively implemented an incident command structure that allowed for collaborative creation of safety measures, policies, and procedures for patients, families, staff, and providers. Although the treatment and protective standards are continuously evolving, this commentary shares our thoughts on how an institution, and specifically, surgical services, may develop collaborative process improvement to accommodate for rapid and ongoing change. Specific changes outlined include early establishment of incident command; personal protective equipment conservation; workforce safety; surgical and ambulatory patient triage; and optimization of trainee education. Please note that the contents of this manuscript are shared in the interest of providing collaborative information and are under continuous development as our regional situation changes. We recognize the limitations of this commentary and do not suggest that our approaches represent validated best practices.

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Plan

Regional Context of Coronavirus-2019 Exposure

Setting

Lessons Learned

Incident command structure

Personal protective equipment conservation

Workforce safety

Surgical case triage

Ambulatory case triage

Resident and fellow education

Conclusions

Disclosure Information: Nothing to disclose.

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Vol 231 - N° 2

P. 269 - août 2020 Retour au numéro

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Collaborative Multidisciplinary Incident Command at Seattle Children’s Hospital for Rapid Preparatory Pediatric Surgery Countermeasures to the COVID-19 Pandemic - 20/07/20

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