Dynamic emergency department response to the evolving COVID‐19 pandemic: the experience of a tertiary hospital in Singapore

Liu, Zhenghong; Teo, Tess Lin; Lim, Mian Jie; Nadarajan, Gayathri; Segaram, Shashi S/O Chandra; Thangarajoo, Sanda; Wee, Liang En; Wee, Jeremy Choon Peng; Tan, Kenneth

doi:10.1002/emp2.12264

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…Thus, from 8 th February till 27 th September 2020, as part of infection control measures, doctors were organised into 5 FTs, each having between 5-7 Consultants, 3-5 EM Senior Residents, 2-3 EM Junior Residents and 7-9 non-EM Medical Officers (MO) (Liu et al, 2020;Quah et al, 2020). The Senior Emergency Physicians (SEPs) consisted of certified specialists in EM (Associate Consultants, Consultants and Senior Consultants); they played supervisory and educational roles to the junior doctors (JD) which included MOs, Junior Residents and Senior Residents.…”

Section: A Settingmentioning

confidence: 99%

How do factors in fixed clinical teams affect informal learning among Emergency Medicine Residents

Wee

Teunissen

2023

TAPS

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Introduction: This study was performed to understand how fixed clinical teams affected informal learning in Emergency Medicine Residents. Better understanding the effects of team dynamics on informal learning may help to optimise learning and improve performance. Methods: From 8th February 2020 till 27th September 2020, the Singapore General Hospital Emergency Department adopted a fixed team system. Zoom interviews were carried out amongst Emergency Medicine Residents who worked in the fixed team system using a semi-structured iterative interview guide. A qualitative content analysis was used for this exploratory study. The interviews were transcribed verbatim, anonymised and coding via template analysis performed. Data collection and analysis were performed until data sufficiency. Results: The themes identified centred around relationship dynamics, team composition and motivation for learning. The first was how improved relationships led to improved trust, communications and camaraderie among team members. This improved peer learning and clinical supervision and provided a more personalised learning experience. A balanced team composition allowed learners to be exposed to experts in various subspecialties. Finally, there was an initial increase in motivation, followed by a decrease with time. Conclusion: In postgraduate medical education, working in a fixed team system with balanced members had positive effects on informal learning by strengthening relationships and communications.

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Section: A Settingmentioning

confidence: 99%

How do factors in fixed clinical teams affect informal learning among Emergency Medicine Residents

Wee

Teunissen

2023

TAPS

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“…During the first wave of the pandemic, the number of patients visiting our ED declined by approximately 20%-25%, a decrease similarly seen in EDs in other countries. 10,15 However, this changed significantly during the second wave, with the rapid influx of patients due to outbreaks in homeless shelters, long-term-care settings, and other hospitals in Ontario. 16 At our facility, all patients being transferred from other hospitals were assessed and stabilized in the ED before they were accepted at inpatient units.…”

Section: Crowdingmentioning

confidence: 99%

“…ED nurses are also coping with working in crowded EDs with limited inpatient beds while observing physical distancing guidelines and having a higher risk of exposure to communicable diseases. [8][9][10] This article discusses the predisposing factors for moral distress and discusses effective personal and organizational strategies to support ED nurses.…”

mentioning

confidence: 99%

Moral distress amid COVID-19

Virani

2021

Nursing

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THE COVID-19 pandemic has raised many psychosocial, ethical, and moral challenges for frontline workers in the ED, significantly impacting their delivery of critical care. 1 Moral distress is "the experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it." 2 Compared with other healthcare professionals during a pandemic, ED nurses are more vulnerable to experiencing moral distress, which has intensified amid COVID-19. [3][4][5] One out of 3 nurses experience moral distress, and 1 out of 10 leave the profession. 7 Nurses and staff physicians are twice as likely to leave the profession due to moral distress compared with other healthcare professionals. 6,7 Faced with issues such as insufficient time to manage competing

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“…In January 2020, a new virus called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) was identified in Wuhan, Hubei Province, China, and became the cause of the global pneumonia outbreak [ 1 ]. The SARS-CoV-2 virus is transmitted through droplets and close contact through activities that produce aerosols, environmental pollution, fomite, and fecal–oral transmission [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Influenced the Endoscopic Services Volume during the COVID-19 Pandemic at National Tertiary Referral Hospital in Indonesia: Dr. Cipto Mangunkusumo Hospital

et al. 2022

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The impact of the COVID-19 pandemic caused a decrease in healthcare services, the intervention of non-surgical procedures, and endoscopy. This study examined the volume of endoscopy at Dr. Cipto Mangukusumo Hospital, the highest referral hospital in Indonesia. A cross-sectional mixed method was used to assess the relationship between endoscopy volume, age, gender, number of COVID-19 cases, type of patient’s case, the origin of treatment, and the kind of endoscopic procedure before and during the pandemic. The secondary data were collected through the hospital’s Electronic Health Record (EHR) System and “Kawal COVID-19” Websites, while the primary data were collected through observation, document reviews, and in-depth online interviews with doctors at endoscopic units. This study period was divided into six intervals of three months, respectively, from January 2020 to September 2021, and 5030 endoscopic procedures were collected. The data were analyzed both quantitatively through the SPSS statistics and qualitatively. The quantitative data presented as descriptive and bivariate results in an Independent T-Test and a Chi-Square test. The results showed there was a significant difference (p = 0.004) in the volume of endoscopes before (the highest volume) and during the pandemic (the lowest volume during April–June 2020 period). The mean age of the patients was higher before the pandemic. There was a significant difference between patient admissions from outpatient and emergency procedures before and during the pandemic. There are changes in the flow of outpatient to do endoscopies which were different from the flow of emergency patients during the pandemic, which focused on the long waiting list for inward entry queues, the mandatory COVID-19 PCR swab, and the criteria of emergency cases for fast-track procedures, the reduced bed capacity, and the expired date of laboratory examinations. The decreased volume was also caused by the limitation of patient intervention by the doctors. However, the duration of the action procedure was accelerated without reducing its quality. Furthermore, there was a high wave of Delta Variant cases from May to July 2021. In addition, the factors of age, type of patient’s case, origin, and treatment showed significant differences before and during the COVID-19 pandemic. Finally, changes in the flow of services also influenced various impacts on endoscopy and service costs. Therefore, further study is required to calculate the unit costs.

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Dynamic emergency department response to the evolving COVID‐19 pandemic: the experience of a tertiary hospital in Singapore

Cited by 8 publications

References 23 publications

How do factors in fixed clinical teams affect informal learning among Emergency Medicine Residents

How do factors in fixed clinical teams affect informal learning among Emergency Medicine Residents

Moral distress amid COVID-19

Factors Influenced the Endoscopic Services Volume during the COVID-19 Pandemic at National Tertiary Referral Hospital in Indonesia: Dr. Cipto Mangunkusumo Hospital

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