Managing a Specialty Service During the COVID-19 Crisis: Lessons From a New York City Health System

Ammar, Adam; Stock, Ariel; Holland, Ryan; Gelfand, Yaroslav; Altschul, David

doi:10.1097/acm.0000000000003440

Cited by 29 publications

(30 citation statements)

References 10 publications

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“…In addition, PDs responding to our survey noted that virtual social gatherings, happy hours, and similar events via videoconferencing software can help bolster resident morale and sense of community. Ammar et al 35 noted similar effects in their report on efforts to maintain wellness among neurosurgical residents at a New York City program. These investigators endorsed the increased use of check-ins between faculty and residents and between residents as a means of maintaining contact during these times of social distancing.…”

Section: Resident Wellnessmentioning

confidence: 74%

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

et al. 2020

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Section: Resident Wellnessmentioning

confidence: 74%

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

et al. 2020

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“…We ranked the results from metadata analyzation according to professional background of the first author, country of residency of the first author and types of articles [s. Table 1]. [10][11][12][13][14][15][16][17][18][19]. Several departments, including their residents, started working in waves of alternating teams to avoid a complete breakdown in case of an outbreak amongst employees.…”

Section: Metadata Analyzation Of Retrieved Articlesmentioning

confidence: 99%

“…Furthermore, the social aspect of discussion with peers can also reduce anxiety and stress [35]. Here, early countermeasures included residents having a daily informal video conference to have a social connection to peers while practicing social distancing [16].…”

Section: Uncertainties and Mental Healthmentioning

confidence: 99%

“…Students should not be put in situations exceeding their competencies, have adequate access to PPE and should be deployed on a voluntary basis [30,32,78]. First year residents, in deployment or new roles within their clinic, need to be supervised accordingly [16,27]. Being possible vectors, residents on duty should have the chance to reduce physical movement.…”

Section: Faculty Preparationmentioning

confidence: 99%

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Preparation of students and residents of human medicine in the first four months of the Covid-19 pandemic. Implications for a second wave.

Wohlfarth

Gloor

Hautz

2020

Preprint

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Introduction: In the Covid-19 pandemic, medical students and residents find themselves in a healthcare environment with measures and policies changing by the hour. Reports regarding those in training were scarce and scattered in the early pandemic, what made an overarching insight a challenge. This review compiles and analyzes the literature addressing the preparation of students and residents in the first four months of the Covid-19 pandemic to find gaps and implications for the current pandemic as well as for future scenarios.Methods: We performed a systematic literature search and content analysis (CA) for articles available in English language that focus on the preparation of students and residents in human medicine within the first four months of the Covid-19 pandemic.Results: We retrieved 82 articles from a wide range of journals, professional backgrounds and countries. CA identified five recurring subgroup topics of «faculty preparation», «uncertainty and mental health», «clinical knowledge», «rights and obligations» and «(self-) support and supply». Within these subgroups the main concerns of «(re)deployment», «interruption of training and career», «safety issues», «transmission of disease», and «restricted social interaction» were identified as potential stressors that hold a risk for fatigue, loss of morale and burnout.Discussion: Students and residents are willing and able to participate, when provided with appropriate deployment, thorough supervision, Personal Protective Equipment (PPE) and valid knowledge. Faculties and policymakers should be in close contact with the youngest in training to value their concerns and intrinsic creativity on the scenario. The use of new technology for interaction and knowledge provision, interviews for voluntary deployment and the provision of mental health support seem appropriate measures to support students and residents under the current pandemic.Conclusion: Our review holds thorough implications for faculties and policymakers. Not only for surge capacity, but also for the safety and the professional identity formation of those in training, it is crucial to understand their needs and concerns. Leaders should strive for a close communication with students and residents, value their intrinsic creativeness and constantly evaluate on their needs regarding knowledge aspects, safety measures, legal concerns and well-being for the construction of nation-wide homogenous policies.

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“…Examples of the latter in our neurosurgical practice include patients with brain tumors, cerebral edema, intracranial aneurysms, and acute large vessel occlusion stroke as well as patients with spinal conditions, at risk of progressive myelopathy. [8][9][10] Therefore, the goal of this study was to report a preoperative surgical triage strategy instituted by Mayo Clinic, Jacksonville, Florida, with regard to safely performing nonelective neurosurgical procedures during the COVID-19 pandemic.…”

mentioning

confidence: 99%

Path to Reopening Surgery in the COVID-19 Pandemic: Neurosurgery Experience

Biase

Freeman

Elder

et al. 2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective: To test the efficacy of an innovative coronavirus disease 2019 (COVID-19) preoperative triage protocol as a way to gradually reopen and ramp-up elective surgeries. Patients and Methods: We reviewed clinical, radiographic, and laboratory data for all patients who underwent surgery within the neurosurgery department from March 26 through April 22, 2020. We collected data on demographic information, comorbidities, preoperative COVID-19 test results, whether COVID-19 respiratory or other symptoms were developed during hospitalization, hospital length of stay, discharge disposition, and postoperative COVID-19 test results. Results: Using a combination of both preoperative outpatient COVID-19 drive-through and inpatient testing to obtain surgical clearance with selected telemedicine evaluations, 103 nonelective neurosurgical procedures were performed in 102 patients. No patients tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) 48 hours before surgery. None of the patients developed any COVID-19 symptoms during their hospitalization or were readmitted to our emergency department postoperatively for COVID-19 symptoms. Conclusion: We describe a multifaceted preoperative triage protocol for safely performing nonelective neurosurgical procedures during the COVID-19 pandemic, which could help other neurosurgical departments and hospitals minimize coronavirus exposure for patients and health care workers. We believe this triage strategy could be implemented at other centers to gradually restart a process toward elective surgeries in a safe way.

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Managing a Specialty Service During the COVID-19 Crisis: Lessons From a New York City Health System

Cited by 29 publications

References 10 publications

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

Preparation of students and residents of human medicine in the first four months of the Covid-19 pandemic. Implications for a second wave.

Path to Reopening Surgery in the COVID-19 Pandemic: Neurosurgery Experience

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