Restructuring ENT out-patient services during the coronavirus disease 2019 pandemic – an iterative approach

Abstract

Background Coronavirus disease 2019 has demanded enormous adjustments to National Health Service provisions. Non-urgent out-patient work was initially postponed or performed virtually, but is now being re-established. In ENT surgery, aerosol-generating procedures pose a particular challenge in out-patient settings. Objective A rapid restructuring of ENT out-patient services is required, to safely accommodate aerosol-generating procedures and increase in-person attendances, whilst coronavirus disease 2019 persists. Methods Data were collected prospectively over four consecutive cycles. Two surveys were conducted. Results were analysed and disseminated, with recommendations for service restructuring implemented at cycle end-points. Results Out-patient activity increased four-fold, associated with a significant rise in aerosol-generating procedures during the study period. Mean aerosol-generating procedure duration dropped weekly, implying a learning curve. Service restructuring occurred at cycle end-points. Conclusion Iterative data gathering, results analysis and outcome dissemination enabled a swift, data-driven approach to the restructuring of ENT out-patient services. Patient and staff safety was ensured, whilst out-patient capacity was optimised.

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…The second, the topics and references. Category Topic and references Change to medical practice Mental health care [254] , [257] , [261] , [273] , [274] , [275] ; Emergency care [276] , [277] ; Substance abuse [253] , [263] , [278] , [279] , [280] ; Oncological care [264] , [281] Health care practices [255] , [259] , [262] , [282] , [283] , [284] ; Pediatric care [283] , [285] Other care [256] , [260] , [268] , [286] , [287] , [288] Modeling Modeling approaches [28] , [265] , [289] , [290] , [291] , [292] , [293] ; Transmission dynamics [294] , [295] , [296] , [297] , [298] Mobile phone data [29] ; estimation [258] Effect of NPIs Effects on: children ...…”

“…This is the largest group of comments and/or perspectives. We find articles focused on a range of medical specialities: mental health care [254] , [257] , [261] , [273] , [274] , [275] , emergency care [276] , [277] , substance abuse [253] , [263] , [278] , [279] , [280] , oncological care [264] , [281] , health care practices [255] , [259] , [262] , [282] , [283] , [284] , pediatric care [283] , [285] , and other care [256] , [260] , [268] , [286] , [287] , [288] .…”

Non-pharmaceutical interventions during the COVID-19 pandemic: a rapid review

“…This is the largest group of comments and/or perspectives. We find articles focused on a range of medical specialities: mental health care [253,256,260,[272][273][274], emergency care [275,276], substance abuse [252,262,[277][278][279], oncological care [263,280], health care practices [254,258,261,[281][282][283], pediatric care [282,284], and other care [255,259,267,[285][286][287].…”

Coronavirus disease 2019 in otolaryngology: special issue

“…As represented by several articles in this month's issue, Covid-19 has, in many cases, resulted in the restructuring of ENT services, including ENT out-patient departments, 3 head and neck cancer services, 4,5 tracheostomy provision and care, 6 surgical techniques, 7 novel methods for performing flexible nasolaryngoscopy, 8 and PPE use. 9 Continuing with the anosmia in Covid-19 theme, Avci et al, in their study of 1534 coronavirus disease patients, report that 44.2 per cent of patients presented with anosmia and 43.9 per cent had dysgeusia.…”

“…As represented by several articles in this month's issue, Covid-19 has, in many cases, resulted in the restructuring of ENT services, including ENT out-patient departments, 3 head and neck cancer services, 4,5 tracheostomy provision and care, 6 surgical techniques, 7 novel methods for performing flexible nasolaryngoscopy, 8 and PPE use. 9…”