The COVID-19 Army: Experiences From the Deployment of Non-Hospitalist Physician Volunteers During the COVID-19 Pandemic

Abstract

Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

Heart failure quality of care and in‐hospital outcomes during the COVID‐19 pandemic: findings from the Get With The Guidelines‐Heart Failure registry

“… 32 For example, hospital medicine physicians or cardiologists may have been re‐deployed to care for patients with COVID‐19, and physician teams with less inpatient medicine experience may have been tasked with caring for less critically ill patients or patients without COVID‐19. 33 …”

“…32 For example, hospital medicine physicians or cardiologists may have been re-deployed to care for patients with COVID-19, and physician teams with less inpatient medicine experience may have been tasked with caring for less critically ill patients or patients without COVID-19. 33 Among patients with COVID-19 and acute HF, greater severity and mortality of COVID-19 in patients with HF may have been due to poor physiologic reserve from coexisting HF in conjunction with greater prevalence of comorbidities in patients with HF such as hypertension, diabetes, and coronary artery disease. 34 Direct viral effects on endothelial dysfunction triggering microvascular disease and inflammatory surges may also contribute to elevated mortality risk.…”

“…Within the hospital, patients may have been cared for by inpatient teams working outside of their given specialty which may have impacted patient outcomes 32 . For example, hospital medicine physicians or cardiologists may have been re‐deployed to care for patients with COVID‐19, and physician teams with less inpatient medicine experience may have been tasked with caring for less critically ill patients or patients without COVID‐19 33 …”

Public health leadership in the COVID-19 era: how does it fit? A scoping review

“…Characteristics attributable to the first group, 'human traits, behaviour and emotional intelligence', were identified in 21 articles (46.7%), 8 of which were research articles, [19][20][21][22][23][24][25][26] 11 opinion pieces [27][28][29][30][31][32][33][34][35][36][37] and 2 reviews. 38 39 In particular, empathy and 'honesty and truthfulness in relationships' were the two most cited characteristics (six and three times, respectively), followed by compassion, emotional intelligence and psychological safety, attention to psychological well-being, emotional effectiveness, equity and values, sense-making and sense-giving (all cited two times).…”

Contributions of Japanese Hospitalists During the COVID-19 Pandemic and the Need for Infectious Disease Crisis Management Education for Hospitalists: An Online Cross-Sectional Study

“…A good relationship between hospitalists and specialist physicians in each medical department is essential during a public health emergency, and there are reports of collaboration between volunteer specialists and hospitalists. 4 It is believed that in Japan, hospitalists have played a similar role during the COVID-19 pandemic. However, this has not been clarified because of the relatively short history of general medicine and hospitalists in Japan and the diverse roles and lack of clear differentiation between hospitalists and specialized medical departments.…”