The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: insights and clinical strategies from a centre at the epicentre

George, Isaac; Salna, Michael; Kobsa, Serge; DeRoo, Scott; Kriegel, Jacob; Blitzer, David; Shea, Nicholas; Shea,; d'Angelo, Alex; Raza, Tasnim; Kurlansky, Paul; Takeda, Koji; Takayama, Hiroo; Bapat, Vinayak; Naka, Yoshifumi; Smith, Craig R.; Bacha, Emile A.; Argenziano, Michael; Argenziano,

doi:10.1093/ejcts/ezaa228

Cited by 21 publications

(32 citation statements)

References 16 publications

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“…More advanced or severe complications in cardiac conditions are currently presenting 43 and may present further post‐pandemic, which may lead to a rise in morbidity and mortality 51 . Delayed care or reluctance of patients to seek medical attention earlier may result in valve disease progressing to symptoms of advanced or decompensated HF 52 …”

Section: Heart Failure Hospitalizationmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.

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Section: Heart Failure Hospitalizationmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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“…Clear decision-making processes were facilitated, for example, by clear definitions of “urgent” and efficient channelling of information to create a clear and consistent message (George et al, 2020). For the latter, suggestions included limiting the use of email chains, using Dropbox or apps like Induction of Clinbee, and bespoke WhatsApp groups (NHS England & NHS Improvement, 2020a).…”

Section: Resultsmentioning

confidence: 99%

“…Redeployed staff experienced anxiety and stress, particularly when lacking adequate support, during night shifts when less staff were available, and due to last minute rota changes. Staff wellbeing needs that required attention included accommodation, testing and family responsibilities (D’souza, Shetty, Apuri, & Moreira, 2020; George et al, 2020). Lim et al, (2020) reported that redeployed ophthalmologists’ anxiety reduced once their redeployment role began.…”

Section: Resultsmentioning

confidence: 99%

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

Juan

Camilleri

Jeans³

et al. 2021

Preprint

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BackgroundA rapid influx of patients to intensive care and infection control measures during the COVID-19 pandemic required the rapid development of innovative redeployment and training strategies.MethodsWe conducted a systematic search of 9 databases including key terms related to intensive care AND training AND redeployment AND healthcare workers. Analysis consisted of a narrative synthesis of quantitative study outputs, and a framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis.ResultsTwenty papers were analysed. These took place primarily in the UK (N=8, 40%) and USA (N=5, 25%). Themes included in the results are Redeployment: Implementation strategies and learnings; Redeployed staff experience and strategies to address their needs; Redeployed staff learning needs; Training formats offered and training evaluations; and Future redeployment and training concerns. Some of the redeployment implementation and training strategies documented in this review are: Skills-based redeployment, buddy support systems, and agreeing on locally-specific principles, rather than strict procedures.ConclusionThe COVID-19 pandemic presented unique challenges to deliver training promptly while following infection control recommendations and develop flexible redeployment strategies. This study synthesises original approaches to tackle these challenges which are relevant to inform the development of targeted and adaptative training and redeployment plans.

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“…Forced by the implications of the coronavirus disease 2019 (COVID-19) crisis, the staff at the New York Presbyterian Hospital managed to rearrange their system of healthcare delivery to improve conditions to deal with the crisis [ 1 ]. They showed what potential for evolvement lies underneath the surface in a time of need.…”

mentioning

confidence: 99%

The coronavirus disease 2019 proves transformability of the cardiac surgery specialty

Steinmaurer

Bley

2020

European Journal of Cardio-Thoracic Surgery

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The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: insights and clinical strategies from a centre at the epicentre

Cited by 21 publications

References 16 publications

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

The coronavirus disease 2019 proves transformability of the cardiac surgery specialty

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