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Published on: April 6, 2019
Emergency department 'outbreak rostering' to meet challenges of COVID-19
Wei Lin Tallie Chua1, Li Juan Joy Quah2, Yuzeng Shen2
1Emergency Medicine, Singapore General Hospital, Singapore tallie.chua.w.l@singhealth.com.sg.
Insights
The Outbreak Response Roster created fixed teams to minimize healthcare worker contact during the COVID-19 pandemic. This strategy aimed to reduce infections and ensure continued emergency department operations.
Area of Science:
- Emergency Medicine
- Infectious Disease Control
- Healthcare Management
Background:
- COVID-19 pandemic created unprecedented challenges for emergency department (ED) staffing.
- Infection control, staff quarantine, and contact minimization significantly impacted ED physician work.
- A single healthcare worker infection could lead to widespread staff quarantine, disrupting operations.
Purpose of the Study:
- To develop and implement an innovative rostering system to mitigate COVID-19's impact on ED staffing.
- To maintain ED operational capacity while prioritizing healthcare worker safety and well-being.
Main Methods:
- Developed an Outbreak Response Roster with fixed, rotating teams of physicians.
- Teams worked 12-hour shifts with no overlap or staggered scheduling to limit interactions.
- Implemented brief handovers and utilized technology for communication and resident education.
Main Results:
- The Outbreak Response Roster successfully created isolated teams to minimize inter-team contact.
- Measures were implemented to support healthcare worker psychological well-being.
- Communication and education strategies adapted to limited face-to-face interactions.
Conclusions:
- The Outbreak Response Roster is an effective strategy for managing ED staffing during infectious disease outbreaks.
- This model enhances operational resilience and protects healthcare personnel.
- Innovative communication and educational approaches are crucial for maintaining team cohesion and training.
Abstract:
The COVID-19 outbreak has posed unique challenges to the emergency department rostering. Additional infection control, the possibility of quarantine of staff and minimising contact among staff have significant impact on the work of doctors in the emergency department. Infection of a single healthcare worker may require quarantine of close contacts at work. This may thus affect a potentially large number of staff. As such, we developed an Outbreak Response Roster. This Outbreak Response Roster had fixed teams of doctors working in rotation, each team that staff the emergency department in turn. Members within teams remained constant and were near equally balanced in terms of manpower and seniority of doctors. Each team worked fixed 12 hours shifts with as no overlapping of staff or staggering of shifts. Handovers between shifts were kept as brief as possible. All these were measures to limit interactions among healthcare workers. With the implementation of the roster, measures were also taken to bolster the psychological wellness of healthcare workers. With face-to-face contact limited, we also had to maintain clear, open channels for communication through technology and continue educating residents through innovative means.
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