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Teamwork in the time of coronavirus: An MGH experience
Arminder S Jassar1, Katy E Perkins1, Thoralf M Sundt1
1Division of Cardiac Surgery, Harvard Medical School, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Insights
The Massachusetts General Hospital
Area of Science:
- Cardiovascular Surgery
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic significantly disrupted healthcare delivery globally.
- Boston was an early epicenter, with Massachusetts General Hospital (MGH) treating a high volume of COVID-19 patients.
- This necessitated substantial resource reallocation and changes in surgical practice.
Purpose of the Study:
- To describe the challenges faced by the MGH Division of Cardiac Surgery during the COVID-19 pandemic.
- To outline the strategies implemented to manage resources and patient care.
- To highlight the division's response and adaptation to the crisis.
Main Methods:
- Reallocation of intensive care unit (ICU) bed capacity.
- Suspension of all deferrable surgical cases.
- Prioritization of urgent and emergent cardiac surgeries.
- Implementation of interventions to support teamwork and adapt to resource fluctuations.
Main Results:
- The Division of Cardiac Surgery unified to manage resource utilization effectively.
- Nonemergent cases were deferred to optimize ICU resources.
- Efficient care was maintained for patients requiring urgent or emergent surgery.
- Established interventions continue to support adaptive teamwork during recovery.
Conclusions:
- The division's culture and practice structure facilitated a successful response to the COVID-19 crisis.
- The hospital's mission to support the community was upheld during the pandemic and its recovery phase.
- The strategies employed demonstrated resilience and adaptability in healthcare provision.
Abstract:
The global pandemic of coronavirus 2019 (COVID-19) caused by coronavirus has had a profound impact on the delivery of health care in the United States and globally. Boston was among the earliest hit cities in the United States, and within Boston, the Massachusetts General Hospital provided care for more patients with COVID-19 than any other hospital in the region. This necessitated a massive reallocation of resources and priorities, with a near doubling of intensive care bed capacity and a halt in all deferrable surgical cases. During this crisis, the Division of Cardiac Surgery responded in a unified manner, dealing honestly with the necessity to reduce Intensive Care Unit resource utilization for the benefit of both the institution and our community by deferring nonemergent cases while also continuing to efficiently care for those patients in urgent or emergent need of surgery. Many of the interventions that we instituted have continued to support teamwork as we adapt to the remarkably fluid changes in resource availability during the recovery phase. We believe that the culture of our division and the structure of our practice facilitated our ability to contribute to the mission of our hospital to support the community in this crisis, and now to its recovery. We describe here the challenge we faced in Boston and some of the details of the structure and function of our division.
