A conceptual framework for Emergency department design in a pandemic

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Benjamin S. Abella¹  Matthew Huei-Ming Ma²  Eunizar Omar³  Sang Do Shin⁴  Gayathri Devi Nadarajan⁵  Marcus Eng Hock Ong⁵  Pei Shan Hoe⁶ 

[1] Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania;Department of Emergency Medicine, National Taiwan University Hospital;Department of Emergency Medicine, Sengkang General Hospital;Department of Emergency Medicine, Seoul National University College of Medicine;Department of Emergency Medicine, Singapore General Hospital;Duke-NUS Graduate Medical School;

关键词: SARS-CoV-2;    COVID-19;    Emergency department;    Operation;    Pandemic;    Framework;   

DOI  :  10.1186/s13049-020-00809-7

来源: DOAJ

【 摘 要 】

Abstract Background The current COVID-19 pandemic is highlighting gaps around the world in the design and workflow of Emergency Departments (ED). These gaps have an impact on both patient care and staff safety and represent a risk to public health. There is a need for a conceptual framework to guide ED design and workflow to address these challenges. Such a framework is important as the ED environment will always remain vulnerable to infectious diseases outbreaks in the future. Aims This paper aims to address issues and principles around ED design and workflow amidst the COVID-19 pandemic. We propose a conceptual framework and checklist for EDs to be prepared for future outbreaks as well. Methods A scoping literature review was conducted, of the experiences of EDs in managing outbreaks such as SARS, H1N1 and COVID-19. The combined experiences of the authors and the experiences from the literature were grouped under common themes to develop the conceptual framework. Results Four key principles were derived- (1) situational awareness, surveillance and perimeter defence, (2) ED staff protection, (3) surge capacity management and (4) ED recovery. The findings were integrated in a proposed conceptual framework to guide ED design in response to an infectious disease outbreak. There are various elements which need to be considered at ED input, throughput and output. These elements can be categorised into (1) system (workflow, protocols and communication), (2) staff (human resources), (3) space (infrastructure), and (4) supply (logistics) and are placed in a checklist for pragmatic use. Conclusion The ED needs to be in a constant state of preparedness. A framework can be useful to guide ED design and workflow to achieve this. As all ED systems are different with varying capabilities, our framework may help EDs across the world prepare for infectious disease outbreaks.

【 授权许可】

Unknown