Liow Ming Han Lincoln, Tay Kenny Xian Khing, Yeo Nicholas Eng Meng, Tay Darren Keng Jin, Goh Seo Kiat, Koh Joyce Suang Bee, Howe Tet Sen, Tan Andrew Hwee Chye
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
JB JS Open Access. 2020 May 15;5(2):e0050. doi: 10.2106/JBJS.OA.20.00050. eCollection 2020 Apr-Jun.
On February 8, 2020, Singapore raised its Disease Outbreak Response System Condition (DORSCON) level to Orange, indicating that coronavirus 2019 (COVID-19) was a severe disease with high human transmissibility. Using lessons learned from the severe acute respiratory syndrome (SARS) outbreak in 2003, the orthopaedic surgery department at Singapore General Hospital, a tertiary-level referral center, was prepared to handle this pandemic through business-continuity planning. The business that we are referring to is the "business" of orthopaedic surgery, encompassing clinical care, education, research, and administration. There is a lack of literature detailing business-continuity plans of surgical departments during pandemics, with new guidelines being developed. A large proportion of orthopaedic work, such as cases of fracture and infection, cannot be postponed. Even elective surgeries cannot be postponed indefinitely as it could result in detriment to the quality of life of patients. The aim of this article is to detail the business-continuity plans at our institution that allowed the delivery of essential musculoskeletal care through personnel segregation measures during the COVID-19 pandemic. Strategies to ensure the provision of timely medical intelligence, the reduction of nonessential ambulatory visits and surgical procedures, ensuring the safety and morale of staff, and continuing education and research efforts were paramount. As the COVID-19 pandemic unfolds, our posture needs to constantly evolve to meet new challenges that may come our way. Our existing business-continuity plan is not perfect and may not be applicable to smaller hospitals. There is conflict between envisioned normalcy, remaining economically viable as an orthopaedic department, and fulfilling training requirements, and educating the next generation of orthopaedic surgeons on the one hand and the need for segregation, workload reduction, virtual education, and social distancing on the other. Orthopaedic surgeons need to strike a balance between business continuity and adopting sustainable precautions against COVID-19. We hope that our experience will aid other orthopaedic surgery departments in adapting to this new norm, protecting their staff and patients, managing staff morale, and allowing the continuation of musculoskeletal care during the COVID-19 pandemic.
2020年2月8日，新加坡将其疾病爆发应对系统警戒级别提升至橙色，这表明2019冠状病毒病（COVID-19）是一种具有高人际传播性的严重疾病。借鉴2003年严重急性呼吸综合征（SARS）疫情的经验教训，作为三级转诊中心的新加坡总医院骨科准备通过业务连续性规划来应对此次大流行。我们所说的业务是指骨科手术的“业务”，包括临床护理、教育、研究和管理。目前缺乏详细介绍大流行期间外科科室业务连续性计划的文献，新的指南正在制定中。骨科的大部分工作，如骨折和感染病例，不能推迟。即使是择期手术也不能无限期推迟，因为这可能会损害患者的生活质量。本文的目的是详细介绍我们机构的业务连续性计划，该计划在COVID-19大流行期间通过人员隔离措施实现了基本肌肉骨骼护理的提供。确保及时提供医疗情报、减少非必要的门诊就诊和外科手术、确保工作人员的安全和士气以及继续开展教育和研究工作的策略至关重要。随着COVID-19大流行的发展，我们的态势需要不断演变以应对可能出现的新挑战。我们现有的业务连续性计划并不完美，可能不适用于较小的医院。一方面，设想的常态、作为骨科科室保持经济上的可行性、满足培训要求以及培养下一代骨科外科医生，与另一方面的隔离需求、工作量减少、虚拟教育和社交距离之间存在冲突。骨科外科医生需要在业务连续性和采取可持续的COVID-19预防措施之间取得平衡。我们希望我们的经验将有助于其他骨科手术科室适应这一新常态，保护其工作人员和患者，管理工作人员的士气，并在COVID-疫情期间继续提供肌肉骨骼护理。 19大流行期间继续提供肌肉骨骼护理。
