Lee Moon O, Ribeira Ryan, Fang Andrea, Cantwell Lauren, Khanna Kajal, Smith Cherrelle, Gharahbaghian Laleh
Department of Emergency Medicine Stanford University School of Medicine Stanford California USA.
J Am Coll Emerg Physicians Open. 2021 Feb 9;2(1):e12221. doi: 10.1002/emp2.12221. eCollection 2021 Feb.
The coronavirus disease 2019 (COVID-19) pandemic created new emergency physician staffing challenges. Emergency physicians may be taken out of the workforce because of respiratory symptoms or pending severe acute respiratory syndrome coronavirus 2 test results. Vulnerable emergency physician populations with increased risk of serious disease and death from COVID-19 include physicians at older ages; those with chronic medical conditions, including cardiac and pulmonary diseases and immunosuppression; and potentially pregnancy. We present our approach to planning for staffing issues through precision scheduling. We describe the actions taken to protect our vulnerable physicians and maximize our physician coverage. Measures include optimizing workforce; increasing backup call system; adjusting shifts based on patient arrival times, volume, and surge predictions; minimizing exposure to COVID-19 and reduce personal protective equipment use through telemedicine, huddles, and, creating lower risk emergency department care areas; and standardizing intubations to limit exposure.
2019年冠状病毒病(COVID-19)大流行给急诊医生人员配备带来了新的挑战。急诊医生可能会因呼吸道症状或严重急性呼吸综合征冠状病毒2检测结果待出而无法工作。因感染COVID-19而患重病和死亡风险增加的脆弱急诊医生群体包括老年医生;患有慢性疾病(包括心脏和肺部疾病以及免疫抑制)的医生;以及可能处于孕期的医生。我们介绍了通过精准排班来规划人员配备问题的方法。我们描述了为保护我们脆弱的医生并最大限度地扩大医生覆盖范围而采取的行动。措施包括优化劳动力;增加后备呼叫系统;根据患者到达时间、数量和激增预测调整班次;通过远程医疗、小组讨论以及创建低风险急诊科护理区域,尽量减少接触COVID-19并减少个人防护装备的使用;以及规范插管操作以限制暴露。