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报到履职:来自疫情中心一家专科外科的经验教训

Presenting for Duty: Lessons From A Specialty Surgery Division at the Pandemic Epicenter.

作者信息

Rao Roshni, Sun Luona, Acevedo Charise, Concepcion Ana, Concepcion Dionisia, Sanchez Josenny, Alicea Catherine, Franco Lisa, Frias Rosanna, Flores Adrianna, Vega Armisia, Baez Jennifer, Soler Nancy, Alvarez Sylvia, Taback Bret, Rao Madhu, Wiechmann Lisa

机构信息

From the Division of Surgery for Breast, Melanoma, and Soft Tissue Tumors, Department of Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY.

出版信息

Ann Surg Open. 2020 Sep 15;1(2):e014. doi: 10.1097/AS9.0000000000000014. eCollection 2020 Dec.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has had catastrophic repercussions across the world and here in the United States. The healthcare system in New York City, the epicenter, has faced significant disruptions due to the sheer volume of cases and critical care needs of severely ill patients. For surgical specialty services, the postponement of all elective surgeries, redeployment of faculty and staff, and cancellation of outpatient clinics became a rapid reality. These circumstances required a nimble restructuring of services and communications to facilitate continued support of academic and clinical missions. Throughout the course of the pandemic, significant adjustments were made in regards to duties, patient services, and communication. The frameworks and techniques utilized are described along with the relevant outcomes. Immediate restructuring of tumor boards, a focused multidisciplinary approach to management that incorporated the barriers presented by the pandemic, optimization of telehealth services, inclusive communication, and a service-oriented approach to redeployment were critical to sustaining the Division of Breast, Melanoma, and Soft Tissue surgery.

摘要

2019冠状病毒病(COVID-19)大流行在全球以及美国造成了灾难性影响。疫情中心纽约市的医疗系统,因病例数量庞大以及重症患者的重症监护需求,面临了重大干扰。对于外科专科服务而言,所有择期手术的推迟、教职员工的重新调配以及门诊诊所的取消迅速成为现实。这些情况需要灵活调整服务和沟通方式,以促进对学术和临床任务的持续支持。在整个大流行期间,在职责、患者服务和沟通方面都进行了重大调整。文中描述了所采用的框架和技术以及相关成果。肿瘤病例讨论会的立即重组、一种纳入了大流行所带来障碍的专注多学科管理方法、远程医疗服务的优化、包容性沟通以及以服务为导向的重新调配方法,对于维持乳腺、黑色素瘤和软组织外科部门的运转至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f684/10455142/9d9e99b77b27/as9-1-e014-g001.jpg

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