Description of a Multi-faceted COVID-19 Pandemic Physician Workforce Plan at a Multi-site Academic Health System

Sachin R Pendharkar,Nimira Alimohamed,Stephanie Smith,Evan Minty,Thomas Allen,Kelly B Zarnke,Shannon M Ruzycki,Kerri A Johannson,Wendy Desjardins-Kallar,Meghan J Elliott,Rahim Kachra,Angela M Hunter ,Caley Shukalek ,Kim Cheema,Paul Macmullan,Jeffrey P Schaefer,A Papini ,Meghan Vlasschaert ,Jane B Lemaire ,W Y Irene ,Parabhdeep Lail,Paul Gibson ,Brendan Kerr,Aleem Bharwani,Gabriel Fabreau

doi:10.1007/s11606-020-06543-1

Sachin R Pendharkar, Nimira Alimohamed + Show 23 more

Open Access

https://doi.org/10.1007/s11606-020-06543-1

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Abstract

BackgroundThe evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems.InterventionThe Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes.MethodsIn this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data.Key ResultsFrom March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units.ConclusionsMEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.

Highlights

In 2020, the COVID-19 pandemic has had far-reaching impacts on health, society, and the global economy
In the pandemic, limited evidence about COVID-19 transmission and clinical characteristics combined with rapid case transmission, early projections suggesting exponential growth, and emerging reports from severely affected jurisdictions such as Lombardy, Italy, and New York City, USA, prompted concerns in many jurisdictions that the number of Pendharkar et al: Pandemic Physician Workforce Plan for COVID-19
The dynamic description of implementation, deescalation, and re-escalation of the pandemic plan is mapped against hospital demand and COVID-19 case volume from March 5 to October 26, 2020, using publicly reported provincial health data[2] and provincial health system operational data for COVID-19 hospitalizations

Summary

Introduction

In 2020, the COVID-19 pandemic has had far-reaching impacts on health, society, and the global economy. Scientific understanding of COVID-19 was rapidly evolving; there was limited evidence to guide the development and implementation of a rapidly scalable acute care physician workforce plan. The Department of Medicine (DOM) at the University of Calgary and Alberta Health Services (AHS)—Calgary Zone established the Medical Emergency-Pandemic Operations Command (MEOC) to rapidly design, test, and implement a physician workforce plan for hospitalized, non-ventilated inpatients with COVID-19. INTERVENTION: The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. In the initial implementation period (March– May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. 234 physicians signed up for hospital shifts, and 227 physicians received

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