Abstract
IntroductionManaging healthcare service during pandemics and outbreaks is a challenging process. The aim is to keep patient safety as the priority, besides, continuing to provide essential healthcare services.MethodsSituational audit was performed for the services rendered before and during COVID-19 pandemic and the elevation of the disease alert status, and a retrospective analysis of the attendance and procedures performed in the service.ResultsWe present a methodology for performing a situational audit and generating service modification for hand and reconstructive microsurgery unit in a pandemic. There was no significant difference between the number of patients seen at outpatient clinics. However, there was a reduction in the numbers of total surgeries performed, with a 40% drop in the number of elective surgeries performed. There was also a reduction of cases seen in the emergency department hand clinic.DiscussionCOVID-19 pandemic is currently affecting not only the health service but also, other vital services all over the world. The pandemic puts significant challenges to acute surgical services in a hospital system involved in the management of the pandemic. Surgeons need to take proactive and a systematic approach in managing the available resources while maintaining essential surgical services. This paper provides the tools and methodology for doctors to plan their services in a pandemic situation.ConclusionsIt is possible to maintain essential surgical services in a pandemic situation through rapid situational audits and generating localised strategies while considering the constraints imposed during the pandemics while maintaining patient and staff safety.
Highlights
Managing healthcare service during pandemics and outbreaks is a challenging process
This study aims to describe and document the process of auditing the services of a hand and reconstructive microsurgery (HRM) and design and develop strategies to ensure the continuity of HRM services required by the community
Before the pandemic of COVID-19, the service includes the provision of outpatient services 4 days in a week, a 5-d ay emergency hand service clinic in the emergency department (ED) from 17:00– 22:00 hours (Hot Hand Clinic), 3 days operating of emergency (P4 system) and elective services in a week
Summary
Managing healthcare service during pandemics and outbreaks is a challenging process. The aim is to keep patient safety as the priority, besides, continuing to provide essential healthcare services. Conclusions It is possible to maintain essential surgical services in a pandemic situation through rapid situational audits and generating localised strategies while considering the constraints imposed during the pandemics while maintaining patient and staff safety. WHO risk assessment for COVID 19 is very high globally.[2] Latest update by the Ministry of Health (MOH) on 8 May 2020 showed the total number of cases 21 707 (768 new), deaths 20 (no new deaths). China’s control measures included the lockdown in Hubei province, which restricted household transmission leading to the burn-out of the virus These stringent strategies may not be reproducible in other countries with different governance systems.[4 5] on 9 March 2020, Italy imposed national quarantine over the whole country and restricted movement of the population through the country except for essential travel for work and health issues. Rome airports terminals are closed.[6 7]
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