The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model

Angela Caswell,Raed Hijazi

doi:10.11648/j.ajns.20190805.11

Abstract

Middle Eastern Corona virus (MERS-Cov) has been acknowledged globally as a novel and evolving pathogen. First detected in 2012, approximately 1,000 confirmed cases reported by World Health Organization and linked to travel to Saudi Arabia. The declaration of an epidemic in the Arabian Peninsula gained the global attention. The summer of 2015 witnessed a MERS-Cov outbreak resulting in the closure of a major Middle Eastern university teaching hospital. Overcrowding and delays were acknowledged as contributory factors. Patient flow processes were not streamlined resulting in frustration amongst staff and patients. Lack of knowledge related to the mode of transmission of this pathogen added to the challenges faced within the Emergency Department. A complete system and service re-design took place with the introduction of the Kingdom’s first Drive Through Screening and Streaming Unit (along with secondary screening and surveillance checkpoints) using an Acute Respiratory Illness tool, to direct potentially infected patients to designated isolation areas to a flu clinic equipped to manage all suspected cases of MERS-Cov and isolated away from the main Emergency Department. This novel concept has been developed to ensure safe and efficient screening and streaming of suspected cases, <i>The Caswell – Hijazi Model</i>.

Highlights

Overcrowding, poor compliance with basic infection, prevention guidelines and lack of knowledge about the evolving, novel pathogen led to the outbreak and closure of one of the largest military university teaching hospitals in the Middle East
Emergency room staff was no longer authorized to travel on the campus trams that linked to the university campus
The service and systems re-design has effectively percentage representing what the team considered the most demonstrated that the measured key performance indicators serious risk and the related effects

Summary

Introduction

During the frenetic days of the MERS-Cov outbreak, the organization was unable to identify or contain the spread of the virus. The ensuing days became untenable as teams became isolated to divisions in an attempt to control further spread of the virus. The Emergency Room was especially affected as two members of the nursing and medical team contracted the virus leading to admission to intensive care. Segregation and uncertainty added to the tensions within the hospital as well as the local community. Emergency room staff was no longer authorized to travel on the campus trams that linked to the university campus. Staff arriving at global destinations had been placed in quarantine.

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Conclusion