Clinical Departments Research Articles

New view on the compatibility of hemoglobin function in the erythrocytes.

Aim: To study the process of hemoglobin oxidation and the enzymatic reactions associated with it. Materials and Methods: Heparinized human blood (15 IU/ml) was obtained from the clinical department. The concentration of oxy- and methemoglobin, auto-oxidation of hemoglobin was determined spectrophotometrically spectrophotometrically. Autooxidation of hemoglobin was recorded spectrophotometrically, and protein concentration was determined by the Lowry method. Monooxygenase activity of hemoglobin was also measured by the method described by Lowry spectrophotometrically. The concentration of O2 and H2O2 in the reaction media was determined on a biomicroanalyzer OR 210/3 (Redelkis). Results: The obtained experimental data allow us to propose a mechanism of "spontaneous autooxidation" of oxyhemoglobin, which can be described by the following equations: Hb2+O2 → Hb3+ + O2 - (1) Hb2+O2 + 2e - + 2H+ →Hb3+ + H2O2 (2) Hb2+O2 + 2e - + 2H+ →Hb2+ + H2O2 (3) Hb2+ + O2 →Hb2+O2 (4) Spectral characteristics of the process of "spontaneous auto-oxidation" indicate the formation of a metform of hemoglobin, the depletion of oxygen by the system was established, at pH 5.6, an increase in the monooxygenase activity of hemoglobin is observed 3-4 times compared to the physiological level. Сonclusions: In addition to the main, previously known functions of hemoglobin (gas transport, peroxidase, monooxygenase), it catalyzes a two-electron oxidase reaction in which O2 is reduced to H2O2. This is confirmed by experimental data on the formation of one of the products of "spontaneous autoxidation" of oxyhemoglobin _ deoxyform at pH 5.6 _ 8.9.

Navigating Strategic Change Process in Healthcare Organizations During Unexpected Crisis Change Process in Healthcare Organizations During Crisis

The Radiation Oncology (RO) clinical department is a significant healthcare facility in university hospitals dedicated to treating cancer patients using radiation. Radiation oncology has undergone significant workflow changes, patient appointments, patient scheduling, treatment flow, medical care, and many more to continuously treat cancer patients safely in healthcare facilities during the pandemic crisis. The present study examined the decision-making, change initiatives, implementation process, and post-transition review of these changes in the department of a major university hospital. In contrast to the usual change initiatives, the executive level made all the crucial decisions with the support of a network of teams and then passed them on to the lower-level employees for quick implementation in the crisis. formulated quickly implemented the formulated decisions, sending the essential communications through various electronic methods. The department performed well in this change initiative/ process, allowing patients to continue radiation treatments by taking the necessary steps to tackle the crisis effectively. The department revenue was reduced over the period, and no employee lost their job due to the effective involvement of the management from the beginning of the crisis. Many employees were allowed to work from home, implemented telehealth programs for patient consultations, and provided patients with specific appointment times for radiation treatments. These steps considerably reduced department traffic to control viral spread issues successfully.

A Cross-sectional Study on the Impact of COVID-19 Pandemic on Postgraduate Medical Training and Mental Health

Abstract Background: The regulations for Postgraduate Medical Education in 2021, established by the National Medical Commission, aim to produce skilled and efficient medical professionals. However, the COVID-19 pandemic has had detrimental effects on the academic aspects, clinical training, and mental health of postgraduates. Most of the studies have primarily focused on the impact of COVID-19 on clinical departments, while pre- and para-clinical departments have been largely ignored. Objective: The objective of this study was to assess the specific impact of COVID-19 on academics, clinical skills, and mental health among postgraduates. Methods: Between mid-August and mid-October 2022, face-to-face interviews were conducted with postgraduates from all three batches using a semi-structured questionnaire. The questionnaire included inquiries regarding the impact of COVID-19 on academic and clinical aspects. The mental health of postgraduates was assessed using the Fear of COVID-19 Scale. A total of 230 responses were collected, entered into MS Excel, and analyzed using SPSS software. Results: Out of approximately 1200 eligible postgraduates, only 230 (19%) participated in the study. Among the findings, 52.9% of postgraduates did not have any physical classes, while 59.6% expressed satisfaction with virtual classes. Virtual examinations had a negative impact on 61.3% of the postgraduates. Furthermore, a significant majority (88.8%) of postgraduates reported being unable to learn clinical procedures due to the absence of ward rounds. The mental health of the postgraduates, except for 96 individuals, was adversely affected. Conclusion: By this study, it can be concluded that COVID-19 has had a severe impact on the academics, clinical skills, and mental health of postgraduates.

Contributing Risk Factors to Self-Contamination During the Process of Donning and Doffing Personal Protective Equipment.

The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs). In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated. About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points. Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors.

In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures. The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses. We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021. We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities. CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

Medical nutrition therapy in amyotrophic lateral sclerosis - Do we act or react? A case report and multidisciplinary review

Background: amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with a progressive course. The current prevalence is between 3 and 6 cases/100,000. Malnutrition is closely related to patient prognosis in ALS. The implications of this conditions have been that we should recommend patient care in a multidisciplinary unit. Case report: the case presented shows the evolution of a patient with ALS. The patient was referred to different clinical departments after neurological evaluation and her nutritional, functional and respiratory status were assessed. There was no nutritional deterioration at diagnosis; however, intake was below energy-protein requirements. The clinical evolution of the patient showed a decrease in muscle mass with preservation of weight and fat mass. "Aggressive" measures to control nutritional status such as gastrostomy were rejected in the initial stages of the disease, but had to be carried out after development of dysphagia and associated malnutrition. This situation of progressive morphofunctional deterioration and the development of disease-related complications made essential the participation of different health services and professionals in its control. Dicussion: the management of ALS in a multidisciplinary manner allows to improve the course of the disease and the quality of life of both the patients and their families. Patient follow-up is based on the adjustment and management of complications. The basis of the relationship with these patients includes maintaining an adequate communication with them and their families, and ensuring joint decision-making about their condition.

Role of radiologists in the diagnosis and management of adrenal disorders.

This study aimed to focus on the role of radiologists in the diagnosis and management of adrenal lesions, particularly primary aldosteronism (PA) and secondary hypertension. As hypertension affects more than one-third of the population in Japan, identifying secondary causes such as PA and adrenal lesions is crucial. Establishing a radiological differential diagnosis of adrenal lesions using advanced imaging techniques, such as computed tomography and magnetic resonance imaging, is crucial. Knowledge of the imaging findings of various benign and malignant adrenal lesions, such as adrenocortical adenomas, cortisol-producing lesions, pheochromocytomas, adrenocortical carcinoma, malignant lymphoma, and metastatic tumors, is necessary. Adrenal venous sampling (AVS) plays a crucial role in accurately localizing aldosterone hypersecretion in PA, especially when imaging fails to provide a clear diagnosis. This paper details the technical aspects of AVS, emphasizing catheterization techniques, anatomical considerations, and the importance of preprocedural imaging for successful sampling. Furthermore, we explore segmental adrenal venous sampling (SAVS), a more refined technique that samples specific adrenal tributary veins, offering enhanced diagnostic accuracy, particularly for microadenomas or challenging cases that may be missed with conventional AVS. The methodology for performing SAVS, along with the interpretation criteria for successful sampling and lateralization, is also outlined. Furthermore, radiologists have initiated treatments for unilateral PA, such as radiofrequency ablation, and play an integral role in the management of adrenal lesions. Collaborative approaches across clinical departments are required to enhance patient management in medical care involving the adrenal gland.

ANALYSIS OF THE RESULTS OF SURGICAL TREATMENT OF THYROID NODULES

The study included the results of treatment of 368 patients with benign thyroid nodules who were admitted to the surgi-cal department of the multidisciplinary clinic of Samarkand State Medical University in the period from 2010 to 2023. Depending on the volume of the thyroid gland to be removed, the following types of operations were performed: Thy-roidectomy, Subtotal resection of the thyroid gland, Hemithyroidectomy with partial resection of the other lobe of the thyroid gland, Hemithyroidectomy, Partial resection of the thyroid gland. The developed algorithm for choosing tactics for surgical treatment of thyroid nodules, taking into account the volume of removal of the thyroid gland according to the conclusion of fine-needle aspiration biopsy or express bopsy, made it possible to improve the quality of care provid-ed by reducing the frequency of immediate postoperative complications from 14.8% (40 patients in the group compari-son) to 2.9% (4 patients in the main group) (χ2 criterion = 4.954; Df=1; p=0.027) and unsatisfactory results in the long-term postoperative period from 32.1% (52 patients in the comparison group) to 11, 3% (in 12 patients in the main group) (χ2 criterion = 4.692; Df = 1; p = 0.031).

Structure of pediatric ophthalmic pathology in Uzbekistan

This study analyzes the structure of eye diseases in children of different age groups based on the materials of the ophthalmology department of the Tashkent Pediatric Medical Institute (TPMI) clinic for 2018-2021. A retrospective analysis of statistical coupons was conducted, which included the medical records of 5613 patients of the ophthalmology department of the TPMI clinic. In the age structure of ophthalmopathology in children who received inpatient treatment at the TPMI clinic in 2018-2021, children aged 5 to 14 years (49.5%) and 1 to 5 years (30.7%) were significantly predominant. The proportion of patients under 1 year old was 11.2% and from 14 to 18 years old - 7.5%. Congenital glaucoma (41%) and lens diseases (30.4%) are characteristic of infants (from 0 to 1 year old); in patients aged 1 to 5 years, lens pathology (37%), congenital glaucoma (25.2%), and injuries (24.7%) were more common; in children aged 5 to 14 years, the pathology of the oculomotor apparatus (32%) and injuries (27.7%) prevailed; in the age group from 14 to 18 years, lens diseases (28.4%) and injuries of the organ of vision (28.1%) were detected more often. The revealed age aspects of nosologies are due to the timing of clinical manifestations of the pathology, late seeking ophthalmic care of parents, presence of a concomitant pathology in the child, which prevents surgical treatment. The results of the study will help optimize planned and emergency ophthalmological care for children in the regions of the republic.

Choroidal Thickness and Central Macular Thickness Measurements with Cirrus HD-OCT in Healthy.

This research was conducted to determine the normal values of choroidal thickness in healthy individuals and to evaluate the relationship between this thickness and age, gender, refraction, axial length and average macular thickness using OCT. In the study, the right eyes of 400 healthy individuals (234 women, 166 men) between the ages of 4 and 70 years, who applied to the Department of Ophthalmology outpatient clinic for examination, were evaluated. Macular thickness, macular volume, and foveal thickness were found to be 249.12 ±21.32 µm, 9.98 ±0.5 µm3 and 280 ±13.45 µm, respectively. According to linear regression analysis, a negative correlation was detected between age and subfoveal choroidal thickness (p < 0.05). It was determined that foveal thickness, retinal volume and average retinal thickness were higher in men, and foveal thickness increased with age (p < 0.05). As a result of the research, it was determined that age is an important factor affecting choroidal thickness. It is thought that, in future, improving in vivo imaging of the choroid and measuring choroidal thickness using OCT will facilitate understanding of the pathophysiological basis of many ophthalmological diseases.

RESULTS OF LAPAROSCOPIC AND LAPAROTOMIC INTERVENTIONS FOR POSTOPERATIVE VENTRAL HERNIA

The study is based on a clinical examination of 105 patients with postoperative ventral hernias who were operated on in the surgical department of the multidisciplinary clinic of Samarkand State Medical University for the period from 2019 to 2023. Depending on the choice of operation, patients were divided into two groups:The first group (main group) consisted of 50 patients operated on laparoscopically, the second group, the comparison group included 55 patients who underwent open (traditional) prosthetic hernioplasty. The use of the laparoscopic "ipom" technique can significantly reduce the number of early postoperative and general complications (by 3.6 times), the duration of hospitalization (from10.2 ± 1.8days before6.2 ± 0.8days), periods of temporary disability (from40.9 ± 5.6days before15.1 ± 1.8days), and also reduce the number of relapses (from 10.9% to 2.0%).

Clinico-epidemiological study of central nervous system tumors at clinical oncology department Tanta University Hospitals

Clinico-epidemiological study of central nervous system tumors at clinical oncology department Tanta University Hospitals

Comparison of clinical tests versus electrodiagnostic testing in the diagnosis of pregnancy-related carpel tunnel syndrome

Background: Pregnancy-related carpal tunnel syndrome (PRCTS) is a persistent mononeuropathy in pregnancy. The incidence of PRCTS has a wide fluctuation range of 0.8% to 70%. Their incidence depends on the diagnostic technique. The nerve conduction study (NCS) is a very specific test for the diagnosis of PRCTS. There have been very few studies to compare the results of diagnosing PRCTS via NCS with clinical tests. Aims and Objectives: To assess the most reliable technique in the diagnosis of PRCTS by comparing clinical tests with the nerve conduction studies in electrodiagnostic (EDX) testing. Materials and Methods: As per inclusion and exclusion criteria, 100 subjects were included in the study. Out of 75 pregnant females, 25 were agematched non-pregnant females as controls. All were enrolled in the ANC clinic and gynecology outpatient department of Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh. All the females were assessed for CTS by the clinical tests as well as the EDX test performed in the department of physiology at JNMCH and AMU. The testing was done at the wrist joint in order to assess the normal functioning of the median nerve. Results: There was a highly significant difference between the two methods for the diagnosis of PRCTS. Out of the total 75 pregnant females enrolled, only 2 were found to be positive for PRCTS via clinical testing, whereas in the EDX techniques, 48% of the pregnant females were diagnosed as having PRCTS. Conclusion: Clinical tests are not emerging as a good method for PRCTS diagnosis, while EDX testing is the gold standard and a prudent method to diagnose PRCTS.

Update on the PriME-PGx initiative: evolution of pharmacogenetics in daily clinical practice.

In 2021, the Clinical Pharmacology Department of Hospital Universitario de La Princesa launched the PriME-PGx initiative (Multidisciplinary Initiative of the Hospital Universitario de La Princesa for the Implementation of Pharmacogenetics) to promote the expansion of pharmacogenetics in hospitalized patients. We establish seven pharmacogenetic profiles based on the specific needs of seven departments: Oncology, Pain Unit, Neuropsychiatry, Internal or Infectious Medicine, Cardiology, Gastroenterology and Immunosuppressants. The experience of the last 3 yearsreflects a total of 1421 reports (37.4% being oncology profiles), with a gradual increase in the number of requests each year. With this project, we aim to expand the availability and utility of pharmacogenetic biomarkers to achieve personalised therapy that avoids adverse drug reactions and therapeutic failure.

Clinical Profile of Post-COVID-19 Patients with Persistent Chest Pain: A Cross-sectional Study

Introduction: Chest pain in post-COVID-19 patients can be due to serious alarming post-COVID-19 sequelae, such as Coronary Artery Disease (CAD), pulmonary embolism, myocarditis, etc. Approximately one-fifth of patients attending clinical Outpatient Department (OPD) following COVID-19 recovery present with persistent chest pain. There is limited knowledge about the clinical profile of patients experiencing persistent post-COVID19 chest pain. Aim: To describe the clinical profile of such patients to fill the knowledge gap and acquire new insights into patients with post-COVID-19 persistent chest pain. Materials and Methods: A cross-sectional study was conducted, enrolling a total of 259 patients with persistent chest pain (i.e., chest pain lasting more than 24 weeks after COVID-19 diagnosis). After detailed history-taking and clinical and laboratory examinations, observed data were collected, compiled, evaluated, and analysed to achieve the study objectives. Results: Out of 259 patients, 133 (51.4%) had cardiac {85 (32.8%)} or pulmonary {48 (18.5%)} abnormalities. Among patients with cardiac abnormalities, CAD, arrhythmia, myocarditis/cardiomyopathy, pericarditis, and PAH were detected in 38 (14.6%), 18 (6.9%), 7 (2.7%), 11 (4.2%), and 11 (4.2%), respectively. Meanwhile, among patients with pulmonary abnormalities, 36 (13.9%) patients had organic residual lesions in the lung parenchyma, 7 (2.7%) had pleuritis, and 28 (10.8%) had pulmonary function abnormalities. The remaining 126 (48.6%) patients experienced chest pain due to non cardiopulmonary aetiologies like gastrointestinal {45 (17.3%)}, musculoskeletal {38 (14.6%)}, psychomotor {35 (13.5%)}, autonomic {8 (3.3%)}, etc. Conclusion: This study found that chest pain in post-COVID-19 patients arises due to multisystemic aetiologies such as cardiac, pulmonary, visceral, autonomic, psychomotor, musculoskeletal, etc. A wide spectrum of serious cardiac abnormalities (such as CAD, arrhythmia, myocarditis, pericarditis, PAH, etc.) contributes to about 1/3rd of cases of persistent chest pain in post-COVID-19 patients.

Knowledge, Attitude, and Practice among Parents toward Early Childhood Development in Belagavi City: A Cross-sectional Study

Context: As the educational levels and socioeconomic status of parents are low in developing countries, providing knowledge about early childhood development (ECD), the importance of early stimulation, proper caregiving practices, and ensuring the quality of the home environment through an integrated intervention is critical. In this situation, it is also critical to consider and assess the parental facts, attitudes, and practices before devising any intervention strategy. Hence, the current study intended to assess the knowledge, attitude, and practice of parents in ECD. Materials and Methods: An observational study was conducted in Belagavi City on 200 parents of children between the age group of 0 and 5 years. A structured questionnaire was used to assess the knowledge, attitude, and practice of the parents about ECD visiting the well-baby clinic and pediatric outpatient department of a tertiary care hospital. Statistical Analysis: For the test of significance, Chi-square and multiple liner regression analysis were used to find out the relationship between factors and to find the dependency status between dependent and independent variables. Results: In knowledge, P = 0.001 indicated significant knowledge of parents about the ECD, providing a strong understanding of their child’s development. The parents frequently paid attention to their children’s behavior, indicating that they had a positive attitude toward their children’s growth with a significant P = 0.001, and in the practice part, P = 0.001 indicated good significant practice of parents by frequently performing home learning techniques. Conclusion: The present study concluded that parents exhibit significant knowledge, positive attitudes, and effective practices regarding child development for children aged 0 to 5 years.

Clinico-epidemiological study of hematological malignancies at clinical oncology department Tanta university hospitals

Clinico-epidemiological study of hematological malignancies at clinical oncology department Tanta university hospitals

Blood transfusion knowledge levels of nurses in İzmir Atatürk training and research Hospital, turkey

Despite their use in life-saving treatment, blood and blood products can cause life-threatening complications. To administer blood transfusion safely, national guidelines and protocols should be consulted in healthcare organizations. In Türkiye, there are guides and regulations published by the Ministry of Health. With the definition of hemovigilance in the regulations; training in clinical use of blood and transfusion practice fields is now mandatory. This study presents data from a survey designed to assess transfusion knowledge levels of clinical departments for the purpose of planning our training programs.A two-part survey was conducted on 110 nurses from various departments. Questions included sociodemographic attributes, department they worked in, employment duration, knowledge level on transfusion practices. Statistical analysis was performed.Of the nurses that participated; 52.7% were above 40 years old, 15.5% were 31–40 years old and 31.8% were below 30 years old. For education; 84.5% of the nurses were graduates or postgraduates. For work experience; 64.5% were working in internal medicine departments, 58.2% had been working as a nurse for 10 or more years while 85.5% worked in the same department for less than 5 years. It was determined that the nurses should know more about transfusion.Beginner nurses in the intense care unit were found to have lower levels of transfusion practice knowledge, from this it was deduced additional training should be scheduled for beginner nurses with low transfusion knowledge. In addition to theoretical instructions, one-on-one training on operation controls and “observation and guidance” style practical training should be implemented. Theoretical and practical topics with inadequate knowledge should be instructed in finer detail to increase the knowledge level in these subjects.

Development of Health Management Through History

Background: One of the main goals of any organization is to achieve certain success, in fact it is the reason for the existence of any organization. Management provides the framework and basis for the control system required to maintain each organization. Management theorists believe that the knowledge and management skills are universal and apply equally to all business processes. Objective: The aim of this article is to present development of health management through history based on facts from appropriate literature as sources. Methods: The method is systematic review of the facts described in the published scientific papers about general and health management stored in scientific databases PubMed Central, Hinari, Scopus, EBSCO, etc., which are relevant to be used in the praxis. Results and Discussion: Management as a method or management skills traces its roots back to the original creation of the human society. In primary community, a human was performing its duties intuitive, and later taught preceding experience, began to plan and organize work activities to help them to more efficiently perform it. That is why it is claimed that management, as a complex activity, is old as human civilization itself. Health management plays a key role in providing a good health care quality, ultimately improving the health of an entire population. Therefore, it is important to provide good education in management to physicians who aspire to be managers and to lead hospitals, clinics and different health institutions. Management in the health care system is an area of scientific management which in terms of economic, socio-economic and socio-political change, crisis and political change, crisis and extraordinary circumstances requires more attention. The world clearly shows a significant interest in the role of all managers in the health sector and highlights the importance of a good and professional managers to solve problems in the functioning of health institutions and their services. At the same time, in the developed countries, the schools of management flourishing by training the managers in managerial skills. Efficiency refers to doing things in a right manner. Scientifically, it is defined as the output to input ratio and focuses on getting the maximum output with minimum resources. Effectiveness, on the other hand, refers to doing the right things. It constantly measures if the actual output meets the desired output. Therefore, efficiency is generally an internal measure and effectiveness an external measure. Conclusion: Health care services, like any other business, need effective managers. Medical and health service managers are either specialists, supervising a clinical department, or generalists, overseeing an entire facility. All management theory in one way or another were good, but could never be uniform for all organizations. That is why today the new theory is based on the fact that each organization requires specific that and that every requires form of management appropriate for it.

Into the Unknown: The Shift in Key Service Performance Indicators after a Clinical Hospital Department Incorporates Virtual Service Delivery Options

Abstract Background Coronavirus disease 2019 (COVID-19) forced health care services to introduce virtual service delivery. Little is known about the impact on health care service delivery. Objectives This case study reports the impact of introducing remote access facilitating virtual service delivery. Methods Key performance indicators of health care service delivery (Nutrition and Dietetic Department, 26.9 full-time equivalents) were monitored over three 6-month periods. These periods were Phase 1 (pre-COVID restrictions), Phase 2 (zero tolerance to COVID), and Phase 3 (living with COVID). Virtual service delivery was initiated between Phases 1 and 2. Virtual service delivery days were defined as days worked virtually in lieu of leave. Results During Phase 2 and Phase 3, there were 87 and 188 extra days of virtual service delivery achieved and an opportunity cost saving of $26,000 USD and $56,000 USD, respectively. Leave hours reduced between Phases 1 and 2 (p < 0.006; mean ± standard deviation [SD] 591 ± 213 and 222 ± 91) and maintained between Phases 1 and 3 (p < 0.342; mean ± SD 494 ± 98) despite the pandemic. No adverse clinical events were reported. Professional quality of life scores were maintained. Conclusion Virtual service delivery through remote access provided many days of otherwise potentially lost productivity, maintained patient care with no adverse events, and sustained Professional Quality of Life despite pandemic challenges. Operationally, lessons learnt included the importance of positive team culture to working effectively, keeping teams connected and adapting different solutions to meet teams' requirements. Incorporating virtual service delivery options into a hospital clinical department showed performance stability across key service performance indicators during the COVID-19 pandemic.