Abstract
BACKGROUND: Surgeons urgently need guidance on how to deliver surgical services safely and effectively during the COVID-19 pandemic. The aim was to identify the key domains that should be considered when developing pandemic preparedness plans for surgical services.
METHODS: A scoping search was conducted to identify published articles relating to management of surgical patients during pandemics. Key informant interviews were conducted with surgeons and anaesthetists with direct experience of working during infectious disease outbreaks, in order to identify key challenges and solutions to delivering effective surgical services during the COVID-19 pandemic.
RESULTS: Thirteen articles were identified from the scoping search, and surgeons and anaesthetists representing 11 territories were interviewed. To mount an effective response to COVID-19, a pandemic response plan for surgical services should be developed in advance. Key domains that should be included are: provision of staff training (such as patient transfers, donning and doffing personal protection equipment, recognizing and managing COVID-19 infection); support for the overall hospital response to COVID-19 (reduction in non-urgent activities such as clinics, endoscopy, non-urgent elective surgery); establishment of a team-based approach for running emergency services; and recognition and management of COVID-19 infection in patients treated as an emergency and those who have had surgery. A backlog of procedures after the end of the COVID-19 pandemic is inevitable, and hospitals should plan how to address this effectively to ensure that patients having elective treatment have the best possible outcomes.
CONCLUSION: Hospitals should prepare detailed context-specific pandemic preparedness plans addressing the identified domains. Specific guidance should be updated continuously to reflect emerging evidence during the COVID-19 pandemic.
| Original language | English |
|---|---|
| Pages (from-to) | 1097-1103 |
| Number of pages | 7 |
| Journal | British Journal of Surgery |
| Volume | 107 |
| Issue number | 9 |
| Early online date | 15 Apr 2020 |
| DOIs | |
| Publication status | Published - Aug 2020 |
Bibliographical note
© 2020 BJS Society Ltd Published by John Wiley & Sons Ltd.Acknowledgements
This report was funded by a National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) and the European Society of Coloproctology. The funders had no role in study design, data collection, analysis and interpretation, or writing of this report. The funders approved the submission of this report for publication. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care.
Keywords
- COVID-19
- Coronavirus Infections/epidemiology
- Cross Infection/prevention & control
- Humans
- Pandemics/prevention & control
- Pneumonia, Viral/epidemiology
- Practice Guidelines as Topic/standards
- Surgical Procedures, Operative/standards
