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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Published in:

Open Access 01-12-2020 | COVID-19 | Review

A conceptual framework for Emergency department design in a pandemic

Authors: Gayathri Devi Nadarajan, Eunizar Omar, Benjamin S. Abella, Pei Shan Hoe, Sang Do Shin, Matthew Huei-Ming Ma, Marcus Eng Hock Ong

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2020

Abstract

Background

The current COVID-19 pandemic is highlighting gaps around the world in the design and workflow of Emergency Departments (ED). These gaps have an impact on both patient care and staff safety and represent a risk to public health. There is a need for a conceptual framework to guide ED design and workflow to address these challenges. Such a framework is important as the ED environment will always remain vulnerable to infectious diseases outbreaks in the future.

Aims

This paper aims to address issues and principles around ED design and workflow amidst the COVID-19 pandemic. We propose a conceptual framework and checklist for EDs to be prepared for future outbreaks as well.

Methods

A scoping literature review was conducted, of the experiences of EDs in managing outbreaks such as SARS, H1N1 and COVID-19. The combined experiences of the authors and the experiences from the literature were grouped under common themes to develop the conceptual framework.

Results

Four key principles were derived- (1) situational awareness, surveillance and perimeter defence, (2) ED staff protection, (3) surge capacity management and (4) ED recovery. The findings were integrated in a proposed conceptual framework to guide ED design in response to an infectious disease outbreak. There are various elements which need to be considered at ED input, throughput and output. These elements can be categorised into (1) system (workflow, protocols and communication), (2) staff (human resources), (3) space (infrastructure), and (4) supply (logistics) and are placed in a checklist for pragmatic use.

Conclusion

The ED needs to be in a constant state of preparedness. A framework can be useful to guide ED design and workflow to achieve this. As all ED systems are different with varying capabilities, our framework may help EDs across the world prepare for infectious disease outbreaks.

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Title: A conceptual framework for Emergency department design in a pandemic
Authors: Gayathri Devi Nadarajan
Eunizar Omar
Benjamin S. Abella
Pei Shan Hoe
Sang Do Shin
Matthew Huei-Ming Ma
Marcus Eng Hock Ong
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: COVID-19
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2020
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-020-00809-7

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Springer Medicine

A conceptual framework for Emergency department design in a pandemic

Abstract

Background

Aims

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aims

Methods

Results

Conclusion

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