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2020 ; 52
(9
): 2596-2600
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Rapid Modification of Workflows and Fellow Staffing at a Single Transplant Center
to Address the COVID-19 Crisis
#MMPMID32471628
Thiessen C
; Wisel SA
; Yamaguchi S
; Dietch ZC
; Feng S
; Freise CE
Transplant Proc
2020[Nov]; 52
(9
): 2596-2600
PMID32471628
show ga
BACKGROUND: Although hospital systems have largely halted elective surgical
practices in preparing their response to the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) pandemic, transplantation remains an essential and
lifesaving surgical practice. To continue transplantation while protecting
immunocompromised patients and health care workers, significant restructuring of
normal patient care practice habits is required. METHODS: This is a
nonrandomized, descriptive study of the abdominal transplant program at 1
academic center (University of California, San Francisco) and the programmatic
changes undertaken to safely continue transplantations. Patient transfers, fellow
use, and patient discharge education were identified as key areas requiring
significant reorganization. RESULTS: The University of California, San Francisco
abdominal transplant program took an early and aggressive approach to
restructuring inpatient workflows and health care worker staffing. The authors
formalized a coronavirus disease 2019 (COVID-19) transfer system to address
patients in need of services at their institution while minimizing the risk of
SARS-CoV-2 in their transplant ward and used technological approaches to provide
virtual telehealth where possible. They also modified their transplant fellow
staffing and responsibilities to develop an adequate backup system in case of
potential exposures. CONCLUSION: Every transplant program is unique, and an
individualized plan to adapt and modify standard clinical practices will be
required to continue providing essential transplantation services. The authors'
experience highlights areas of attention specific to transplant programs and may
provide generalizable solutions to support continued transplantation in the
COVID-19 era.