CHEST Guidelines-The-Influence-of-the-COVID-19-Pandemic-on-ICU-Orga

The-Influence-of-the-COVID-19-Pandemic-on-ICU-Orga

Pdf Summary

The qualitative study titled "The Influence of the COVID-19 Pandemic on ICU Organization, Care Processes, and Frontline Clinician Experiences" sheds light on the adaptations of ICU operations and the experiences of intensivists during the COVID-19 pandemic across various U.S. hospitals. Conducted through semi-structured interviews with 33 intensivists from tertiary and community hospitals, the study identifies key strategies and challenges faced during the health crisis using the "four S" framework: space, staff, stuff, and system.<br /><br />Key findings include the beneficial effects of canceling elective surgeries to increase ICU capacity and the need for clearly defined thresholds to guide such actions during future surges. The most significant challenge noted was the shortage of ICU staff, particularly nurses and respiratory therapists, which affected patient care. Effective practices to address these shortages included tiered staffing models, just-in-time training for non-ICU clinicians, designated treatment teams, and engaging medical trainees in ICU roles.<br /><br />The study also highlighted widespread PPE shortages and the resultant distress among clinicians. Enhanced transparency, involvement of frontline clinicians in decision-making, and hands-on PPE training were underscored as critical components in maintaining trust and effectiveness of the emergency response.<br /><br />Despite variations between hospital types, a common thread was the necessity of trust and clear communication between hospital administration and frontline staff. The research calls for improved participatory governance in hospital decision-making during crisis situations to fortify clinician trust and optimize patient care outcomes.

Keywords

COVID-19

ICU organization

frontline clinicians

intensivists

hospital adaptations

staff shortages

PPE shortages

participatory governance

emergency response

patient care