Challenges Faced | Modifications/Comments |
Uncertainty in risk stratification of patients due to evolving case definitions | · Institution set up a Pandemic Response Planning Team · Formation of dedicated Department workgroup to oversee Pandemic Response · Updated case definitions based on national and global situation · Recognition that case definitions will always lag behind actual cases · Anaesthetist should and must take on an active leadership role in risk assessment of all patients presenting for surgery · Creation of user-friendly, quick screening questionnaire for intra-Department usage (see Figure 1) |
Timely dissemination of information | · Establishment of effective communication channels ² Detailed information disseminated through work emails ² Practical summaries disseminated real-time through encrypted mobile messaging systems |
Manpower rostering | · Uncertainty of evolving global situation and need for preparedness for a surge in patients · Prohibition of overseas leave for all staff to augment manpower · OT Team segregated into 2 teams with each team working 7 continuous days and 12 h shifts to minimise risk of cross-transmission · Simulation of contingency roster for 3 weeks to ensure workability, then down-triaging to routine roster to prevent burnout · Use of shadow roster-routine roster ongoing with capability to implement contingency roster almost immediately should the need arise |
Unfamiliarity with PAPR | · Staff education ² Regular refresher sessions for Anaesthetists and Nurses to increase familiarity with PAPR ² Donning and removing of PAPR to improve staff’s response time ² In situ Simulation training including resuscitation scenarios with the use of PAPR |
Communication difficulties with PAPR | · Instructions to be brief and succinct · Effort made to speak clearly and project your voice · Acknowledgement and confirmation via read back and hand sign · Maintain situational awareness and alertness |
Sustainability of supply of PPE | · Centralised distribution to ensure close monitoring of supplies · Diversification of procurement and establishment of reliable supply chain in advance |
Healthcare worker fatigue | · Clear directives from Pandemic Preparedness Committee · Reliable flow of communication to allay anxieties · Allowance of rest days for staff while remaining contactable and on stand-by · Anonymous hotlines for peer support or counselling services made available for all staff |