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Emergency Restructuring of a General Surgery Residency Program During the Coronavirus Disease 2019 PandemicThe University of Washington Experience

Educational Objective
To review emergency restructuring of general surgery resident care teams in an attempt to optimize workforce well-being.
1 Credit CME
Abstract

Seattle, Washington, is an epicenter of the coronavirus disease 2019 epidemic in the United States. In response, the Division of General Surgery at the University of Washington Department of Surgery in Seattle has designed and implemented an emergency restructuring of the facility’s general surgery resident care teams in an attempt to optimize workforce well-being, comply with physical distancing requirements, and continue excellent patient care. This article introduces a unique approach to general surgery resident allocation by dividing patient care into separate inpatient care, operating care, and clinic care teams. Separate teams made up of all resident levels will work in each setting for a 1-week period. By creating this emergency structure, we have limited the number of surgery residents with direct patient contact and have created teams working in isolation from one another to optimize physical distancing while still performing required work. This also provides a resident reserve without exposure to the virus, theoretically flattening the curve among our general surgery resident cohort. Surgical resident team restructuring is critical during a pandemic to optimize patient care and ensure the well-being and vitality of the resident workforce while ensuring the entire workforce is not compromised.

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Article Information

Accepted for Publication: March 28, 2020.

Corresponding Author: Amer H. Nassar, MD, Department of Surgery, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 (anassar@uw.edu).

Published Online: April 6, 2020. doi:10.1001/jamasurg.2020.1219

Author Contributions: Dr Nassar had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Nassar, Zern, Lynge, Smith, Horvath, Wood.

Acquisition, analysis, or interpretation of data: McIntyre, Petersen, Horvath, Wood.

Drafting of the manuscript: Nassar, Zern, Smith, Petersen, Horvath, Wood.

Critical revision of the manuscript for important intellectual content: Zern, McIntyre, Lynge, Smith, Horvath, Wood.

Administrative, technical, or material support: Petersen, Horvath, Wood.

Supervision: Zern, McIntyre, Lynge, Smith, Horvath, Wood.

Conflict of Interest Disclosures: None reported.

References
1.
National Institutes of Health. Coronavirus disease 19 (COVID-19). Published 2020. Accessed March 21, 2020. https://www.nih.gov/health-information/coronavirus
2.
Worldometer. COVID-19 coronavirus pandemic. Published 2020. Accessed March 21, 2020. https://www.worldometers.info/coronavirus/
3.
Centers for Disease Control and Prevention. Interim guidance for implementing home care of people not requiring hospitalization for coronavirus disease 2019 (COVID-19).Published 2020. Accessed March 19, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html
4.
Washington State Department of Health. What to do if you were potentially exposed to someone with confirmed coronavirus disease (COVID-19). Accessed March 18, 2020. https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDexposed.pdf
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