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Rapid Development of Resident-Led Procedural Response Teams to Support Patient Care During the Coronavirus Disease 2019 EpidemicA Surgical Workforce Activation Team

Educational Objective
To understand how a surgical workforce activation team can help offload procedural work from the other medicine departments
1 Credit CME

Surgeons are no strangers to mass casualty incidents. Although the coronavirus disease 2019 (COVID-19) epidemic may not involve many trips to the operating room, the lessons learned in organizational management of prior natural disasters, mass shootings, and transportation incidents are valuable. At our institution, more than a quarter of patients who initially present with COVID-19 have been intubated, requiring multiple, time-consuming bedside procedures for hemodynamic monitoring and central venous access. As the hospital architecture has changed to suit the demands of the coronavirus pandemic, its workforce has also needed to evolve.

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Article Information

Corresponding Author: Barbara E. Coons, MD, Department of Surgery,Columbia University Irving Medical Center, 177 Fort Washington Ave, 7GS-313, New York, NY 10023 (bc2486@cumc.columbia.edu).

Published Online: April 30, 2020. doi:10.1001/jamasurg.2020.1782

Conflict of Interest Disclosures: None reported.

Additional Contributions: Many people from the Columbia University Irving Medical Center Department of Surgery contributed to the conception of this project and the writing of this article. Beth R. Hochman, MD, Tracey Arnell, MD, and Craig R. Smith, MD, provided incredible institutional leadership. Erin M. Duggan, MD, MS, and Andrew J. Benintende, MD, contributed to the writing and brainstorming of this article. Jake G. Prigoff, MD, and Meghal Shah, MD, contributed to the data collection and institutional review board approval. Tejas Sathe, MD, helped with the graphic design of the visual abstract. We give many thanks to the Columbia University surgical residents for their hard work thus far. None of these individuals were compensated for their contributions.

References
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Maury  E , Guglielminotti  J , Alzieu  M , Guidet  B , Offenstadt  G .  Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion?   Am J Respir Crit Care Med. 2001;164(3):403-405. doi:10.1164/ajrccm.164.3.2009042PubMedGoogle ScholarCrossref
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Ezaru  CS , Mangione  MP , Oravitz  TM , Ibinson  JW , Bjerke  RJ .  Eliminating arterial injury during central venous catheterization using manometry.   Anesth Analg. 2009;109(1):130-134. doi:10.1213/ane.0b013e31818f87e9PubMedGoogle ScholarCrossref
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