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Medical Education and Training

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

JAMA Surgery

Published Online: April 30, 2020

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Article Information and Disclosures

Barbara E. Coons, MD¹;

Sophia F. Tam, MD¹;

Shunpei Okochi, MD¹

Author Affiliations

¹Department of Surgery,Columbia University Irving Medical Center, New York, New York

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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

Merrer J , De Jonghe B , Golliot F , et al; French Catheter Study Group in Intensive Care. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA. 2001;286(6):700-707. doi:10.1001/jama.286.6.700 PubMed Google Scholar Crossref

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.164.3.2009042 PubMed Google Scholar Crossref

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.0b013e31818f87e9 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.