| Popis: |
The COVID-19 pandemic profoundly affected clinicians’ work patterns and the clinical activity within the hospital. In the Maternity Department at St Thomas’s hospital in London, COVID-19 positive patients were cared for separately on Hospital Birth Centre and cancellation of elective theatre lists led to empty theatres and under-utilised surgical wards. Over a 6 week period, we looked at the relocation of the low risk elective caesarean section (ELCS) pathway or ‘green’ according to a devised Traffic light Criteria, to a separate floor and evaluated the impact on relevant process measures. This involved strong leadership and multidisciplinary team involvement to ensure that the new pathway was integrated smoothly, without disruption to patient care. We compared our data related to this pathway to baseline data from previous work on the ELCS pathway and discussed the pandemic changes and how this created an opportunity to address challenges. We evaluated patient and staff experience using specifically designed questionnaires. On 56% of the days, the average time to discharge was less than 36 hours compared to 48 hours prior to relocation during COVID-19. 67% of cases were completed in less than 45 minutes. On 33% of days during the relocation period, all cases were in theatre before 09:15am compared to 20% prior to relocation. There were no HDU admissions and 7 postpartum haemorrhages (EBL Overall positive patient feedback was obtained from the 17 completed questionnaires during the relocation. However, only 65% of women felt they were given adequate information about the birth of their baby and 53% about their postnatal recovery. 50% of trainees felt that their learning experience had improved with respect to performing ELCS. This work has shown that challenges like the COVID-19 pandemic can present opportunities for innovative solutions to be developed and implemented at short notice. |
