Surgical capacity is disaster preparedness: A scoping review of how surgery and anesthesiology departments responded to COVID-19.

Hodan Abdi, Jacqueline Cellini, Matthew T Hey, Madeleine Carroll, Lili B Steel, Mayte Bryce-Alberti, Radzi Hamzah, Rachel E Wittenberg, Anam Ehsan, Latoya Stewart, Raina Parikh, Raisa Rauf, Kiana Winslow, Isaac G Alty, Craig D McClain, Geoffrey A Anderson

Journal: American journal of disaster medicine 2024;19(2):119-130

PMID: 38698510

Abstract

OBJECTIVE

This study evaluated how surgical and anesthesiology departments adapted their resources in response to the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

This scoping review used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol, with Covidence as a screening tool. An initial search of PubMed, Embase, Web of Science, Global Index Medicus, and Cochrane Systematic Reviews returned 6,131 results in October 2021. After exclusion of duplicates and abstract screening, 415 articles were included. After full-text screening, 108 articles remained.

RESULTS

Most commonly, studies were retrospective in nature (47.22 percent), with data from a single institution (60.19 percent). Nearly all studies occurred in high-income countries (HICs), 78.70 percent, with no articles from low-income countries. The reported responses to the COVID-19 pandemic involving surgical departments were grouped into seven categories, with multiple responses reported in some articles for a total of 192 responses. The most frequently reported responses were changes to surgical department staffing (29.17 percent) and task-shifting or task-sharing of personnel (25.52 percent).

CONCLUSION

Our review reflects the mechanisms by which hospital surgical systems responded to the initial stress of the COVID-19 pandemic and reinforced the many changes to hospital policy that occurred in the pandemic. Healthcare systems with robust surgical systems were better able to cope with the initial stress of the COVID-19 pandemic. The well-resourced health systems of HICs reported rapid and dynamic changes by providers to assist in and ultimately improve the care of patients during the pandemic. Surgical system strengthening will allow health systems to be more resilient and prepared for the next disaster.

Address: Program in Global Surgery and Social Change, Harvard Medical School; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Yale New Haven Hospital, New Haven, Connecticut.; Division of Nutritional Sciences, Cornell University, Ithaca, New York.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts.; Harvard Medical School, Boston, Massachusetts.; Columbia University Vagelos College of Physicians and Surgeons, New York, New York.; Department of General Surgery, University of Connecticut, Storrs, Connecticut.; Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts.; Countway Library, Harvard Medical School, Boston, Massachusetts.; Program in Global Surgery and Social Change, Harvard Medical School; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts. ORCID: https://orcid.org/0000-0002-4867-1167.; Program in Global Surgery and Social Change, Harvard Medical School; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.; Program in Global Surgery and Social Change, Harvard Medical School; Division of Trauma, Burn, and Surgical Critical Care, Brigham and Woman's Hospital, Boston, Massachusetts.

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