- During the COVID-19 pandemic, a variety of measures can increase social distancing in the emergency department (ED), presumably without compromising care.
Why this matters
- The ED is a potential SARS-CoV-2 transmission hotspot.
- Main principles:
- Reduce number of people in ED.
- Minimize lengths of stay.
- Minimize interpersonal contact.
- Reducing transmission between workers:
- As patient volume fell, ED reduced and staggered shifts and created larger backup staff pool.
- Telemedicine consults rose.
- Individuals reserved computers for a shift.
- Signage discouraged staff gatherings.
- Restaurants offering donations were asked to send individual meals.
- Reducing transmission between workers and patients:
- Rapid assessment areas outside ED.
- Reduce number of examinations to 1, e.g., by resident while attending watches via video.
- Nurses batched work to reduce number of entries to a patient’s room.
- Use of bedside computers was discouraged.
- Providers called or videoconferenced with patients in rooms when possible.
- Leadership engaged in hands-on dissemination and real-time coaching by COVID-19 champions offering cafeteria coupons as incentives.
- Provider infection rates have been "low" despite these EDs being hard-hit by pandemic.
- Guidelines available as free 1-page document.
- Description of social-distancing measures in Yale EDs.
- Funding: None disclosed.
- Many measures must be rethought as patient volumes increase.