Maintaining safe endoscopy in a global pandemic

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Initiative Type
Model of Care
Status
Deliver
Added
Last updated

Summary

How do you keep staff and patients safe during a global pandemic whilst maintaining vital endoscopic services and avoiding diagnostic delays? By coming together as a team and making rapid, pragmatic but clear decisions in the face of rapidly changing information.

This project demonstrates how Sunshine Coast Hospital and Health Service (HHS) managed the risk by investigating and implementing a range of safety measures to ensure that staff and patients were safe while operating in a high-aerosol environment like endoscopic services.

As a result, they managed to avoid having any major events or needing to delay urgent diagnostic and therapeutic procedures. 

This was a multi-departmental project delivered from gastroenterology, surgery, and anaesthetic medicine. It also required the participation of multiple professional streams from medical, nursing and administrative support. It was true team effort.

 

Key dates
Aug 2021
Aug 2021
Implementation sites
Sunshine Coast University Hospital
Partnerships
Multi-departmental project delivered from gastroenterology, surgery and anaesthetic medicine. It equired the participation of multiple professional streams from medical, nursing and administrative support. It was true team effort.

Aim

To practice safe endoscopy in a rapidly changing environment whilst avoiding disadvantaging patients who are waiting for urgent diagnostic and therapeutic procedures.

 

Benefits

  • no meaningful long-term effects on the endoscopy waitlist.
  • no evidence of a significant delay to diagnosis of serious illness. 
  • the endoscopy department continued to deliver its core business in a safe and sustainable way at a time of unprecedented global disruption and with a rapidly evolving field of knowledge about a highly infectious virus.

 

Background

In March 2020 information about the effects of COVID-19 on surgery was rapidly evolving and limited. There was significant concern regarding a highly infectious respiratory virus and its transmission during aerosol generating procedures, which obviously would affect gastroenterology to a large extent. 

Solutions Implemented

  • development, roll out, scenario testing and implementation of COVID safe endoscopy for high risk patients
  • development of clear local guidelines for PPE use in endoscopy 
  • proactive and dynamic waitlist management to minimise impact on diagnostic endoscopy services whilst maintaining safe practice at a time of high workload and anxiety.

     

Evaluation and Results

The department operated safely throughout the pandemic with no infection control breaches recorded.

During April 2020, the period of national lockdown, the department continued to operate high volume endoscopy with only a modest reduction of activity during this month (February: 629 procedures, March: 619, April: 430). This compares very favourably to other sites within the state.

By May 2020, the department was exceeding pre-pandemic throughput (658 cases) and continued to increase activity through June, July and August to make up the shortfalls accumulated through the lockdown period (June: 910, July: 833, August: 779).

 

Lessons Learnt

  • people and teams pull together to find solutions in an emergency 
  • endoscopy can continue to be delivered safely even during a global pandemic.
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Key contact

Jonathan Mitchell
Acting Director of Gastroenterology
Sunshine Coast HHS
0752021012
jonathan.mitchell@health.qld.gov.au

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