Massachusetts Chapter of the American College of Surgeons

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Creation of a Surgical Overflow Service to Offload Asymmetric Workforce Needs during the SARS-CoV-2 Pandemic
Patrick Heindel, MD, Tiffany Cao, BS, Jennifer Beatty, PA-C, Gerard Doherty, MD, C. Keith Ozaki, MD
Brigham and Women's Hospital, Boston, MA

To attenuate the asymmetric burden on the Department of Medicine (DOM) during the SARS-CoV-2 pandemic, the Department of Surgery (DOS) created a Surgical Overflow Service (SOS) staffed by surgeons to divert selected patients typically cared for primarily by medical providers. We hypothesized that the SOS would help prevent redeployment of the DOS workforce.

From December 8, 2020óJanuary 22, 2021, patients with defined diagnoses were triaged to the SOS. A chief surgical resident, intern, and night-float resident were redeployed to the SOS, and staffed with the relevant surgical specialty on-call attending. Data were collected prospectively via an IRB approved protocol.

Over the six-week period, 40 patients were cared for on the SOS (383 patient-days, mean length of stay 9.8 days, Figure 1). The most common primary diagnoses were bowel obstruction (33.3%, n=13), peripheral vascular disease (17.9%, n=7), and inflammatory bowel disease (12.8%, n=5; Figure 2). Approximately half of the patients (47.5%, n=19) underwent a procedural intervention while admitted. There were no deaths. No broader redeployment was necessary.

The SOS laid the foundation for future resource reallocation to adapt to scenarios where medical needs increase concomitantly with a decreased surgical volume, while preventing mandated redeployment.

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