Containing SARS-CoV-2 in hospitals facing finite PPE, limited testing, and physical space variability: Navigating resource constrained enhanced traffic control bundling
Autor
De Georgeo, Michael R.
De Georgeo, Julia M.
Egan, Toby M.
Klee, Kristi P.
Schwemm, Michael S.
Bye-Kollbaum, Heather
Kinser, Andrew J.
Institución
Resumen
The COVID-19 outbreak has led to a focus by public health practitioners and scholars on
ways to limit spread while facing unprecedented challenges and resource constraints. Recent
COVID-19-specific enhanced Traffic Control Bundling (eTCB) recommendations provide a
cogent framework for managing patient care pathways and reducing health care worker
(HCW) and patient exposure to SARS-CoV-2. eTCB has been applied broadly and has proven
to be effective in limiting fomite and droplet transmissions in hospitals and between hospitals
and the surrounding community. At the same time, resource constrained conditions involving
limited personal protective equipment (PPE), low testing availability, and variability in
physical space can require modifications in the way hospitals implement eTCB. While eTCB
has come to be viewed as the standard practice, COVID-19 related resource constraints often
require hospital implementation teams to customize eTCB solutions. We provide and describe
a cross-functional, collaborative on-the-ground adaptive application of eTCB initially piloted
at two hospitals and subsequently reproduced at 16 additional hospitals and health systems in
the US to date. By effectively facilitating eTCB deployment, hospital leaders and practitioners
can establish clearer ‘zones of risk’ and related protective practices that prevent transmission
to HCWs and patients. We outline key insights and recommendations gained from recent
implementation under the aforementioned constraints and a cross-functional team process that
can be utilized by hospitals to most effectively adapt eTCB under resource constraints.