Reinventing hospital care during the COVID-19 pandemic

As the world continues to battle the Novel Coronavirus (SARS-CoV-2) in homes, communities, the workplace, public areas, and pretty much anywhere where public life bustled with everyday normalcy, one institution has been a surprising and worrying battleground—the hospital. During the early months of the pandemic, hospitals struggled to control infection rates inside their premises. NHS England reported around mid-May that nearly 20% of patients hospitalised with COVID-19 contracted the disease while being treated for other illnesses in hospitals. Similar figures were reported around the world: in a study involving a tertiary care university hospital in Turkey (March-May 2020), positivity rates for SARS-CoV-2 among doctors, nurses, and support staff were found to be nearly 6%, 8%, and 11% respectively.

In such dire situations, it has been necessary for hospitals and healthcare leadership to quickly adapt and reinvent patient care to ensure the safety of their frontline staff, patients, and their communities. Though hospitals and healthcare systems did struggle initially with challenges, such as overwhelming patient inflow, near-capacity occupancy, and scarcity of protective equipment and ICU beds with ventilators, they have over time also been able to strengthen and improve measures to curb virus transmission inside their facilities.

Recent data now shows that rigorous and robust infection control measures implemented in hospitals can effectively prevent the transmission of COVID-19 to visiting or admitted patients. This is a promising development since a widespread fear of contracting COVID-19 in a hospital setting has discouraged many patients to seek essential care.

New preventive measures and COVID-19 infection control in hospitals

Crisis management teams (CMT) and similar leadership in hospitals play a major role in steering the healthcare system in difficult times like these. Operational updates are required in CMT policies, admission protocols, staff and resource utilization, and treatment guidelines to restrict the virus from spreading inside hospitals.

The following are the infection control measures to help hospitals safeguard their patients and medical personnel:

1. Universal masking of all hospital staff, patients, and visitors:

The foremost preventive measure against COVID-19 in public places remains the diligent and correct usage of face masks. Hospitals must ensure proper face coverings for patients/ visitors/ attendees and personal protective equipment (PPE) for all hospital staff.

2. Testing and screening measures/ admission protocols:

• For routine consultations, patient screening must begin at the hospital gate/ entrance with mandatory temperature checks and by providing sanitizer dispensers.

• Patients with special needs and attendants must undergo isolated screening outside the building.

• COVID-19 testing facilities should be located in blocks isolated from the main hospital building.

• Fever clinics should operate outside the main hospital building for patients with flu-like symptoms.

• All hospital employees (medical and non-medical) must be screened daily at separate staff entries.

3. Personal protective equipment (PPE) in accordance with the Ministry of Health and Family Welfare (MoHFW) recommendations:

• PPE must be available for all medical as well as non-medical staff.

• Specific zones and protocols for donning and doffing personal protective equipment by hospital stall must be created.

4. Daily symptom screening for doctors and patients:

• Any healthcare personnel that might be exposed to COVID-19 must be managed and monitored.

• Communication should be effective within the hospital facility and external communication related to COVID-19 should be planned for the availability of accurate information to the wider community.

6. Dedicated non-Covid OPDs and wards:

• Separate wards, rooms, and bed spaces for non-Covid patients must be made available in separate hospital blocks/ buildings/ branches to prevent contact between patients.

• Distancing protocols must be maintained in OPDs with socially distanced seating arrangements.

• Regular sanitization of all waiting areas, consultation rooms, restrooms, and passageways must be carried out periodically.

7. Effective intra-hospital communication channels:

• The communication between frontline staff and the CMT must be continuous to mitigate and meet challenges.

• All additional/ pop-up ICUs and wards must be connected to communications systems for quick response.

8. Restricted visitor policy:

• With visitors not being allowed family meetings should be organized via web-based applications to reduce stress of the patients and their families.

9. Tele or video consultations:

Remote consultations or online appointments should be provided with doctors through video calling as per government guidelines for at-risk patients, senior citizens, and anyone hesitant to visit the hospital premises.

While the unprecedented pandemic has forced people to stay home and made them scared of visiting hospitals, the healthcare needs of patients remain ever-present and require professional care. In such a situation, reinventing hospital care and ensuring a safe environment with robust infection control protocols is an important duty for hospitals.

Carefully adapting, implementing, and following comprehensive infection control measures can prevent the spread of COVID-19 within a hospital. Educating the community about these safety and preventive measures will further help reassure patients and create confidence in the public to visit healthcare institutions. Sagar Hospitals are committed to the complete safety and health of their patients. The Jayanagar branch of Sagar Hospitals is dedicated exclusively to the treatment of non-Covid patients and out-patient consultations. Complete infection control measures, including proper distancing and sanitation protocols, have been implemented. Additionally, RT-PCR testing (the standard and reliable test for COVID-19) facilities have been kept outside the hospital premises to ensure safety for all patients and attendants. If you are suffering from non-Covid medical conditions, but are afraid to seek the required medical attention, please reach out to our experts at Sagar Hospitals for booking an appointment and receiving necessary safety-related information. Book an appointment with our experts at the Department of Preventive Healthcare at Sagar Hospitals for more information on preventive measures against dangerous illnesses and diseases.