COVID – Crisis Management in Congenital Heart Surgery Programs

by Dr. Elizabeth H. Stephens

From World Journal for Pediatric and Congenital Heart Surgery

All of us in the congenital heart surgery community have been dramatically affected by COVID, most particularly in our ability to take care of our patients. As programs across the country have faced severely decreased resources and threats to our small workforce, the leaders of our congenital heart surgery organizations have collaborated to provide guidance on the management of congenital heart surgery programs during this crisis. This document is meant to be dynamic and be applied in the context of each program’s resources and to individual patients within those settings. As the impact of COVID continues to evolve, so should our strategies in managing our programs. A key component to the success of our field in providing care during this time is our ability to collaborate and cooperate, from sharing knowledge and resources to emotional support.

Specifically within this paper, we provide guidance regarding the prioritization of surgical patients. Many factors must be considered, including resource utilization, the clinical status of the patient and the potential risk of delaying surgery, risk of exposure for patient, family, and staff, and relative needs of other patients at a given institution. Within this discussion we have provided a table of common conditions we treat and guidance on how such patients may be prioritized, which again should be considered in the context of a given institution and region and each individual patient’s condition. We also address issues relative to preserving a small workforce comprised of a limited number of providers with unique, irreplaceable skillsets. We review strategies to reduce overall exposure by modifying providers’ schedules, minimizing duplication of care, remote working for certain team members, and of course proper protection and vigilant surveillance for symptoms. We also address social distancing, the role of congenital cardiac team members in the care of non-cardiac patients, modification of training and education during this time, and the importance of mental and emotional fortitude.

While this document was created during the throes of the COVID pandemic, it presents key concepts for those facing dramatically depleted resources from any cause. Our specialty has been marked by solidarity and camaraderie, and carries a history notable for collaboration, adaptation, and readiness. These qualities are needed now more than ever.

Article Details

COVID-19: Crisis Management in Congenital Heart Surgery
First Published June 4, 2020 Research Article
Elizabeth H. Stephens, MD, PhD, Joseph A. Dearani, MD et al.
DOI: 10.1177/2150135120931398
World Journal for Pediatric and Congenital Heart Surgery

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