![]() We identified EDs with pandemic-related telehealth programs through literature review and snowball sampling. ![]() ![]() MATERIALS AND METHODS: From September-November 2020, we conducted semi-structured interviews with ED leaders across the United States. We interviewed ED leaders who implemented telehealth programs to inform responses to the ongoing COVID-19 pandemic and future emergencies. TL DR: This article describes the alignment of an emergency department (ED) specific Forward Command structure with the hospital incident command system (ICS) and presents this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situations.Ībstract: The COVID-19 pandemic has placed unprecedented demands on health systems, where hospitals have become overwhelmed with patients amidst limited resources Disaster response and resource allocation during such crises present multiple challenges A breakdown in communication and organization can lead to unnecessary disruptions and adverse events The Federal Emergency Management Agency (FEMA) promotes the use of an incident command system (ICS) model during large-scale disasters, and we hope that an institutional disaster plan and ICS will help to mitigate these lapses In this article, we describe the alignment of an emergency department (ED) specific Forward Command structure with the hospital ICS and address the challenges specific to the ED Key components of this ICS include a hospital-wide incident command or Joint Operations Center (JOC) and an ED Forward Command This type of structure leads to a shared mental model with division of responsibilities that allows institutional adaptations to changing environments and maintenance of specific roles for optimal coordination and communication We present this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situationsĪbstract: OBJECTIVE: During the first nine months COVID-19 pandemic, many emergency departments (EDs) experimented with telehealth applications to reduce virus exposure, decrease visit volume, and conserve personal protective equipment.
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