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Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic

Zoe Li Orcid Logo, Samantha Leong, Mohammad Malik, Nader Ibrahim, Claire Sin-Hidge, Rachel Clancy Orcid Logo, Thomas Dobbs, Zita Jessop Orcid Logo, Robert T. Duncan Orcid Logo, Sarah Hemington-Gorse, Tomas Tickunas, Jeremy Yarrow, Peter Drew, Dean Boyce, Iain Whitaker

Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume: 75, Issue: 2, Pages: 831 - 839

Swansea University Authors: Nader Ibrahim, Thomas Dobbs, Zita Jessop Orcid Logo, Peter Drew, Dean Boyce, Iain Whitaker

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DOI (Published version): 10.1016/j.bjps.2021.09.016

Abstract

In March 2020, South Wales experienced the most significant COVID-19 outbreak in the UK outside of London. We share our experience of the rapid redesign and subsequent change in activity in one of the busiest supra-regional burns and plastic surgery services in the UK. A time-matched retrospective s...

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Published in: Journal of Plastic, Reconstructive & Aesthetic Surgery
ISSN: 1748-6815 1878-0539
Published: Elsevier BV 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa58736
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We share our experience of the rapid redesign and subsequent change in activity in one of the busiest supra-regional burns and plastic surgery services in the UK. A time-matched retrospective service evaluation was completed for a 7-week "COVID-19" study period and the equivalent weeks in 2018 and 2019. The primary aim of this study was to evaluate plastic surgery theatre use and the impact of service redesign. Comparison between study periods was tested for statistical significance using two-tailed t-tests. Operation numbers reduced by 64% and total operating time by 70%. General anaesthetic cases reduced from 41% to 7% (p&lt;0.0001), and surgery was mainly carried out in ringfenced daycase theatres. Emergency surgery decreased by 84% and elective surgery by 46%. Cancer surgery as a proportion of total elective operating increased from 51% to 96% (p&lt;0.0001). The absolute number of cancer-related surgeries undertaken was maintained despite the pandemic. Rapid development of COVID-19 SOPs minimised inpatient admissions. There was a significant decrease in operating while maintaining emergency and cancer surgery. Our ringfenced local anaesthetic Plastic Surgery Treatment Centre was essential in delivering a service. COVID-19 acted as a catalyst for service innovations and the uptake of activities such as telemedicine, virtual MDTs, and online webinars. Our experiences support the need for a core burns and plastic service during a pandemic, and show that the service can be effectively redesigned at speed. [Abstract copyright: Copyright &#xA9; 2021. 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spelling 2022-03-16T11:47:13.6576664 v2 58736 2021-11-22 Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic f1e47991b9903dae5fc909ae0019e9b0 Nader Ibrahim Nader Ibrahim true false d18101ae0b4e72051f735ef68f45e1a8 Thomas Dobbs Thomas Dobbs true false 0184f610b62d649a59dad304e48ea03b 0000-0003-2886-9165 Zita Jessop Zita Jessop true false 8735934fa61446388936421af7149981 Peter Drew Peter Drew true false de38dbbca6639388a610ae76a25d8952 Dean Boyce Dean Boyce true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2021-11-22 HDAT In March 2020, South Wales experienced the most significant COVID-19 outbreak in the UK outside of London. We share our experience of the rapid redesign and subsequent change in activity in one of the busiest supra-regional burns and plastic surgery services in the UK. A time-matched retrospective service evaluation was completed for a 7-week "COVID-19" study period and the equivalent weeks in 2018 and 2019. The primary aim of this study was to evaluate plastic surgery theatre use and the impact of service redesign. Comparison between study periods was tested for statistical significance using two-tailed t-tests. Operation numbers reduced by 64% and total operating time by 70%. General anaesthetic cases reduced from 41% to 7% (p<0.0001), and surgery was mainly carried out in ringfenced daycase theatres. Emergency surgery decreased by 84% and elective surgery by 46%. Cancer surgery as a proportion of total elective operating increased from 51% to 96% (p<0.0001). The absolute number of cancer-related surgeries undertaken was maintained despite the pandemic. Rapid development of COVID-19 SOPs minimised inpatient admissions. There was a significant decrease in operating while maintaining emergency and cancer surgery. Our ringfenced local anaesthetic Plastic Surgery Treatment Centre was essential in delivering a service. COVID-19 acted as a catalyst for service innovations and the uptake of activities such as telemedicine, virtual MDTs, and online webinars. Our experiences support the need for a core burns and plastic service during a pandemic, and show that the service can be effectively redesigned at speed. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.] Journal Article Journal of Plastic, Reconstructive &amp; Aesthetic Surgery 75 2 831 839 Elsevier BV 1748-6815 1878-0539 COVID-19; Service reconfiguration; Plastic surgery; Service; Burns; Telemedicine 1 2 2022 2022-02-01 10.1016/j.bjps.2021.09.016 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2022-03-16T11:47:13.6576664 2021-11-22T11:51:37.6146771 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Zoe Li 0000-0003-1129-3200 1 Samantha Leong 2 Mohammad Malik 3 Nader Ibrahim 4 Claire Sin-Hidge 5 Rachel Clancy 0000-0001-7033-4901 6 Thomas Dobbs 7 Zita Jessop 0000-0003-2886-9165 8 Robert T. Duncan 0000-0001-6765-5536 9 Sarah Hemington-Gorse 10 Tomas Tickunas 11 Jeremy Yarrow 12 Peter Drew 13 Dean Boyce 14 Iain Whitaker 15
title Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
spellingShingle Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
Nader Ibrahim
Thomas Dobbs
Zita Jessop
Peter Drew
Dean Boyce
Iain Whitaker
title_short Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
title_full Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
title_fullStr Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
title_full_unstemmed Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
title_sort Rapid redesign and effect on clinical workload of a supra-regional burns and plastic surgery service during the COVID-19 pandemic
author_id_str_mv f1e47991b9903dae5fc909ae0019e9b0
d18101ae0b4e72051f735ef68f45e1a8
0184f610b62d649a59dad304e48ea03b
8735934fa61446388936421af7149981
de38dbbca6639388a610ae76a25d8952
830074c59291938a55b480dcbee4697e
author_id_fullname_str_mv f1e47991b9903dae5fc909ae0019e9b0_***_Nader Ibrahim
d18101ae0b4e72051f735ef68f45e1a8_***_Thomas Dobbs
0184f610b62d649a59dad304e48ea03b_***_Zita Jessop
8735934fa61446388936421af7149981_***_Peter Drew
de38dbbca6639388a610ae76a25d8952_***_Dean Boyce
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Nader Ibrahim
Thomas Dobbs
Zita Jessop
Peter Drew
Dean Boyce
Iain Whitaker
author2 Zoe Li
Samantha Leong
Mohammad Malik
Nader Ibrahim
Claire Sin-Hidge
Rachel Clancy
Thomas Dobbs
Zita Jessop
Robert T. Duncan
Sarah Hemington-Gorse
Tomas Tickunas
Jeremy Yarrow
Peter Drew
Dean Boyce
Iain Whitaker
format Journal article
container_title Journal of Plastic, Reconstructive &amp; Aesthetic Surgery
container_volume 75
container_issue 2
container_start_page 831
publishDate 2022
institution Swansea University
issn 1748-6815
1878-0539
doi_str_mv 10.1016/j.bjps.2021.09.016
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description In March 2020, South Wales experienced the most significant COVID-19 outbreak in the UK outside of London. We share our experience of the rapid redesign and subsequent change in activity in one of the busiest supra-regional burns and plastic surgery services in the UK. A time-matched retrospective service evaluation was completed for a 7-week "COVID-19" study period and the equivalent weeks in 2018 and 2019. The primary aim of this study was to evaluate plastic surgery theatre use and the impact of service redesign. Comparison between study periods was tested for statistical significance using two-tailed t-tests. Operation numbers reduced by 64% and total operating time by 70%. General anaesthetic cases reduced from 41% to 7% (p<0.0001), and surgery was mainly carried out in ringfenced daycase theatres. Emergency surgery decreased by 84% and elective surgery by 46%. Cancer surgery as a proportion of total elective operating increased from 51% to 96% (p<0.0001). The absolute number of cancer-related surgeries undertaken was maintained despite the pandemic. Rapid development of COVID-19 SOPs minimised inpatient admissions. There was a significant decrease in operating while maintaining emergency and cancer surgery. Our ringfenced local anaesthetic Plastic Surgery Treatment Centre was essential in delivering a service. COVID-19 acted as a catalyst for service innovations and the uptake of activities such as telemedicine, virtual MDTs, and online webinars. Our experiences support the need for a core burns and plastic service during a pandemic, and show that the service can be effectively redesigned at speed. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.]
published_date 2022-02-01T04:15:30Z
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score 11.01306

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