Establishing a New Normal for Hospital Care: A Whole of Hospital Approach to Coronavirus Disease 2019 (COVID-19)

• Published in: Clinical infectious diseases 2021-11, Vol.73 (9), p.e3136-e3143
• Main Authors: Lum, Brandon X, Liu, Eugene H, Archuleta, Sophia, Somani, Jyoti, Bagdasarian, Natasha, Koh, Catherine S, Sin, Clara S, Wong, Mushan, Quek, Swee Chye, Fisher, Dale A
• Format: Article
• Language: English
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/ciaa1722

Abstract Singapore’s hospitals had prepared to receive patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), planning various scenarios and levels of surge with a policy of isolating all confirmed cases as inpatients. The National University Hospital adopted a whole of hospital approach to coronavirus disease 2019 (COVID-19) with 3 primary goals: zero hospital-acquired COVID-19, all patients receive timely necessary care, and maintenance of staff morale. These goals to date have been met. A large influx of COVID-19 cases required significant transformation of clinical and operational processes. Isolation room numbers almost tripled and dedicated COVID-19 cohort wards were established, elective care was postponed, and intensive care units were augmented with equipment and manpower. In the wake of the surge, establishing a new normal for hospital care requires maintaining vigilance to detect endemic COVID-19, establishing contingency plans to ramp up in case of another surge, while returning to business as usual. Singapore’s National University Hospital shares measures taken to manage surge caused by COVID-19, while maintaining essential clinical service and staff safety and morale. As massive case numbers recede, the hospital is establishing hospital practices for the new normal.