Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study. Issue 2 (22nd February 2021)

• Record Type: Journal Article
• Authors: Dutta, Usha; Sachan, Anurag; Premkumar, Madhumita; Gupta, Tulika; Sahoo, Swapnajeet; Grover, Sandeep; Sharma, Sugandhi; Lakshmi, P V M; Talati, Shweta; Biswal, Manisha; Suri, Vikas; Singh, Mini P; Ghai, Babita; Chhabra, Rajesh; Bharti, Bhavneet; Samanta, Jayanta; Arora, Pankaj; Mohindra, Ritin; Malhotra, Sunita; Singh, Gurmeet; Guru, Rashmi Ranjan; Pandey, Navin; Koushal, Vipin; Kumar, Ashok; Bhogal, Ranjitpal Singh; Aggarwal, Arun K; Goel, Kapil; Malhotra, Pankaj; Yaddanapudi, Narayana; Mahajan, Pranay; Thakur, J S; Sehgal, Rakesh; Ghosh, Arnab; Sehgal, Inderpaul Singh; Agarwal, Ritesh; Jayashree, Muralidharan; Bhalla, Ashish; Jain, Sanjay; Kochhar, Rakesh; Chakrabarti, Arunaloke; Puri, Goverdhan Dutt; Ram, Jagat;
• Is Part Of: BMJ open. Volume 11:Issue 2(2021)
• Publication Date: 2021-02-22
• Subjects: health policy -- human resource management -- health & safety -- clinical governance -- international health services -- organisation of health services; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-043837
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. Setting: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. Participants: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. Results: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. Conclusion: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.