key: cord-0831003-n5nte7pt
authors: Hammersmith, Kimberly J.; Claman, Daniel B.; Townsend, Janice A.
title: Teaming up to prevent intradepartmental disease spread during a pandemic
date: 2020-07-26
journal: J Dent Educ
DOI: 10.1002/jdd.12326
sha: 631c29b0c79c462313ae1cc7def6e1126cdc560e
doc_id: 831003
cord_uid: n5nte7pt

nan

Our pediatric dentistry postdoctoral program trains 16 residents under the guidance of 9 full-time and >20 part-time faculty. We provide care in the nation's second-largest children's hospital, with ≈40,000 dental encounters per year. The pandemic drastically affected the way we provided care to our patients. Recommendations and mandates from federal, state, organized dentistry, and hospital entities made us reconsider how to provide urgent dental treatment while keeping our workforce healthy during unprecedented times. Community mitigation measures have been proposed to slow the spread of disease such as a novel influenza virus, 1 delay the pandemic peak until pharmaceutical interventions, such as vaccines, are available, and to reduce stress on health care systems. 2 However, social distancing techniques, such as working from home and spacing of 6 feet, are not applicable for clinical dentistry. Our department provides care in 6 different hospital venues. Under normal operations, this entails trainees and faculty interacting and comingling daily, along with staff and members in other departments. Pandemic guidance for healthcare settings has primarily focused on provider and patient screening and engineering controls, such as personal protective equipment. These precautions do not prevent community spread of virus from being transmitted in the workplace, threatening an entire department of exposure and quarantine.

As our usual method of providing patient care could have potentially spread severe acute respiratory coronavirus-2 (SARS-CoV-2) quickly throughout our entire department if 1 member were to become infected, we divided our faculty and trainees into discrete teams, with weekly rotations to cover hospital emergency clinic, sedation and inpatient care clinic, general anesthesia, and teledentistry. These teams, consisting of a faculty leader and either 2 or 3 trainees, occupied separate physical spaces while providing treatment, maintaining as much physical distance as possible. Subsequently, any member who contracted SARS-CoV-2 would be unable to infect anyone beyond his/her team. Additionally, as some teams worked on administrative and didactic tasks when not assigned to clinical venues, we were able to substitute these teams in the place of any team that fell ill. Our agility allowed us to maintain our commitments to patients while allowing for the possibility of quarantine and recovery time. Staff rotated similarly on teams. We continuously re-evaluated the need and structure for our teams as patient care restrictions were eased, patient volume increased, and our clinical care gradually resumed to what became a new normal.

these broad recommendations involved segregating teams caring for coronavirus disease 2019 (COVID-19) patients from other workers. 3 Others advocated for small teams to reduce the impact on personnel if quarantine were needed 4 and to separate individuals with overlapping skill sets. 5 Our mitigation plans concurred with this guidance. We kept our department safe, healthy, and agile with a team approach. To date, we have had no infections among faculty or trainees. 

Department of Health and Human Services

Nonpharmaceutical measures for pandemic influenza in nonhealthcare settings -social distancing measures

Preventing intra-hospital infection and transmission of COVID-19 in healthcare workers

Special guidelines for medical workers during the Covid-19 pandemic*

The American College of Cardiology's (ACC) Interventional Council and the Society of Cardiovascular Angiography and Intervention (SCAI), Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic