In Aotearoa New Zealand, this section should be read in conjunction with the New Zealand Pandemic Action Plan [Link].
 
In Australia, this section should be read in conjunction with Federal, State and Territory Plans:

  • Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) [Link]
  • ACT [Link]
  • New South Wales [Link]
  • Northern Territory [Link]
  • Queensland [Link]
  • Tasmania [Link]
  • Victoria  [Link]
  • Western Australia [Link]

We recommend the following:

  1. That ED leadership are actively involved with the Hospital Incident Management Team (HIMT), or equivalent, which should have been activated during the Preparedness / Standby phase of pandemic planning (Australia) or the Keep it out/ Stamp it Out (Aotearoa New Zealand) phase of pandemic planning. Active involvement of the ED in the HIMT and broader hospital planning, through direct membership or consultation, will facilitate collaboration with all areas of the hospital, which is essential for the complete and integrated, whole-of-hospital response to a pandemic. 
  2. That the hospital pandemic plan is consistent with state and federal guidelines and that, where possible, these plans are used without modification.
  3. That the hospital pandemic plan should include all aspects of the standard Health Incident Management Plan. These will have differing titles in different jurisdictions but should include: 
    • Command, Coordination, Control. 
    • Planning, including structural elements and staffing required for different stages of pandemic response. 
    • Recovery. 
    • Communications (both external and internal).
    • Operations (business as usual plus pandemic response including clinical protocols, infection control). 
    • Logistics (supplies and workforce). 
    • Intelligence (data gathering).
    • Investigation.
    • Finance. 
  4.  The ED should not duplicate activities undertaken by the HIMT, but should provide input to ensure the plan fulfils the needs of the ED and its patients, whilst supporting the rest of the healthcare sector in managing the pandemic.
  5. FACEMs should develop clinical guidelines in conjunction with relevant colleagues, including infection control, to ensure a consistent approach to patient care.
  6. Code Brown should not be the primary response to a pandemic. Unlike a mass casualty event, time is available and should be used for planning and preparation, in order to avoid or delay the need for a Code Brown response. If Code Brown is used, there should be a clear, defined benefit over and above that of the hospital’s pandemic plan.
  7. EDs have a robust system to cope with sick leave due to exposed staff having to be isolated, so that the department is still able to cope with the workload.
  8. ED leaders advocate for the development of co-ordinated systems across different healthcare networks for the provision of staff in the event of localised workforce depletion
  9. ED leaders advocate for the continued ability to provide clinical resources to services reliant on a FIFO medical workforce or which State cross borders

We align with the following resources:

  1. Australian Government, Emergency Response Plan for Communicable Disease Incidents of National Significance: National Arrangements. [Link]
  2. Australian Department of Health National Communicable Diseases Plan. [Link]
  3. Management of Respiratory Disease Outbreaks: including Severe Influenza, Pandemic Influenza and Emerging Respiratory Illness. Australasian College for Emergency Medicine [Link]
  4. United States Centers for Disease Control and Prevention Checklist for Health Services. [Link]

This document should be read in conjunction with relevant ACEM standards, including:

  • G26 Guidelines for reducing the spread of communicable infectious disease in the emergency department. [Link]
  • Measures to decrease ED demand
  • Measures to increase ED capacity
  • Measures to maintain healthcare system flow
  • Measures to improve communication
  • Section disclaimer
  • Resources
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