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Emergency department ‘outbreak rostering’ to meet challenges of COVID-19
  1. Wei Lin Tallie Chua,
  2. Li Juan Joy Quah,
  3. Yuzeng Shen,
  4. Nur Diana Zakaria,
  5. Paul Weng Wan,
  6. Kenneth Tan,
  7. Evelyn Wong
  1. Emergency Medicine, Singapore General Hospital, Singapore
  1. Correspondence to Dr Wei Lin Tallie Chua, Emergency Medicine, Singapore General Hospital, Singapore 169108, Singapore; tallie.chua.w.l{at}


The COVID-19 outbreak has posed unique challenges to the emergency department rostering. Additional infection control, the possibility of quarantine of staff and minimising contact among staff have significant impact on the work of doctors in the emergency department. Infection of a single healthcare worker may require quarantine of close contacts at work. This may thus affect a potentially large number of staff. As such, we developed an Outbreak Response Roster. This Outbreak Response Roster had fixed teams of doctors working in rotation, each team that staff the emergency department in turn. Members within teams remained constant and were near equally balanced in terms of manpower and seniority of doctors. Each team worked fixed 12 hours shifts with as no overlapping of staff or staggering of shifts. Handovers between shifts were kept as brief as possible. All these were measures to limit interactions among healthcare workers. With the implementation of the roster, measures were also taken to bolster the psychological wellness of healthcare workers. With face-to-face contact limited, we also had to maintain clear, open channels for communication through technology and continue educating residents through innovative means.

  • infectious diseases, viral
  • management, HR management
  • emergency department operations
  • planning
  • disaster planning and response

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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  • Correction notice Since this article first published online, the author name Diana Zakaria has been updated to Nur Diana Zakaria.

  • Contributors WLTC wrote the main manuscript and created the accompanying tables and figures. LJJQ and YS edited the manuscript based on their experience with roster making in the department. DZ and PWW assisted in gathering information relating to physician perspectives and well-being. KT provided oversight on the content of the article as Head of Department. EW provided guidance throughout the development of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.