Table 2

Summary of key themes

Departmental reconfigurationLimitations created by the physical estates when ‘zoning’ the ED.Use of Perspex screens.
Temporarily using fire exits as ambulance entrances.
Performing AGP delivery outside the ED where feasible.
Relocating services away from ED.
Unpredictable number of ED attendances affecting departmental ‘zoning’.Phased zoning informed by daily operational meetings.
Mobile equipment trolleys.
Patients with ‘incidental COVID-19’ being triaged to non-COVID-19 zones.Screening chest radiographs.
Increased use of CT chest.
Clinical pathwaysDeveloping clinical pathways for a novel condition.Cohort patients into five groups according to observations and investigations.
Early escalation of care decisions to facilitate patient cohorting.
Mobile emergency rapid intubation teams to facilitate specialist airway management.
WorkforceStaffing an additional zone in ED, including ensuring appropriate senior cover.Augment ED workforce with staff redeployed from other clinical areas.
Review of rotas to extend senior cover.
Maintaining staff well-being and managing staff expectations.Well-being hubs.
Access to psychological support.
Introduction of ‘NOVID’ and ‘wobble’ rooms.
Rotating staff between zones.
Governance and communicationCommunicating frequently changing information.Use of social media, messaging services and daily team briefings.
Timing team briefings after daily operational meeting.
PPEStaff anxiety around effectiveness of PPE.Single source of information on PPE to aid communication.
  • AGP, aerosol-generating procedure; PPE, personal protective equipment.