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Russian doll approach to COVID-19

COVID-19 created a new clinical landscape calling out for CAs to assist with new workflows.

The challenge was the pace of change, need for speed and constant iterative design. Social distancing compounded the issue as we became mindful to avoid the sort of meetings that once proved so helpful for generating consensus.

To meet these demands we actively decided to respond with the same strengths the Virus possessed. The ability to function more as a network. Adaptability became our new objective.

This made us reflect on the message by Ret. General Stanley McChrystal in his book ‘Team of Teams’ (worth a read, no affiliations). Just like their adversaries in Iraq, COVID-19 proves to be effective without a chain of command or hierarchy.

Our response was to match COVID-19 at its own game and foster the network model. Over the past few weeks we have been on a relentless mission to forge links with our partners across the globe. We love breaking down professional silos in medicine.

Our “Russian Doll” approach:

  • Forging links within our department: We worked with our awesome Perioperative Allergy Service at RNSH, to develop a cognitive aid on Amino-steroid Anaphylaxis (a highly stressful situation in COVID-19 patients). Our close links with our Incident + Quality team, also enabled us to improve our COVID-19 Operating Theatre Huddles.

  • Forging links across disciplines: As you have noticed, we’ve been working with our surgeons and Intensivists to create shared mental models and resources for Donning/Doffing, Code-Blue (coming soon) and Laparoscopic technique. We recently launched ASCAR channel to streamline the process of information dissemination.

  • Forging links domestically: We have collaborated with various tertiary and quaternary hospitals across the country to enable our aids to be customised for local use. To help the process we created ‘customisability guide’ to enable the tailoring process. We have also teamed up with the Safe Airway Society to collaborate on a set of Cognitive Aids and video that guide COVID-19 intubation.

  • Forging links internationally: We are grateful to our partners in North America who felt it appropriate and helpful to share our aids and workflow patterns. We are thinking of them during this difficult time. Check out the EMIC website for an insight into the vast network of Cognitive Aid collaborators.

As Stan McChrystal says:

“We will win the local battles by building cohesion where the battle lines meet and ensuring every locality has access to the information and resources they need to save lives”

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