Adaptation of an obstetric anesthesia service for the SARS-CoV-2 pandemic: description of checklists, workflows, and development tools.

BACKGROUND: Care of the pregnant patient during the SARS-CoV-2 pandemic presents many challenges, including creating parallel workflows for infected and non-infected patients, minimizing waste of materials, and ensuring that clinicians can seamlessly transition between types of anesthesia The exponential community spread of disease limited the time for development and training METHODS: The goals of our workflow and process development were to maximize safety for staff and patients, minimize risk of contamination, and reduce the waste of unused supplies and materials We used a cyclical improvement system and the plus/delta debriefing method to rapidly develop workflows consisting of sequential checklists and procedure-specific packs RESULTS: We designed independent workflows for labor analgesia, neuraxial anesthesia for cesarean delivery, conversion of labor analgesia to cesarean anesthesia, and general anesthesia In addition, we created procedure-specific material packs to optimize supplies and prevent wastage Finally, we generated sequential checklists to allow staff to perform standard operating procedures without extensive training CONCLUSIONS: Collectively, these workflows and tools allowed our staff to urgently care for patients in high-risk situations without prior experience Over time, we refined the workflows using a cyclical improvement system We present our checklists and workflows as well as the system we used for their development, so that others may use them to their benefit