General Santos Doctors’ Medical School Foundation Inc.

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Process Improvement Approaches for Increasing the

Response of Emergency Departments against the
COVID-19 Pandemic: A Systematic Review

In Partial Fulfillment of the Requirements in NCM 122

For the Degree of Bachelor of Science in Nursing

Submitted By:

MENCHAVEZ, DAVE-DAN MICHAEL B.

Submitted To:

February 2023
 SUMMARY

The COVID-19 pandemic has had a significant impact on the dynamics of

Emergency Departments (EDs) across the world, emphasizing the importance of

addressing various operational inefficiencies. Reduce the quality of care given to

infected patients. The EDs are still fighting this epidemic by applying tactics that

maximize their performance in an unstable healthcare environment. However, given the

increasing number of admissions and the severity of the coronavirus sickness, the

efforts have been insufficient. As a result, the major goal of this research is to conduct a

literature analysis on process improvement interventions aimed at boosting. The based

on the inadequacies identified in the realistic situation, the ED reaction to the present

COVID-19 epidemic will be used to define future research lines. As a result, we used

the Preferred Reporting Items for Systematic Guidelines for Reviews and Meta-

Analyses (PRISMA) to conduct a review of research articles published between

December 2019 and April 2021 utilizing ISI Web of Science, Scopus, PubMed, IEEE,

Google Scholar, and Science Direct databases. The publications were further

categorized based on the study domain, primary goal, journal, and year of publication.

A total of 65 publications published in 51 journals were found to meet the inclusion

criteria. Our analysis discovered that the majority of apps were aimed in predicting

health outcomes in COVID-19 patients using machine learning and data analytics

approaches. To improve ED performance under social-economic constraints, healthcare

decision makers are highly advised to mix artificial intelligence tools with approaches

from the operations research (OR) and quality management domains.

 NURSING IMPLICATIONS

The SARS-CoV2 (COVID-19) sickness initially occurred on December 30, 2019, in

Wuhan, China, and is expected to continue affecting the worldwide population soon. COVID-19

clinical indicators range from non-symptomatic infection to severe pneumonia and mortality. In

terms of healthcare, the rapid and unexpected spread of COVID19 over the world in

approximately four months in 2020 has had a huge impact. Because of the massive, irregular,

and overwhelming number of infected patients expected to attend the emergency rooms (EDs)

of the afflicted nations. The COVID-19 impact is significantly more severe in areas with limited

infrastructure and inadequate emergency department readiness to catastrophes, which have led

to higher illness and mortality rates compared to more developed nations, must be addressed.

Without considering the enormous number of cases (164.5 million cases and 3.4 million deaths

worldwide as of May 20, 2021 burden on the emergency care systems' financial resources.

Numerous EDs are currently operating at or close to full capacity due to the circumstances

detailed below. In pandemic conditions with anticipated demand peaks, EDs may find it difficult

to carry out their functional tasks and built capacity may no longer be functional and to fulfill this

requirement. The patients' worsening waits times and overcrowding, as well as the high rates of

patients leaving emergency care wards without being seen (LWBS), are indications of this.

Additionally, there is a concerning increase in the number of COVID-19 patients who are in

increasingly serious health conditions, which, when combined with the growing demand places

a heavy burden on EDs globally. Knowing this, the decision-makers are then counseled to

swiftly deploy strong emergency care configurations to lessen the pandemic's effects, thereby

reducing the burden placed on the stakeholders (i.e., healthcare authorities, COVID-19 patients,

and health professionals) involved in this service as the pandemic develops. The COVID-19's

acceleration characteristics the infection requires adaptable EDs to reconfigure their systems in

order to distribute limited resources to save the most lives possible. The possible clinical
consequence on this study are the risk of bias assessment, dealing with the missing data, and

heterogeneity evaluation. The devastation caused by COVID-19 and the complexity and multi-

causality of EDs necessitate solutions that combine many study areas from the field of industrial

engineering. By doing so, the decision-making process will be supported — increasing their

response to the present pandemic inside these units.