Clinical Redeployment of an Academic Family Medicine Department in an Early, Severe COVID-19 Pandemic in the Bronx, NY

Balance necessity of redeployment with respect for individuals' personal and family situations

Recognize and adapt to shifts in community's health care needs

Identify and use existing expertise within the department

Quickly create structures to uptrain and support individuals in new or different roles

Identify providers who need medical accommodations

Understand the universe of clinical needs that need to be covered by the team

Acknowledge unavoidable losses including disruption of residency program, with commitment to support overall learning plans

Use consistent systems to determine how roles are distributed across department

Reassign time from suspended activities (administration, education, research) to clinical support

Plan for several layers of sick coverage

Maintain connection between socially distanced colleagues

Rapid dissemination of information

Reduce anxiety by discussing upcoming changes

Feedback on and troubleshooting of new structures and processes

Recognize a range of contributions from providers and staff in different roles

Frequent leadership huddles with medical directors and residency leadership

WhatsApp thread for rapid administrative communications eg, sick call coverage

Daily departmental e-mails that incorporate team photos, shout-outs, and quotes with well wishes from primary care patients

Weekly provider meetings for hospitalists and for primary care physicians

Adopt and/or apply clinical skills in high demand during COVID-19 surge

Reorient community health services to match patient and community needs

Provide support to a hospital system under unprecedented stress

Identify and disseminate educational resources early and on an ongoing basis

Leverage family medicine and specialist faculty for teaching on novel or newly salient clinical skills

Communicate clearly with operational leadership to support system-wide planning

Create strong relationships with experienced colleagues for coaching and/or consultation

Iterate primary care team-based workflows to meet new and shifting demands

Maximize physical safety

Maximize psychological safety

Ensure personal protective equipment (PPE) is consistently available at point of care

Implement “buddy system” to ensure providers including residents consistently follow proper PPE protocols

Deploy family physicians together as teams, instead of dispersing them in redeployment throughout the medical center

Include standard time off and sick coverage

Address concrete needs for hospital teams such as food, transportation, parking, extra scrubs