P2 COVID-19 Spaces initiative reduces staff exposure while maintaining the quality of care

Introduction and ObjectivesThe COVID-19 pandemic brought new challenges to the healthcare system, with every patient contact a potential risk to staff. This required rapid changes to traditional working methods in order to protect healthcare staff from virus exposure, reduce staff anxiety, and manage limited Personal Protective Equipment (PPE) supplies. We aimed to rapidly implement a new strategy for ward working, which would maintain high-quality patient care while reducing staff virus exposure and PPE consumption.MethodsWe developed an integrated team working concept called SPACES (Shared Patient Assessments Cuts Exposure for Staff) to gain maximum benefit from every staff-patient contact, regardless of the individual’s team role. For example, a doctor undertaking a ward round would also perform observations, deliver meals, drinks and medication, and undertake procedures such as venesection, at one single visit saving patient contacts by other healthcare colleagues. All staff applied the same principle for each patient contact. We recorded individual staff entries into each bay (n=5) and side room (n=7) over 24 hours using the SPACES approach, and compared this to pre-SPACES estimates. We also reviewed Ward patient and staff feedback pre- and post-SPACES.ResultsWe estimated that pre-SPACES there were 97 individual staff entries into a bay of 4 patients, and 36 into each side room, per 24 hours. Using SPACES, we reduced this to a median [IQR] of 20 [12–22] entries per bay and 11 [10–16] entries per side room (p=0.06 and 0.02 respectively). This decreased PPE consumption by approximately 75%. Patient satisfaction survey responses before and after implementing SPACES were unchanged. Staff feedback on SPACES reflected high levels of satisfaction, increased sense of teamwork, and reduced anxiety of contracting COVID-19.Abstract P2 Figure 1Number of staff entries into bays and side-rooms over 24 hours with SPACES compared to estimates without. Median with inter-quartile range shown for 5 bays and 7 side rooms surveyed. P-value is Wilcoxon signed rank testConclusionsWe showed that using the SPACES initiative in a COVID-19 ward decreased staff exposure to highly infectious patients, with resultant PPE use reductions, while maintaining a high standard of patient care and strengthening team spirit and staff morale. Following our successful trial period, SPACES received support from the British Thoracic Society and the Royal Colleges of Physicians and Nursing. It