key: cord-1001854-jqay469v authors: Kwan, Wai-Man; Mok, Chun-Keung; Kwok, Yick-Ting; Ling, Hung; Lam, Hon-Wai; Law, Tat-Hong; Leung, Pik-Man; Mak, Man-Yu; Que, Tak-Lun; Kan, Chun-Hoi; Tang, Yiu-Hang title: Using the Systems Engineering Initiative for Patient Safety (SEIPS) model to describe the planning and management of the COVID-19 pandemic in Hong Kong date: 2021-03-03 journal: Int J Qual Health Care DOI: 10.1093/intqhc/mzab042 sha: 64e3ba2ccbd49b7557ad2d7e9497225956794738 doc_id: 1001854 cord_uid: jqay469v nan The COVID-19 pandemic has had massive impact on healthcare systems highlighting that the relatively deficient medical facilities to cater the high patient load and the shortage of personal protective equipment (PPE) to ensure staff safety are the major problems to tackle [1, 2] . Hong Kong public hospitals faced the same challenges. It is crucial for the hospital management to formulate decisive strategies through a systems approach and take swift actions to handle these situations. The Systems Engineering Initiative for Patient Safety (SEIPS) model, consisted of five main domains namely organization, person, tasks, technologies and tools, and environment, is a renowned tool which adopts human factors principles and offers a comprehensive conceptual framework in facilitating hospital management to understand its own system [3, 4] . Evidence showed that this model had been successfully applied in handling the COVID-19 pandemic [5] . The aims of this article are to apply the SEIPS model to systematically describe the strategies and actions taken by the five public hospitals in the New Territories West Cluster (NTWC) of Hong Kong Hospital Authority and examine if the SEIPS model could support organizations in planning for and managing a pandemic. The strategies and actions taken in the NTWC since the COVID-19 pandemic in February 2020 are summarized in Table 1 , and the key actions of each domain are highlighted below. The hospital management played a key leading role in formulating strategies and action plans to face the pandemic. The 'NTWC Management Committee in COVID-19 Pandemic' was set up at the outset of the pandemic by the Cluster Chief Executive (CCE) who oversaw the hospital operations. This Committee, consisted of key hospital leaders, served as a communication platform for all stakeholders to continuously monitor the rapidly changing situation, make swift decisions and disseminate important messages. The CCE also communicated closely with the Hospital Authority Head Office and other regional clusters on the strategic approaches at the corporate level. COVID-19 is a newly emergent disease without effective cure to date [6] . Keeping staff's knowledge updated on the management and infection control precautions is important to ensure staff safety and alleviate fear. The formation of designated clinical COVID-19 teams including anaesthesia and physiotherapy allowed staff to acquire clinical experience in handling COVID-19 patients. Evidence also showed that healthcare professionals had high burnout due to workload and stress in the pandemic [7] . Therefore, rapid psychological support including support kits for quarantined or infected staff and stress management and resilience workshops was available to support the well-being of the workforce. Shortage of PPE supply has been a global issue since the pandemic. The PPE standard was regularly adjusted according to the latest understanding of the disease. The Infection Control Team is responsible for updating relevant guidelines and informing staff the required standards for infection precautions [1, 8] . A PPE taskforce was formed to closely monitor the stock, supply and consumption of PPE in the cluster and ensure staff wearing PPE rationally and appropriately through unit visits. In order to ensure social distancing and reduce patient encounters in hospitals, telemedicine was introduced in services like rehabilitation, psychiatry and allied health in the NTWC to provide patient access to care [9] . Since it was a new service model to the NTWC, further study on the staff and patient satisfaction has to be conducted to evaluate its effectiveness. Stringent precautionary measures were taken at hospital entrances to reduce people traffic and perform screening of febrile visitors. Foreseeing the admission pressure of COVID-19 patients, the NTWC management proactively converted some general medical wards to isolation facilities to hospitalize suspected and confirmed COVID-19 patients. Air quality including air flow and exchange was maintained by the Facilities Management Unit to meet the required infection control standards. Triage and Test Centres were also set up at the Accident and Emergency Departments which were successful in segregating patients with suspected COVID-19 symptoms at designated areas before consultation. The SEIPS model was used to describe the work taken by the NTWC in combatting the COVID-19 pandemic. It highlights the importance of systems thinking in different aspects from the staff to the organization to ensure that a comprehensive management framework is planned, implemented and monitored in a pandemic. Critical supply shortages -the need for ventilators and personal protective equipment during the COVID-19 pandemic Challenges and issues about organizing a hospital to respond to the COVID-19 outbreak: experience from a French reference centre Human factors systems approach to healthcare quality and patient safety Work system design for patient safety: the SEIPS model Using the Systems Engineering Initiative for Patient Safety (SEIPS) model to describe critical care nursing during the SARS-CoV-2 pandemic (2020) Coronavirus Vaccine: When Will We Have One? Darlington: The BBC Factors contributing to healthcare professional burnout during the COVID-19 pandemic: a rapid turnaround global survey Coronavirus: hospitals must learn from past pandemics The time is now: a guide to sustainable telemedicine during COVID-19 and beyond All authors contributed to the design and strategies. WK, CM and YK contributed to the manuscript. All authors read and approved the final manuscript. No ethical approval is required as no staff or patients are involved. The authors received no funding in conducting this study.