ArticleBMJ open2020
Rapid ethnographic assessment of the COVID-19 pandemic April 2020 'surge' and its impact on service delivery in an Acute Care Medical Emergency Department and Trauma Center.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed.
- Trial
- Frontline Healthcare Workers' Reflections on Operationalizing the COVID-19 Pandemic Response: A Qualitative Study.Journal of nursing management · 2026Article
- Methods for community-engaged data collection and analysis in implementation research.Implementation science communications · 2025Article
- Randomized clinical trial of peer integrated collaborative care intervention after physical injury.Trauma surgery & acute care open · 2025Article
- PEARR tool training and implementation: building awareness of violence and human trafficking in a hospital system.Frontiers in medicine · 2024Article
- Stepped collaborative care versus American College of Surgeons Committee on Trauma required screening and referral for posttraumatic stress disorder: Clinical trial protocol.Contemporary clinical trials · 2024Article
- A rapid qualitative methods assessment and reporting tool for epidemic response as the outcome of a rapid review and expert consultation.PLOS global public health · 2023Article
- Challenges and opportunities in rapid disaster research: lessons from the field in New Mexico and Vanuatu.Frontiers in sociology · 2023Article
- Integrating Rapid Evidence Generation and Synthesis in the Researcher's Methods Toolkit.Acta medica Philippina · 2023Article
- Article
- "Everything…Fell Apart Once COVID-19 Hit"-Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study.International journal of environmental research and public health · 2022Article
- COVID-19 has heightened tensions between and exposed threats to core values of emergency medicine.CJEM · 2022Article
- Qualitative Research Methods in Chronic Disease: Introduction and Opportunities to Promote Health Equity.Annual review of public health · 2022Review
- Health care workers' experiences during the COVID-19 pandemic: a scoping review.Human resources for health · 2022Article
- A Rapid Ethnographic Assessment of the Impact of the COVID-19 Pandemic on Mental Health Services Delivery in an Acute Care Medical Emergency Department and Trauma Center.Administration and policy in mental health · 2022Article
- Emergency trauma care during the COVID-19 pandemic: A phenomenological study of nurses' experiences.International emergency nursing · 2022Article
- Understanding system barriers and facilitators in transnational clinical cancer research: The value of rapid and multimodal ethnographic inquiry.Frontiers in sociology · 2022Article
- Catalyzing the Translation of Patient-Centered Research Into United States Trauma Care Systems: A Case Example.Medical care · 2021Review
- Non-pharmaceutical interventions during the COVID-19 pandemic: A review.Physics reports · 2021Review
- Clinical ethnography in severe mental illness: a clinical method to tackle social determinants and structural racism in personalised care.BJPsych open · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesAssess the impacts of the COVID-19 pandemic on service delivery by frontline healthcare providers in acute care medical and emergency department settings and identify strategies used to cope with pandemic-related physical and mental health demands.
designRapid clinical ethnography of patient-provider encounters during an initial pandemic 'surge' conducted by a team of clinician-researchers using a structured protocol for qualitative data collection and analysis.
settingLevel 1 trauma centre at Harborview Hospital in Seattle Washington in April 2020.
participantsFrontline clinical providers serving as participant observers during performance of their clinical duties recorded observations and summaries of conversations with other providers and patients.
resultsWe identified four different kinds of impacts: procedural, provider, patient and overall. Each impact highlighted two or more levels of a socioecological model of services delivery: (1) the epidemiology of COVID-19, (2) outer setting, (3) inner or organisational setting and (4) individual patient and provider. Despite significant changes in procedures that included COVID-19 screening of all admitted patients, social distancing and use of personal protective equipment, as well as changes in patient and provider behaviour, the overall impact of the pandemic on the emergency department and acute care service delivery was minimal. This is attributed to having a smaller surge than expected, a quick response by the healthcare system to anticipated demands for service delivery and protection of patients and providers, adequate supplies and high provider morale.
conclusionsAlthough limited to one setting in one healthcare system in one community, the findings offer some important lessons for healthcare systems that have yet to be impacted as well as systems that have been more severely impacted. Each of the socioecological framework levels was found to impact service delivery to patients, and variations at each of these levels account for variations in that quality of care globally.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.