Preparing Your Institution for COVID-19, part 1 of 3: COVID-19 Patient Flow

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Target audience:  Healthcare managers and senior clinical staff in LMICs.

Aim: To help managers of healthcare institutions prepare their institution for the arrival and escalation of a COVID-19 epidemic.

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This short video focuses on how health facilities should prepare for the spread of COVID-19 coronavirus in sub-Saharan Africa.

It emphasises WHO recommendations and is based on a document by Dr David Weakliam, Director of Ireland’s Health Service Executive Global Health Programme

Implementing a health service response to COVID-19 is part of a wider national, local and population-based response to control the epidemic. Population measures are of utmost importance but are not the focus of this video.


There are 3 priority objectives: To manage flow of COVID-19 patients. To protect the welfare of your health care workers. And to maintain essential health services.

Your plan must be communicated clearly to all staff and patients. And backed up by visible posters and signs.


Consider the physical structure of your building. You will need to provide hand washing facilities in multiple locations for staff, and ideally for patients.        

ALL patients attending the hospital, even those attending for routine appointments or following injury, should enter through a single-entry point. At entry, ALL patients should be questioned, and temperature measured. As Covid 19 circulates more widely, all patients with fever, cough, breathlessness or severe lethargy could be Covid 19 positive and should not gain entry to the hospital until completion of a clinical assessment.

Consider erecting temporary structures, tents for example, within the hospital grounds to provide a suitable COVID 19 assessment clinic. Following this assessment, ANY patient who may be suffering from COVID 19 needs segregation from other patients.

All health facilities should plan for some weeks of increasing Covid 19 activity likely to overwhelm existing hospital capacity. Advance planning to cope with such a surge is critical and may involve utilisation of adjacent buildings or additional field hospitals. Consider also how to mobilise additional staff and consumables when demand increases.

Separating possible COVID-19 patients from others is essential. Admitted patients should be housed in a COVID19 isolation unit, as physically separate from the main hospital as possible. This will allow the remainder of the hospital to function as close to normal as feasible.  If complete isolation of such patients is not feasible, Covid 19 patients should be cohorted together, but away from other patients.

All healthcare staff involved at screening, assessing, or caring for potential Covid 19 patients should be wearing personal protective equipment as far as this is possible.

The number of staff caring for each patient should be kept to a minimum. And staff caring for a cohort of COVID 19 patients should not mix with staff or patients from the main non-COVID 19 hospital during their shift.


Voice over: Elias Phiri

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Bumba Crossing by Kevin MacLeod is licensed under a Creative Commons Attribution licence (…) Source:… Artist:

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