https://muj.journals.ekb.

eg
Medicine Updates [email protected]
Faculty of medicine [email protected]
January 2021,volume 4, issue 4 DOI: 10.21608/muj.2020.51668.1036

ISSN : 2682-2741

Submitted: 33/11/2020
Accepted : 17/12/2020 Pages:103- 119

" HOSPITAL CRISIS PREPERDNESS PLAN

FOR COVID-19 pandemic "
Clinical Pharmacist: Ahmed ELSukkary
Nurse: Iman Rizk
Nurse: Rania Rabee 'Abd Al-Ghani
Nurse: Samar Bakr Al-Sanusi
Nurse: Marwa Salah Ali Muhammad
Nurse: Maha Al-Saeed
ABSTRACT

Background: Healthcare facilities like ( Hospital , clinics , Pharmacies … etc. )

have a vital role in response to emergencies on an international and local scales ,
as in infectious disease epidemics , The readiness of hospitals facing pandemic
threats like pandemic like ( SARS-COV2 ) in appropriate way is dictated to huge
extent by health infrastructures of countries and local regions.
During this pandemic many facilities have a chance, even with all risks and
challenges that is the facility facing, to provide a special service and have a
chance to make a remarkable contribution to healthcare infrastructure in their
countries by making their organizations a value-based model.
The main goal of this plan is to ensure that Hospital management has held
effective policies and procedures for implementing a program for Emergency
Risk management plan capable to facing effectively risks like pandemics,
providing perfect services in flied where mistakes costs a lot.
Results
 Application of such steps make an approach to save healthcare team.
 Avoid nosocomial infection.
 Save available resources and life.
 Increase hospital income to face financial in-situ challenges.
 Better coordination, collaboration and leveraging will result into a more
effective response. Preparedness if there is more waves of same virus or
bioterrorism.

Conclusion & Recommendation

Pandemic will have a vast temporary or even permanent change to few services.
Market condition could trend as mixture of suffered practices, low income.
Hospitals and healthcare system leaders have a chance to make a remarkable
contribution to healthcare infrastructure in their countries by making their
organizations a value-based model.
by using business strategies of cost effectiveness.
On micro level all services should be permanently redesigned. On macro level,
stimulus funding, government aids and charities help in expenses specially in
outpatient facilities and give a push to these business models.

We recommend Hospital also to have a good communication channels with

other hospitals in the area, with Vaccine Center in country as in case of vaccine
availability to be enrolled in list of eligible. Also, if there is a possibility to held
clinical trials that will not conflict with the current event, it should be ran out
with taking all ethical, medical, academic criteria on consideration, as it’ll be.
Key words: Medication, Safety, Pharmacy, Health, Project, Hospital
preparedness plan, Crisis management.

Introduction
Corona virus’s family is an important and famous pathogen all over the world
to human and animal. At November 2019 a Novel family member has been
identified as the causative pathogen of a cluster of pneumonia cases in Wuhan
City located in Province of Hubei, China. Spreading rapidly resulting in outbreak
in China then invading all foot step on earth.

The source of SARS-CoV-2 remains unknown.

Although, available scientific community suppose that it is zoonotic origin
possibly came along from undomesticated animal species or an intermediate
vector (animal or one of its waste). transmission between humans confirmed in
Wuhan, China.

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many healthcare providers there has caught this infection in their healthcare
facilities where they work with nearly the similar clinical symptoms.
Most popular symptoms are Fever, Coughing and chest tightness that
differentiate its severity according to each case.
After its outbreak in China a cluster of cases appeared in other countries.
In the first of 2020 specifically February 2020, The World Health Organization
Called the new spreading pandemic caused by the SARS-CoV-2 (Covid19)
Which is an abbreviation to Corona Virus disease 2019.

Reference:
- US National Library of Medicine National Institutes of Health
- WHO Timeline - COVID-19
- Egypt MOH Protocol for COVID19

Aim of the work

 Provide a guide to follow when facing Covid19 Surveillance in Hospitals

or any healthcare facility having the same setting.
 Putting a standard to follow in the management of Covid19 Patients.
 Provide a guide to make maximum benefit and the minimum waste of
resources available Like (Laboratory testing / PPE / Beds etc.).
 Applied as a tool for quality control/audit helping for COVID-19
surveillance and infection control / Supply management / Human
resources and prevention program.
Vision: Hospital Free from Covid19

Mission: Provide patient tracks that prevent infection to Health care team

Goal: Establishing effective system that manage all requirement of

COVID-19 suspected/confirmed patient treatment.
By the End of march 2020 The Hospital will be ready to receive Covid19
patients.

Scope: COVID-19 suspected/confirmed patient

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 Methodology

General Principal:
Readiness to face any emergency or hazard. Risk management program
should be on standby mood to be able to have Emergency response when it’s
needed rapidly.

Hospital Emergency Committee

A multi-sectoral coordination planning committee has been created to
overseeing cross multi-level preparedness and response activities of the
COVID-19 outbreak, chaired by the Chief medical director.
Also there will be a Project manager chaired by A Hospital vice president
.
- The Hospital Emergency Management Committee should must be
consist of representatives of Hospital mail activities ( Medical affairs,
Nursing care, pharmacy services, emergency department services,
infection control, Laboratory & screening services, administration,
engineering and maintenance sector, administration, human resources
management, food & beverage services, laundry, waste management and
cleaning).
- It’s responsible for developing strategic and action plans, ensuring
operational readiness for any COVID-19 outbreak, also reviews and
endorses the decisions provided by MOH.
- They meet weekly to coordinate preparedness and response; meeting can
be virtual if there is another consideration.
- Each meeting should be recorded and documented to be edited for any
updates or new decisions.
 Responsibilities & tasks of the Hospital Emergency Committee:
 Hold Emergency Risk management plan to maintain coordination between
different sectors of hospital maintaining risk assessment, prevention,
preparedness, response and recovery.
 Provide Hospital with Emergency plan respond to all-hazards, build
policies and specify plans that deals with internal and external types of
emergencies.

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 Responsible for:
- Evaluation of risks that hospital is exposed to.
- Put measuring criteria that reduce emergency risk.
- Define activities and resources needed to the hospital to be prepared
facing an emergency.
- Define methods of evaluation for example: (SWOT Analysis) of hospital
services and emergency preparedness (i.e., staff training)
- Forming algorism for the facility incident management and a general
response plan.
- Pass readiness activities in cooperation with other entities on the health
system theatre, including other healthcare facilities working in the area
and neighboring private and public-sector healthcare centers.
- Setting up communication channels with non-government health or non-
health authorities, volunteer organizations and other businessmen, leaders
or influencers.
N Department NAME Title
1 Hospital administration
2 Infection control/hospital epidemiology
3 Public relations adviser/public information
coordinator
4 Medical staff (e.g., physician, surgeon, physical
therapist, etc.)
5 Nursing management administration
6 Human resources management (employee
recruitment, training and development,
performance appraisal)
7 Facility personnel representative (e.g., union
representative)
8 Occupational safety and health administration
9 Critical care unit
10 Accident & emergency department
11 Engineering and maintenance
12 Environmental (housekeeping) services
13 Security
14 Diagnostic imaging (radiology)
15 Staff development/education
16 Pharmacy administration
17 Data storage & Information technology
18 Purchasing agent / Supply chain
19 Laboratory & Screening services

- Assign a hospital epidemiologist / Microbiologist / clinical Pharmacist or infectious disease

specialist with the authority declaring for early warning and surveillance in the facility,

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analyzing data and evaluating Level of threatening.

- Assign responsible staff for coordinating preparedness planning, including a COVID-19

response coordinator (with back-up).
They are responsible for a colossal scope of actions needed to comply to a specific
emergent situation.
These actions, which are the base of the facility’s incident management system, can be
divided according to 5 main functions:
1. Response, recovery management and coordination tasks (Take command and making
decisions).
2. Response and recovery planning function (Develop awareness of current situation,
specify objectives and response and recovery strategies covering the timeframe of the
epidemic or other emergency)
3. Logistical function (calling and expanding the necessary resources and maintaining of
the infrastructures or setting it up if needed)
4. Operational management function (Grantee the availability and re-distribution of
skilled staff and other resources to react directly to complication arising from the
emergency).
5. Administrative function (Paying bills, tallying costs, tabulate debts, holding up
contracts).

Department
N Name Title Contact Nu

Back-up team
Department
N Name Title Contact Nu

The Incident Action Plan

It is a document adopted by the Incident Command Group in hospital. Mainly it
is a development of the facility emergency Response Plan to the demands & the
needs and current situation of emergency and is revised as the emergent so its
parameters improve. It declares how could the hospital respond to such nascent
situation. It assigns a person who will be responsible for providing estimates of
the available resources and the additional needs to complete these tasks.
It also presents a standard measure against which progress in achieving the
hospital’s response objectives can be done.
- List of all hospital services in priority order.
List of hospital services that must provide at any time with any circumstances.

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- update the effective admission and discharge criteria According to priorities
decided.
Criteria and Protocols for patients discharge from isolation (i.e., becoming
noninfectious) without needing for retesting:
o For cases with symptoms: 10-14 days after onset of symptom, + at
least three additional days with no symptoms at all (including no fever,
no pyretic intake and without any respiratory symptoms)
o For cases without symptoms: 10 days after testing positive for SARS-
CoV-2
- Ensure Two ways communication between the Hospital incident management
group & the concerned stakeholders inside & outside the hospital.
- Appoint a team of social workers and psychiatrist to provide physical support
for both (healthcare workers, patients and their families)
- Assign responsible staff for applying Healthcare Quality criteria during
pandemic to assure health service did not affected with stress and overload.
- Economic and financial expert is applied as a consultant during the pandemic
to set a strategic plan for fund raising and expenses cost.

Respiratory Triage & Isolation

• Set a protocol for triage for seek of ensuring that patients with acute
respiratory infection are recognized.
a. utilizing from screening surveys \ questionnaires following the updates of
case definition” Respiratory Triage checklist”.
b. Recommended suitable PPE during the pandemic, according to the workplace,
personnel, and type of activity.

• Create an equipped triage station at the gates or entrance of the hospital,

supported by trained healthcare provider.
• Allocate an exclusive waiting and examination area for patients complaining
of fever and/or respiratory symptoms. The area should be well ventilated, away
from other cases and secure.
• Appoint a triage supervisor responsible for daily revision of all triage
operations.
• Ensure at least a distance of one-meter between beds regardless of whether
patients are suspected of having COVID-19.

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 Admission
• Establish Diagnosis and Treatment Protocol for COVID-19.
• Ensure General measure Avoid mixing of suspected and confirmed cases.
• Cases should be admitted in different rooms under Negative pressure or HEPA
filter unit each with separate toilet, in case of large rooms similar cases of same
severities put together with plastic non transparent curtains between beds that is
cleaned regularly also if a public toilet should be ensured that is cleaned before
and after each use.
• Check the availability of oxygen supplies and means of respiratory support, in
addition to sufficient sedation for intubated patients.
• Narrow visitors to those essential for patient support.
• Ensure visitors apply all precaution and wearing suitable PPE.
• Having a record of all persons entering the patient’s room- including facility
staff and visitors.
- is necessary.
Patient Transport

• Avoid transporting patients from their rooms or area unless medically

necessary.
• If transportation is needed, the patient uses a medical mask, use safe transport
tracks to limit exposure for all surrounding people in the facility (Staff, patients,
visitors).
• Ensure healthcare providers who are transporting patients applying hand
hygiene and wearing suitable PPE.
• Alert the area which will receive the patient to create any precautions needed
as early as possible before the patient’s arrival.
• There should be a safe track for patient and healthcare providers away from
infected patients with good ventilation.
• Each property (bed – tray – ambulance … etc.) used Must Be disinfected with
prober technic to avoid transmission of pathogens.

Infection Prevention & Control

• Ensure that healthcare providers are following standard precautions for all
patients.
• Verbal instructions, informational posters, cards, etc. should be provided all
around the facility to ensure that healthcare providers, patients, and visitors are
aware of precautions of hand hygiene, respiratory precautions, appropriate PPE
to wear and prevention of healthcare-associated infections.

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• Hand hygiene (water, soap, paper towel, alcohol-hand rub) situations, and
waste trashes are distributed across the hospital at strategic locations.
• Ensure all healthcare providers wear Rubber gloves, masks and closed shoes
before starting cleaning and disinfection process.
Before starting the disinfecting and cleaning process, skin areas must be
protected and the exposed areas of the body, such as arms, must be protected by
wearing a waterproof apron or wearing a thick clothing.
Protection of eye may be needed if there is a risk of using chemicals aerosols,
vapors or sprays.
These tools should be disposed after the completion of the process.
• Contact precautions Must be followed for both suspected or confirmed
COVID-19 cases.
• All researches and protocols recommend against spraying people with
disinfectants (such as using sterilization rooms and gates) as this practice can be
harmful and will not reduce the ability of the infected person to be infectious.
• Avoid misuse or mixing disinfectants and other cleaning chemical during the
disinfection process to avoid the release of toxic gases that may lead to health
problems.
• Ensure healthcare providers having airborne precautions while aerosol-
generating procedures (invasive and noninvasive), such as tracheal intubation,
non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual
ventilation before intubation, bronchoscopy, collection of nasopharyngeal
swap/aspirate and autopsy.
• Clean and disinfect surfaces routinely which the patient is in contact.
• Provide equipment that is either single-use and disposable or if equipment
needs to be shared (e.g., stethoscopes, blood pressure cuffs, thermometers, food
trays) among patients, clean and disinfect between use for each patient (e.g., by
using Diluted Chlorine Solution 0.5 % or ethyl alcohol 70%).
• Nasal canulae and oxygen masks and should be disposable (single-use).
• Laundry, food service utensils and medical waste must be disinfected or
discharged in accordance with safe routine procedures.

Healthcare workers (HCWs)

• An exclusive team of HCWs should be designated to give care for suspected

or confirmed cases to reduce the risk of transmission.
• Choosing them should follow a restricted criterion and avoid staff of high-risk
group.

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• Ensure that all staff members receive training on precautions of contact,
droplets, and airborne when dealing with patients (including donning and
doffing, hand hygiene, respiratory hygiene, correct use of PPE, masks tested for
fitting, etc.).
• Trace and call all healthcare workers who had protected (proper use of PPE) or
unprotected (without wearing PPE or PPE used improperly) exposed to
suspected or confirmed patients with COVID-19.
• Ensure that adequate personal protective equipment (PPE) (i.e.,
medical/surgical masks, N95/FFP2 respirators, gloves, gowns, eye protection) is
accessible to staff.
• If the supply of PPE is limited, prioritize staff caring for cases.
• Designated skilled ward staff to work in rate and demand areas (e.g. infectious
disease wards, emergency and intensive care units) to support surge.
• Provide training and on situ exercises related to areas of need, including
following infection prevention and control procedures and policies, clinical
management, to ensure staff safety.
• Prioritize staffing needs by unit or service and distribute personnel
accordingly.
• Estimate staff absenteeism in advance and monitor it continuously.
• Readiness and trained to meet an increased demand for health services (Surge
capacity) is a cornerstone of the overall approach to managing health
emergencies. It has implications for the functioning of the entire hospital.

Laboratory
• Ensure the availability of basic laboratory testing (e.g., complete blood count,
electrolytes, blood gas analysis, blood culture, biochemistry profile, and sputum
examination).
• Train staff on packaging and transportation procedures for specimen according
to national and international transport regulations and requirements.
• Laboratory Must follow biosafety measures and comply with national
guidelines or these provided in the WHO Laboratory Biosafety Manual.
• The hospital laboratory provides critical services for several essential hospital
activities, such as surveillance, infection prevention and control, and patient
management.
• WHO guidelines for collecting, preserving, and shipping specimens must be
followed.
• Adoption of standardized laboratory procedures, checklists, forms and log
sheets.

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• Laboratory waste discharge ad management, cleaning must be given high
priority among the hospital’s activities.
• Prioritizing laboratory activities should strike a balance between the need to
identify causative agents of an epidemic and the need to ensure continuity of
routine testing activities.
• contributes to the safety and efficiency of operations and facilitates exchange
of information and cooperation on laboratory management not only in the
hospital but also between hospitals and throughout national, regional and
international laboratory networks.

Radiology Services

• Ensure sustainable radiology operations and restricted pathways for COVID-

19 PLAN.
• Central coordination for COVID-19 preparedness for messaging between
hospital infection control and the radiology department.
• Standard, droplet and contact precautions.

Operating Room (confirmed or suspected COVID-19 Patients)

• will not be brought to Post-Anesthesia Care Unit (PACU) or holding areas.
• will be managed in a designated Operation Room-Other than major one-to
minimize staff & patient exposure.
• Will be recovered in the designated Operation Room or transferred to ICU into
a room with negative pressure or well-ventilated single room with portable
HEPA filter.
• Ensure a high-quality Heat and Moisture Exchanging Filter (HMEF) can
remove at least 99.97% of airborne particles of 0.3 microns or greater is placed
between the endotracheal tube (ETT) and reservoir bag during procedure to
avoid contaminating the atmosphere.
• Plan forward to provide space of time to allow all staff to wear PPE and
barrier precautions.
• Limit the number of staff in the room to the absolute minimum required for
the care and support of the patient without exposing patient or healthcare staff
any hazard.
Recommendation:
 Consider early intubation to avoid the risk of a crash intubation when it’s a
matter of life and no time to apply PPE safely.
 Apply Disposable mask, goggles, footwear, gown and gloves. Look for the
double glove technique if it’s available.
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 N95 masks at a minimum shall be utilized. Powered air purifying respirators
(PAPR) devices may offer superior protection when dealing with an airway of
an infected patient.
 Application of Standard American Society of Anesthesiologists monitoring
must be applied before induction of anesthesia.
 Atomized local anesthetic can aerosolize the virus, so Avoid awake fiberoptic
intubation, unless specifically indicated.
 Assign the most experienced anesthesia professionals available to perform
intubation.
 Seal all used airway equipment in a double zip-locked plastic bag. It must then
be removed for decontamination and disinfection.
Logistics
 Logistics contain under it meaning many activities as transport, warehousing,
procurement, stock monitoring, tracking and reporting.
 Logistics calls for a proactive and anticipatory management approach.
 Stockpiles and chain supply management of special Medicine, tools and
equipment (such as antimicrobial and antiviral medicines and personal
protective equipment) are needed in readiness for a possible increased demand
during an emergency.
 The core function of the hospital’s Incident Command Group is to provide
coordination of logistics between the various hospital departments.
 Giving support for transport of the patient is an essential logistic function
include transfer of patients between hospitals, especially referral hospitals.
 Major disasters (i.e.: epidemics) can put severe burden on functions of
logistics: To overcome these complications we require the coordination of
other partners and stakeholders (including other, possibly private-sector,
hospitals) and opening the communication channels with charities or public
fund.
 Ensuring the readiness & availability of back-up of resources and support for
the maintenance of essential equipment are very important logistic functions.

Hospital pharmacy
 During an epidemic, having essential medicines available at any time for
patients and feed different departments of the facility is critical to efficient
management of patient overload and to the continuity of hospital services to
non-epidemic patients.
 In many hospitals, maintains stocks of medicines and other healthcare
necessities (such as blood, oxygen, solutions, vaccines, laboratory reagents and
disinfectants) in readiness for an emergency is on the burden of the pharmacy,
so this must be managed in professional way.

441
 The need for medicines and protective equipment will depend on the rate of
consumption, nature of the emergency and the risks it poses.
 The pharmacy may participate in the management and redistribute of
donation include the medicines received from local, national or even
international sources.
 Adoption of Policies and standard procedures of pharmacy, checklists and log
sheets to ensure safety and efficiency of operations, managing routine (non-
emergency) pharmaceutical services, facilitates exchange of information and
cooperation between neighboring hospitals, regional health facilities and health
authorities.
 Updating the stock of medicines and supplies, including oxygen, antibiotics,
antipyretics and antiviral drugs.

Financial Management
 As part of preparedness to Covid19, financial resources management for
maintenance of existing disaster response structures and to ensure effective
emergency response is important, Securing PPE, Salaries, Food should Be
priorities.
 Preservation and survival of hospital during COVID-19 will be dependent on
their ability to maintain cash and liquidity, developed cash flow projections to
assess and guide needed immediate actions.
 Cautiously follow COVID-19 expenses Understanding the impact of added
COVID-19 expenses may be critical later in securing funding or other
assistance. Expenses tell an important part of the story of COVID-19’s impact
on hospital.
 All expenses payment should be covered for at least 3 months ahead.
 The budget calculation used per-patient costing exercise performed by the
health and financial Department employee, which was based on the existing
financial, human resource, supplies, utilities, accommodation, transportation,
information management and waste management related data. Costs are
derived mainly taken from existing government financial and procurement
data. Fixed cost like infrastructure and opportunity cost like continuation of
existing services are not included.
 Funding will be from: Existing domestic resources as Emergency department,
Donor mapping will be conducted for COVID response and channelized for
filling
 the gap where necessary.

441
 Surveillance

• Call-center and text-based reporting systems will be established to enable

effective event-based surveillance.
• Hospital Staff, surveillance officers, medical recorders, statisticians and
laboratory personnel will be trained/oriented based on the guidelines.
• KPIs Should be held for each member of staff and each point of plan to avoid
misleading or mistakes that may affect both patient and staff members.
• A control Phase Should be held before starting the project to ensure that is
every aspect is covered.
• Survey should be held to each cured patient, helping project manager
correcting missing objects or undetermined mistakes.

Summary
In this project, we are dealing with a plan to set the Hospital (S) prepared to
face the emerging Corona virus (Corvid 19), by preparing the hospital to
receive, treat and isolate infected cases according to the severity of the case
(suspicion - moderate infection - infection that needs intensive care), as well as
with Providing an emergency reception service, with no conflict between
receiving Corona infected cases and emergency situations, with special
pathways for each of them, under the management of a multi-sectoral planning
council, each of which is responsible for establishing and preparing its role in
the plan and following it up, The council meets on a weekly basis to discuss
new decisions and latest updates on treatment protocols and dealing with
infected patients.
The presence of teams responsible for implementing the preparation plan and
running it on a daily basis, with the presence of an alternate team in the event of
the first being infected or forced to undergo isolation.

There is a protocol to differentiate between infected and uninfected cases by

using
a thermometer, and for this to help in how to deal with cases coming to the
hospital and which path you will take.

Transportation of patients in the hospital and the Department of Infection

Control and Prevention are discussed as they have a major role in the permanent
work in the hospital.

Managing human resources from the workforce of health service providers,

administrators, and hospital workers has a large factor to be discussed so that
the hospital can provide an integrated health service in the event of infection of
one of its members or go for quarantine.
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Managing the pharmacy, medical supplies, and preventive equipment,
controlling the stock and providing a reserve in a way that prevents its loss,
misuse or waste.

Ensuring medical devices and their maintenance, laboratory tools, and the
availability of prevention methods for health service providers when dealing
with patients.

Providing logistical services including equipment, transportation, and

communication methods with different institutions

Equip operating rooms with adequate tools, equipment and preventive measures
needed to deal with cases infected with the virus in emergency situations.

Providing the necessary medicines in the hospital pharmacy and reviewing

stores, methods of preservation, dealing with the possibility of drug shortages.

The economic and financial management of the plan and how to provide
financial support during the crisis period.

The existence of methods for evaluating the manpower and the extent of its
efficiency and psychological and professional readiness to deal with daily
situations and add the necessary advantages and incentives to encourage them to
do work in a professional and professional manner.

Conclusion & Recommendations

The pandemic will likely lead to long-term permanent change to few services.
Hazard and public directives (like waves of infection) may lead to a longer or
multiphase crisis response. Market condition could trend as combination of
stressed practices, low income. Hospitals and healthcare system leaders have a
chance to make a remarkable contribution to healthcare infrastructure in their
countries by making their organizations a value-based model.
by using business strategies of cost effectiveness, with aid of planed cost
transformation outlined. On micro level all services should be permanently
redesigned. On macro level, stimulus funding, government aids and charities
help in expenses will help some outpatient healthcare facilities avoid bankrupt.
Practices that do not survive may more seriously consider true affiliation or
merger agreement with large healthcare systems to sustain in industry.
We recommend Hospital also to have a good communication channels with other
hospitals in the area, with Vaccine Center in country as in case of vaccine
availability to be enrolled in list of eligible.

441
Also, if there is a possibility to held clinical trials that will not conflict with the
current event, it should be ran out with taking all ethical, medical, academic
criteria on consideration, as it’ll be.

References
 Joint Commission International Accreditation Standards for Hospitals Including Standards
for Academic Medical Center Hospitals 7th, 2020.
 GAHAR, Guidelines for COVID-19 Disease Hospital Readiness, Structural &
Operational, Checklist.
 Management Booklet Coronavirus Disease MOHP- 2019.
 WHO, Infection prevention and control during health care when novel coronavirus (nCoV)
infection is suspected (WHO/2019-nCoV).
 WHO, Hospital Readiness Checklist for COVID-19, World Health Organization Regional
Office for Europe, Copenhagen, 2020
 CDC, Guidance for Cleaning and Disinfecting.
 CDC, Comprehensive Hospital Preparedness Checklist for Coronavirus Disease 2019
(COVID-19)
 IDSA Newsletters.
 ASHP COVID-19 Resource Center.
 Management of Children with Respiratory Manifestations during COVID-19 Pandemic,
National Protocol, Egyptian Pediatric Clinical Practice Guidelines Committee, SCUMIN
Hospitals, 2020.
 Novel Corona Virus (2019-nCoV) Infection Guidelines Saudi Arabia: Ministry of Health.
 Health Sector Emergency Response Plan Government of Nepal, MOHP May 2020.
 NATIONAL COVID-19 PREPAREDNESS AND RESPONSE PLAN, Ministry of
Disaster Management Affairs and Public Events Ministry of Health, Republic of Malawi
(June 2020)
 COVID-19: PRUDENT FINANCIAL MANAGEMENT FOR HEALTHCARE
ORGANIZATIONS huron consulting group Newsletter.
 Bioterrorism :A Guide for Hospital Preparedness by Joseph R. Masci, M.D. and Elizabeth
Bass
 Implications and future strategies on cost management for hospitals during and after
COVID-19 - International Journal of Community Medicine and Public Health.
 Competence for Health-System Pharmacies Assessment Tools

Acknowledgement
We would like to express our gratitude to supervisor Prof. Dr. Heba Youssef
Mohammed, who guided us throughout this project, saved no efforts to let us
have complete understanding of Diploma content, added to us from real life
experience that enriches the content of the curriculum.
We would also like to thank our families and friends who supported us and
offered deep insight into the study, With Special Thank to Dr. Mohamed Naser
El-laban.

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We would also like to extend my thanks to Al-Sadat Academy Team and
Alazhar University Hospital who enabled us to have the chance to learn and cope
with last updates and have such powerful knowledge ,skills ,tools that we hope
to apply it through our daily basis work in the Hospital or even in our personal
daily life.
Again thank you all.

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