American Journal of Nursing Science

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The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model

Received: 11 May 2019    Accepted: 05 July 2019    Published: 05 August 2019
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Abstract

Middle Eastern Corona virus (MERS-Cov) has been acknowledged globally as a novel and evolving pathogen. First detected in 2012, approximately 1,000 confirmed cases reported by World Health Organization and linked to travel to Saudi Arabia. The declaration of an epidemic in the Arabian Peninsula gained the global attention. The summer of 2015 witnessed a MERS-Cov outbreak resulting in the closure of a major Middle Eastern university teaching hospital. Overcrowding and delays were acknowledged as contributory factors. Patient flow processes were not streamlined resulting in frustration amongst staff and patients. Lack of knowledge related to the mode of transmission of this pathogen added to the challenges faced within the Emergency Department. A complete system and service re-design took place with the introduction of the Kingdom’s first Drive Through Screening and Streaming Unit (along with secondary screening and surveillance checkpoints) using an Acute Respiratory Illness tool, to direct potentially infected patients to designated isolation areas to a flu clinic equipped to manage all suspected cases of MERS-Cov and isolated away from the main Emergency Department. This novel concept has been developed to ensure safe and efficient screening and streaming of suspected cases, The Caswell – Hijazi Model.

DOI 10.11648/j.ajns.20190805.11
Published in American Journal of Nursing Science (Volume 8, Issue 5, October 2019)
Page(s) 200-209
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

MERS-Cov, Service and System Redesign, Caswell – Hijazi Model

References
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[5] David I Ben-Tovim, Jane E Bassham, Denise M Bennett, Melissa L Dougherty, Margaret A Martin, Susan J O’Neill, Jackie L Sincock and Michael G Szwarcbord. Redesigning care at the Flinders Medical Centre: clinical process redesign using “lean thinking.” Med J Aust 2008; 188 (6 Suppl): S27.
[6] Sahin M. K. Aker S. Tuncel E. K. Knowledge, Attitudes and Practices Concerning Middle East Respiratory Syndrome Among Umrah and Hajj Pilgrims in Samsun, Turkey 2015. Advisory Board Meeting of the WHO Collaborating Centre for Mass Gathering Medicine, Riyadh. International Journal of Infectious Disease. Volume 24, pp 51-53.
[7] Armony M. Israelit S. Mandelbaum A. Marmer Y. N. Tseytlin Y. Yom-Tov G. B. On Patient Flow in Hospitals: a data-based queueing science perspective. Stochastic Systems 2015 volume5 #1: 146-19.
[8] Singer, A. J. Thode, H. C. Viccellio, P. Pines, J. M. The Association between Length of Emergency Department Boarding and Mortality. Academic Emergency Medicine 13th December 2011.
[9] Beveridge, R. Clarke, B. Janes, L. Savage, N. Thompson, J. Dodd, G. Murray, H. Nijssen-Jordan, C. Warren, D. Vandebencoeur, A. Implementation Guidelines for The Canadian Emergency Department Triage and Acuity Scale (CTAS). Version 16. November 1998.
[10] Scott, I. Vaughan, L. Bell, D. International Journal of quality Health Care (2009) 21 (6): 397-407.
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[12] Pearson, S. D. Goulart- Fisher, D. Lee, T. H. Clinical pathways as a strategy for improving care: problems and potential. Ann. International Med. 1995, 123: 941-8.
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[14] Wolf, L. 2014 Research as Problem Solving: Theoretical Frameworks as Tools. Journal of Emergency Nursing Volume 41. Issue 1 p 83-85.
[15] Ordensson, S. Johnsson, H. Rognes, J. Lind, L. Goransson, K. Ehrenberg, A. Asplund, K. Castren, M. Farrohkina, N. 2011. A systematic review of triage-related interventions to improve patient flow in emergency departments. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 19: 43.
Author Information
  • Department of Nursing King Abdullah Specialist and Children’s Hospital, Saudi Arabia Kingdom, University of South Wales and South Bank University, United Kingdom

  • Department of Emergency, Shaikh Khalifa Medical City, Abu Dhabi, George Washington University, Columbia, King Abdulaziz University, Saudi Arabia Kingdom, Seton Hall University, New Jersey

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  • APA Style

    Angela Caswell, Raed Hijazi. (2019). The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model. American Journal of Nursing Science, 8(5), 200-209. https://doi.org/10.11648/j.ajns.20190805.11

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    ACS Style

    Angela Caswell; Raed Hijazi. The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model. Am. J. Nurs. Sci. 2019, 8(5), 200-209. doi: 10.11648/j.ajns.20190805.11

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    AMA Style

    Angela Caswell, Raed Hijazi. The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model. Am J Nurs Sci. 2019;8(5):200-209. doi: 10.11648/j.ajns.20190805.11

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  • @article{10.11648/j.ajns.20190805.11,
      author = {Angela Caswell and Raed Hijazi},
      title = {The Impact of MERS-Cov: Service and Systems Re-design: The Creation of the Caswell – Hijazi Model},
      journal = {American Journal of Nursing Science},
      volume = {8},
      number = {5},
      pages = {200-209},
      doi = {10.11648/j.ajns.20190805.11},
      url = {https://doi.org/10.11648/j.ajns.20190805.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajns.20190805.11},
      abstract = {Middle Eastern Corona virus (MERS-Cov) has been acknowledged globally as a novel and evolving pathogen. First detected in 2012, approximately 1,000 confirmed cases reported by World Health Organization and linked to travel to Saudi Arabia. The declaration of an epidemic in the Arabian Peninsula gained the global attention. The summer of 2015 witnessed a MERS-Cov outbreak resulting in the closure of a major Middle Eastern university teaching hospital. Overcrowding and delays were acknowledged as contributory factors. Patient flow processes were not streamlined resulting in frustration amongst staff and patients. Lack of knowledge related to the mode of transmission of this pathogen added to the challenges faced within the Emergency Department. A complete system and service re-design took place with the introduction of the Kingdom’s first Drive Through Screening and Streaming Unit (along with secondary screening and surveillance checkpoints) using an Acute Respiratory Illness tool, to direct potentially infected patients to designated isolation areas to a flu clinic equipped to manage all suspected cases of MERS-Cov and isolated away from the main Emergency Department. This novel concept has been developed to ensure safe and efficient screening and streaming of suspected cases, The Caswell – Hijazi Model.},
     year = {2019}
    }
    

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