Ultrasound Workflow in a Pandemic: Lessons Learned from COVID-19.

The 2019 novel coronavirus (COVID-19) pandemic has posed unique, sudden challenges to health care systems. This is true particularly in the context of ultrasound logistics given the risks of inherent prolonged close contact of patients with sonographers and equipment during sonographic image acquisition. We describe the adaptations and modifications in scheduling, workflow, and imaging protocols implemented in our radiology department ultrasound division (a large urban academic center). The hierarchy of controls to minimize exposures to occupational hazards to protect workers, outlined by The National Institute for Occupational Safety and Health (NIOSH) are listed from most effective to least effective: elimination, substitution, engineering controls, administrative controls, and PPE (personal protective equipment (PPE)). Most of the mitigation techniques used in the ultrasound department to reduce hazards to workers involved administrative controls and PPE. We reduced preventable risks by using sterile precautions, imaging triage, and strategically minimizing image acquisition times. These implementations provide a modifiable framework for rapid adaptation during the evolving COVID-19 pandemic, including resurgences of variant strains. This framework ensures a level of preparedness for possible future pandemics or other widespread emergencies.