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Table 2 List of decisions, reasons, and decision level

From: SARS and hospital priority setting: a qualitative case study and evaluation

Decisions: Staff and Patients Reasons Decision Level
Determine which staff to deploy to help with screening at the doors Operational need; Screening capability; Infection control; Medical need Hospital Command
Determine urgent patients and care for those first Medical need Individual Clinicians
The hospital as a whole determined few hospital workers unessential Operational need; Screening capability; Infection Control Hospital Command
Redeploy staff from screening back to clinical areas Medical need; Duty to care; Operational need Hospital Command
Hire screeners Medical need; Operational need; Infection control Hospital Command
Remove pregnant staff from the clinical environment Staff safety Corporate Command; Hospital Command
Decant staff and inpatients (25) from 8th floor general medicine to make room for SARS unit and potential SARS patients Operational need; Medical need Hospital Command; Department Managers/Chiefs
Separate staff entrance from visitor and patient entrance Operational need; Infection control Corporate Command; Hospital Command
Send staff home Infection control Department Managers/Chiefs
Decisions: Beds Reasons Level Made At
Accept SARS patient transfers from other hospitals Duty to care Corporate Command; Individual Clinicians
Each GTA and Simcoe County hospital to establish a SARS specific isolation unit. Infection control MOHLTC
Hospitals greater than 500 beds will be expected to provide a 30 bed unit each. (Mar 27)   
Create SARS unit physical space on 8B with negative pressure capabilities Directive; Infection control; Medical need; Operational need; Duty to care Hospital Command; Department Managers/Chiefs; Individual Clinicians
Decisions: Clinical Activity Reasons Decision Level
Maintain emergency based activity during initial days of outbreak Duty to care; Medical need Corporate Command; Hospital Command
Ramp up clinical activity Duty to care; Medical need Corporate Command
Allocate OR time by division Medical need; Surgeon activity Department Managers/Chiefs
Determine which patient needed urgent OR care this could be listed second Medical need Individual Clinicians
SARS II – the decision not to cancel surgery again Medical need; Duty to care Corporate Command
Treat some 'elective cases' in the OR as being urgent Medical need; Surgeon activity; Duty to care; Squeaky wheel Individual Clinicians; Department Managers/Chiefs
Determine what/who is emergent and urgent in terms of clinical volumes in family medicine Screening capability; Medical need; Squeaky wheel Department Managers/Chiefs; Individual Clinicians
Family Medicine did not go out into the community to provide care in the initial stages of SARS (care to detox centres, shelters) Infection control; Screening capability Corporate Command; Department Managers/Chiefs
Decisions: Visitors Reasons Decision Level
No Visitor Policy except for compassionate grounds (such as palliative care, critically ill children or visiting a patient whose death may be imminent) Infection control MOHLTC
Restrict visitors for certain hours (5–9 pm) Screening capability Hospital Command
Lift visiting restrictions on case-by-case basis Compassion; Squeaky wheel; Medical need Department Managers/Chiefs
Hospitals must restrict access to each hospital site. Ideally, access should be restricted to one staff and one public entrance for each building Infection control MOHLTC