COVID-19 has greatly affected the world and our entire nation’s healthcare system. During the pandemic, the jackson Health System and the University of Miami have developed many initiatives to care for a surge of patients and to successfully protect our staff. Examples of the changes made on a hospital and departmental level are below:

• Securing extensive PPE availability

• Transitioning our ED rooms to negative pressure rooms, including new negative pressure resuscitation rooms and an entire negative pressure area for admitted patients

• Plexiglass barrier between physician stations and patients

• COVID specific area in ED for high risk COVID-suspicious or confirmed patients

• Outdoor tent for screening of non-high risk COVID-suspicious patients

• Don-doff training of PPE for all staff

• All didactics (for now) are online except for simulation and procedural training

• When procedures/sim are taught in person, there is social distancing and masks are worn at all times

• Daily hospital COVID numbers emailed to all employees and posted on Twitter

• Frequent townhalls for ED resident questions/concerns

• Rapid COVID PCR testing and 15 min antigen testing

• Badge Buddy: a nifty app that allows all residents to check in before every shift. Any residents with symptoms or exposures can answer the app’s questions, and will then be told what to do next

• Specialized intubation equipment such as intubation boxes, plastic protective covers, and HEPA viral filters