Introduction
Information technology has become an integral part of hospital care. In May 2021, a ransom-type attack on IT systems took place at Waikato District Health Board, causing a sudden and complete DHB-wide IT failure. This tested the adaptability and resilience of clinical, non-clinical and managerial staff to provide continuity in patient care.
Method
The impact of the ‘cyber-attack’ on plastic surgery outpatient services in the first week was reviewed. Actions and learning points were identified that other hospitals could employ in the event of such a disaster. The emphasis in outpatient clinic was on explaining the situation to our patients and managing expectations concerning delayed results. The effects of SMO-led temporary infrastructure on patient outcomes was evaluated.
Results
209 patients were documented as expected to attend clinic: 132 were seen, 50 rescheduled if their appointments were deemed non-urgent, with an average deferral time of 46.5 days. Five rescheduled patients were subsequently lost to follow-up and not re-referred. The most common sequelae were delays in booking surgery or radiotherapy due to unavailable histology records, affecting 11 patients. Four patients had their care expedited due to the capacity to provide a see-and-treat service for excision biopsy. Eight patients had no subsequent electronic upload of their handwritten clinic documentation, even one year later. 97 patients were deemed to require online histology or operation notes, while 50 patients were deemed to require fresh radiographs for optimum decision making. 14 patients outsourced their radiographs. General Practitioner communication regarding histology helped greatly to reduce surgical booking delays.
Discussion
Using what we have learnt from the experience of the Cyber-attack in the plastic surgery outpatient department, we have formulated high-yield interventions and preparations to pre-empt shortcomings which appear clearer with the help of a year of hindsight, to aid other departments in such a disruptive event.