Implementation of warfarin to direct oral anticoagulant conversion initiative in pharmacist-run anticoagulation clinics during COVID-19 pandemic.

Due to community transmission of coronavirus disease 2019 (COVID-19), social distancing and stay-at-home orders were implemented statewide in an effort to limit the spread of disease. This posed unique challenges for patients on medications requiring close and continued monitoring by clinic staff, such as anticoagulation clinics. Thus, innovative measures were implemented at Cleveland Clinic Health System (CCHS) to maintain the health and care of ambulatory patients. An initiative to evaluate patients for warfarin to direct oral anticoagulants (DOAC) conversion was used in the pharmacist-run anticoagulation clinics. This article describes how patients were screened for eligibility, the education to pharmacists, the utilization of student learners in the process, and the workflow for provider notification of conversion. Follow up monitoring, challenges encountered, and future directions are also described.

Open knowledge commons versus privatized gain in a fractured information ecology: lessons from COVID-19 for the future of sustainability

COVID-19 has shone a bright light on a number of failings and weaknesses in how current economic models handle information and knowledge. Some of these are familiar issues that have long been understood but not acted upon effectively – for example, the danger that current systems of intellectual property and patent protection are actually inimical to delivering a cost-effective vaccine available to all, whereas treating knowledge as a commons and a public good is much more likely to deliver efficient outcomes for the entire global population. But COVID-19 has also demonstrated that traditional models of knowledge production and dissemination are failing us;scientific knowledge is becoming weaponized and hyper-partisan, and confidence in this knowledge is falling. We believe that the challenges that COVID-19 has exposed in the information economy and ecology will be of increasing applicability across the whole spectrum of sustainability;sustainability scholars and policymakers need to understand and grasp them now if we are to avoid contagion into other sectors due to the preventable errors that have marred the global response to COVID-19.Alternate abstract:Social media summaryCOVID-19 highlights both the failures of privatized knowledge and worrying fractures in the wider information ecology.