ABSTRACT
During the COVID-19 pandemic, healthcare systems rapidly responded to challenges in healthcare delivery with innovation. Innovations developed during the COVID-19 pandemic have filled needed gaps in medical care and many may be sustained long term. The unique conditions and processes that facilitated such rapid, successful, and collective innovation should be explored to support future change in healthcare. Decentralized decision making, crowdsourcing, and nontraditional information sharing may be valuable for ongoing innovation in healthcare delivery. Shared, collective purpose in solving challenges in healthcare appear critical to this work. Health care systems aiming to sustain rapid healthcare delivery innovation should consider these processes and focus on facilitating shared purpose to sustain ongoing innovation.
Subject(s)
COVID-19 , Humans , Pandemics , Delivery of Health Care , Health Facilities , Information DisseminationABSTRACT
This study explored the impact of COVID-19 on the mental health and wellbeing and trust support of Tees Esk and Wear Valleys (TEWV) NHS forensic staff using an online google survey during the second wave of the pandemic. Survey respondents were a voluntary cross-sectional sample of 246 TEWV staff working in the forensic directorate staff;this included males (n = 60, 24.5%);with the majority of staff aged between 36–50 years (n = 99, 40.2%) and 50 years or older (n = 80, 32.5%). The results showed that staff working at home and on the front line were both affected by depression, stress and anxiety. Those most at risk were younger staff members. We concluded that the mental health and well-being of staff working should be a priority. It is important to consider targeted support that should be aimed at younger staff members to provide an open culture enabling for those who want support to have readily available signposted resources. Staff working in different settings may have experienced a different impact of COVID-19 on their mental health and wellbeing, and whilst some interventions might be successfully applied across the service, it would be beneficial to understand the unique needs of staff working in specific settings.
ABSTRACT
During the COVID-19 pandemic, healthcare systems rapidly responded to challenges in healthcare delivery with innovation. Innovations developed during the COVID-19 pandemic have filled needed gaps in medical care and many may be sustained long term. The unique conditions and processes that facilitated such rapid, successful, and collective innovation should be explored to support future change in healthcare. Decentralized decision making, crowdsourcing, and nontraditional information sharing may be valuable for ongoing innovation in healthcare delivery. Shared, collective purpose in solving challenges in healthcare appear critical to this work. Health care systems aiming to sustain rapid healthcare delivery innovation should consider these processes and focus on facilitating shared purpose to sustain ongoing innovation.
ABSTRACT
BACKGROUND: Preterm infants may remain in neonatal intensive care units (NICUs) to receive proper nutrition via nasogastric tube feedings. However, prolonged NICU stays can have negative effects for the patient, the family and the health system. AIM: To demonstrate how a patient-centred, design thinking informed approach supported the development of a pilot programme to enable earlier discharge of preterm babies. METHOD: We report on our design thinking-empathy building approach to programme design, initial outcomes and considerations for ongoing study. RESULTS: Through the use of design thinking methods, we identified unique needs, preferences and concerns that guided the development of our novel early discharge programme. We found that stable, preterm infants unable to feed by mouth and requiring nasogastric tubes can be cared for at home with remote patient monitoring and telehealth support. In addition, novel feeding strategies can help address parental preferences without compromising infant growth. CONCLUSION: A patient-centred, design thinking informed approach supported the development of a pilot programme to enable earlier discharge of preterm babies. The programme resulted in a reduced length of stay, thereby increasing NICU bed capacity and limiting hospital turn-aways.
Subject(s)
Intensive Care Units, Neonatal , Patient Discharge , Hospitals , Humans , Infant , Infant, Newborn , Infant, Premature , ParentsABSTRACT
Before the predicted March 2020 surge of COVID-19, US healthcare organizations were charged with developing resource allocation policies. We assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. Personnel and providers from 68 organizations from 34 US states responded. While half of the organizations did not yet have formal allocation policies, all but 4 were in the process of developing policies. Using manual abstraction and natural language processing, we summarize the origins and features of the policies. Most policies included objective triage criteria, specified inapplicable criteria, separated triage and clinical decision making, detailed reassessment plans, offered an appeals process, and addressed palliative care. All but 1 policy referenced a sequential organ failure assessment score as a triage criterion, and 10 policies categorically excluded patients. Six policies were almost identical, tracing their origins to influenza planning. This sample of policies reflects organizational strategies of exemplar-based policy development and the use of objective criteria in triage decisions, either before or instead of clinical judgment, to support ethical distribution of resources. Future guidance is warranted on how to adapt policies across disease type, choose objective criteria, and specify processes that rely on clinical judgments.