ABSTRACT
STATEMENT OF PROBLEM/QUESTION: Post-acute COVID-19 syndrome presents new diagnostic and management challenges for primary care physicians, creating a need for dedicated care for affected patients. DESCRIPTION OF PROGRAM/INTERVENTION: To date, the COVID19 pandemic has infected >300 million people worldwide. It is estimated that more than 50% develop Post-acute COVID-19 syndrome. Symptoms persisting >6 months lead to activity impairment and reduced quality of life. In March 2021, we implemented a Post-acute COVID-19 recovery program embedded in a primary care setting. Using an integrated approach, the program utilizes a patient navigator who performs a standardized intake process and assists with information collection and navigation to specialty care. Social workers assist with mental health/community resource access. Five general internal medicine physicians see referred patients 5 half days a week in multiple locations. Intake visits review patient history, previous testing, and ongoing symptoms, and a standard quality of life evaluation is made with a PROMIS-29 score. Templates use new patient and return visits times of 40 minutes (6 slots) and 20 minutes (2 slots) respectively. Expedited specialty care is achieved through prioritized access within two weeks through collaboration with numerous specialists. Monthly case conferences allow clinicians to connect with specialists, discussing challenging cases and common clinical scenarios (e.g., dysosmia, dysgeusia). Additionally, a support group for patients is being developed, as is an “e-consult” option for primary care physicians to engage with the clinic. MEASURES OF SUCCESS: Referrals to program, patients seen, template fill rate, no show rate, new patient visit lag time, revenue generated, and medical diagnoses treated. Future measures will include interval comparison of PROMIS- 29 scores and utilization of e-consults. FINDINGS TO DATE: There have been 557 formal referrals to the program with 620 total patients seen. 584 (84%) were seen by general internal medicine as first contact. Template utilization: 93% and No-show rate of 7%. Median new patient lag: 28 days. Through December 2021, total charges and payments have been $173,445 and $79,692, respectively. Top 3 procedure codes billed: 99215, 99244, and 99214. Top 5 categories of symptoms by primary diagnostic code billed excluding post viral syndrome (111 patients, 18%): Neurologic (headache, fatigue, inattention, etc) (149 patients, 24%), Respiratory (128, 20%), Cardiac (64, 10%), Psychiatric (59, 9.5%), Loss of taste/smell (24, 4%). Top 5 referrals from program: PT/OT/speech therapy, pulmonary rehab, ENT, sleep medicine, and psychology/psychiatry. KEY LESSONS FOR DISSEMINATION: There is high demand for expertise in treatment of Post-Acute COVID-19 syndrome. Primary care physicians, coupled with dedicated, timely access to specialty care and rehab services can successfully manage patients with post-COVID-19 symptoms.
ABSTRACT
This shortform textbook explores practical applications of how business ethics impacts working lives, allowing readers to reflect on their own moral compass through the use of ethical dilemmas. Highlighting the extensive breadth of issues related to business ethics, the authors introduce and analyze ethical and unethical behaviors of firms through numerous real -life examples including Patagonia, Costco, LVMH, Bill Gates, Muhummad Yunus, Enron, WorldCom, Samsung, Purdue Pharma, Vale Mining and the COVID-19 crisis. Regardless of career path or occupation, Absolute Essentials of Business Ethics is a valuable resource to understand why people make decisions based on their own ethical values and beliefs. Useful at both undergraduate and graduate levels, this unique textbook will serve students of business ethics around the world. © 2021 Peter A. Stanwick and Sarah D. Stanwick.