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1.
Neurology ; 2021 Dec 17.
Article in English | MEDLINE | ID: covidwho-1593693

ABSTRACT

The standard neurology clinical experience in medical school focuses primarily on bedside patient encounters; however, the limitations of the clinical environment due to the current COVID-19 pandemic have accelerated the need for virtual curriculum development. To provide guidance to Neurology clerkship directors during this unprecedented time, the American Academy of Neurology (AAN) Undergraduate Education Subcommittee (UES) formed a workgroup to develop an outline for a 'virtual curriculum', provide recommendations, and describe models of integrating virtual curricula into the neurology clerkship.In this overview, we discuss different methods of virtual instruction, hybrid models of clerkship training and the challenges to its implementation, professionalism issues, and modification of feedback and assessment techniques specific to the virtual learning environment. We also offer suggestions for implementation of a hybrid virtual curriculum into the neurology clerkship.The virtual curriculum is intended to supplement the core neurology in-person clinical experience and should not be used for shortening or replacing the required neurology clinical clerkship.

2.
J Stroke Cerebrovasc Dis ; 30(7): 105802, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1188832

ABSTRACT

While use of telemedicine to guide emergent treatment of ischemic stroke is well established, the COVID-19 pandemic motivated the rapid expansion of care via telemedicine to provide consistent care while reducing patient and provider exposure and preserving personal protective equipment. Temporary changes in re-imbursement, inclusion of home office and patient home environments, and increased access to telehealth technologies by patients, health care staff and health care facilities were key to provide an environment for creative and consistent high-quality stroke care. The continuum of care via telestroke has broadened to include prehospital, inter-facility and intra-facility hospital-based services, stroke telerehabilitation, and ambulatory telestroke. However, disparities in technology access remain a challenge. Preservation of reimbursement and the reduction of regulatory burden that was initiated during the public health emergency will be necessary to maintain expanded patient access to the full complement of telestroke services. Here we outline many of these initiatives and discuss potential opportunities for optimal use of technology in stroke care through and beyond the pandemic.


Subject(s)
COVID-19 , Continuity of Patient Care , Delivery of Health Care, Integrated , Ischemic Stroke/therapy , Outcome and Process Assessment, Health Care , Telemedicine , Continuity of Patient Care/economics , Delivery of Health Care, Integrated/economics , Fee-for-Service Plans , Health Care Costs , Healthcare Disparities , Humans , Insurance, Health, Reimbursement , Ischemic Stroke/diagnosis , Ischemic Stroke/economics , Occupational Health , Outcome and Process Assessment, Health Care/economics , Patient Safety , Telemedicine/economics
3.
Stroke ; 51(8): 2587-2592, 2020 08.
Article in English | MEDLINE | ID: covidwho-680789

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has in some regions overwhelmed the capacity and staffing needs of healthcare systems, necessitating the provision of resources and staff from different disciplines to aid COVID treatment teams. Stroke centers have multidisciplinary clinical and procedural expertise to support COVID treatment teams. Staff safety and patient safety are essential, as are open lines of communication between stroke center leaders and hospital leadership in a pandemic where policies and procedures can change or evolve rapidly. Support needs to be allocated in a way that allows for the continued operation of a fully capable stroke center, with the ability to adjust if stroke center volume or staff attrition requires.


Subject(s)
Coronavirus Infections/therapy , Hospital Departments/organization & administration , Pandemics , Patient Care Team/organization & administration , Pneumonia, Viral/therapy , COVID-19 , Communication , Delivery of Health Care , Humans , Leadership , Occupational Health , Organizational Policy , Personnel Staffing and Scheduling
4.
Stroke ; 51(7): 2263-2267, 2020 07.
Article in English | MEDLINE | ID: covidwho-247793

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future.


Subject(s)
Betacoronavirus , Emergency Medical Services/statistics & numerical data , Pandemics , Stroke/epidemiology , Triage , Acute Disease , Asymptomatic Diseases , COVID-19 , Canada/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Delayed Diagnosis , Equipment Contamination , Health Workforce , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Occupational Diseases/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Protective Devices , Resource Allocation , SARS-CoV-2 , Stroke/complications , Stroke/diagnosis , Stroke/therapy , Symptom Assessment , Time-to-Treatment , Transportation of Patients , Travel , Triage/methods , Triage/standards , Unconsciousness/etiology , Workflow
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