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1.
Nutrients ; 14(2)2022 Jan 13.
Article in English | MEDLINE | ID: covidwho-1725901

ABSTRACT

The transition from adolescence to adulthood is a critical period for the development of healthy behaviors. Yet, it is often characterized by unhealthy food choices. Considering the current pandemic scenario, it is also essential to assess the effects of coronavirus disease-19 (COVID-19) on lifestyles and diet, especially among young people. However, the assessment of dietary habits and their determinants is a complex issue that requires innovative approaches and tools, such as those based on the ecological momentary assessment (EMA). Here, we describe the first phases of the "HEALTHY-UNICT" project, which aimed to develop and validate a web-app for the EMA of dietary data among students from the University of Catania, Italy. The pilot study included 138 students (mean age 24 years, SD = 4.2; 75.4% women), who used the web-app for a week before filling out a food frequency questionnaire with validation purposes. Dietary data obtained through the two tools showed moderate correlations, with the lowest value for butter and margarine and the highest for pizza (Spearman's correlation coefficients of 0.202 and 0.699, respectively). According to the cross-classification analysis, the percentage of students classified into the same quartile ranged from 36.9% for vegetable oil to 58.1% for pizza. In line with these findings, the weighted-kappa values ranged from 0.15 for vegetable oil to 0.67 for pizza, and most food categories showed values above 0.4. This web-app showed good usability among students, assessed through a 19-item usability scale. Moreover, the web-app also had the potential to evaluate the effect of the COVID-19 pandemic on students' behaviors and emotions, showing a moderate impact on sedentary activities, level of stress, and depression. These findings, although interesting, might be confirmed by the next phases of the HEALTHY-UNICT project, which aims to characterize lifestyles, dietary habits, and their relationship with anthropometric measures and emotions in a larger sample of students.


Subject(s)
Diet/methods , Ecological Momentary Assessment/statistics & numerical data , Feeding Behavior , Health Behavior , Mobile Applications , Program Development/methods , Adult , Female , Humans , Italy , Male , Pilot Projects , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
2.
Interface (Botucatu, Online) ; 25(supl.1): e210123, 2021. ilus
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1538283

ABSTRACT

Considerando a escassez de espaços efetivos e afetivos de criação, reflexão e escuta que incitem o processo ensino-aprendizagem durante a pandemia de Covid-19, estruturou-se um projeto de ensino intitulado Curadorias Inventivas e Participativas. O presente trabalho constitui relato de experiência do referido projeto, cujo objetivo foi contribuir para a formação de terapeutas ocupacionais, favorecendo espaços de expressão, acolhimento e estudo. Os procedimentos foram estruturados em oito módulos sequenciais e seus resultados organizados em quatro categorias, a saber: Costurando a experiência: as curadorias vividas; Curadorias que conectaram: a formação de um coletivo; Ensinagem e as curadorias: contribuições para a formação profissional; e Outras ressonâncias. Compreende-se que o projeto contemplou seus objetivos, proporcionando uma experiência menos tradicional no âmbito do ensino acadêmico. Esteve comprometido com as relações entre as acadêmicas e seus cotidianos na pandemia (AU)


Considering the lack of effective and affective spaces for creating, reflecting and listening that promote the teaching-learning process during the Covid-19 pandemic, we developed a project entitled Inventive and Participatory Healing Spaces. This work describes the experiences of this project, whose aim was to contribute to the professional training of occupational therapists, fostering the development of spaces of expression, welcoming and study. The results are grouped into the following four categories: weaving experience: lived healing spaces; healing spaces that connected: forming a collective; teaching and healing spaces: contributions to professional training; and other resonances. The findings show that the project met its objectives, providing a less traditional experience within academic teaching. The project was committed to relations between the students and their daily lives during the pandemic (AU)


Considerando la escasez de espacios efectivos y afectivos de creación, reflexión y escucha que inciten el proceso enseñanza-aprendizaje durante la pandemia de Covid-19, se estructuró un proyecto de enseñanza titulado Curadurías Inventivas y participativas. Este trabajo se constituyó como relato de experiencia del referido proyecto, cuyo objetivo fue contribuir con la formación de terapeutas ocupacionales favoreciendo espacios de expresión, acogida y estudio. Los procedimientos se estructuraron en ocho módulos secuenciales y sus resultados se organizaron en cuatro categorías, a saber: Costura de la experiencia: las curadurías vividas; Curadurías que conectaron: la formación de un colectivo: Ensinagem y las curadurías: contribuciones para la formación profesional y otras resonancias. Se entiende que el proyecto alcanzó sus objetivos, proporcionando una experiencia menos tradicional en el ámbito de la enseñanza académica. Estuvo comprometido con las relaciones entre las academias y sus cotidianos en la pandemia (AU)


Subject(s)
Occupational Therapy/education , Program Development/methods , Data Curation , COVID-19 , Students, Health Occupations/psychology , Problem-Based Learning
4.
Clin Obstet Gynecol ; 64(3): 422-434, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1331601

ABSTRACT

Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.


Subject(s)
Family Planning Services/history , Global Health/history , Developed Countries , Developing Countries , Family Planning Policy/trends , Family Planning Services/methods , Family Planning Services/organization & administration , Family Planning Services/trends , Global Health/trends , History, 20th Century , History, 21st Century , Humans , Program Development/methods , Program Evaluation/methods
5.
Ann Glob Health ; 87(1): 66, 2021.
Article in English | MEDLINE | ID: covidwho-1325925

ABSTRACT

Introduction: Partnerships are essential to creating effective global health leadership training programs. Global pandemics, including the HIV/AIDS pandemic, and more recently the COVID-19 pandemic, have tested the impact and stability of healthcare systems. Partnerships must be fostered to prepare the next generation of leaders to collaborate effectively and improve health globally. Objectives: We provide key matrices that predict success of partnerships in building global health leadership capacity. We highlight opportunities and challenges to building effective partnerships and provide recommendations to promote development of equitable and mutually beneficial partnerships. Findings: Critical elements for effective partnership when building global health leadership capacity include shared strategic vision, transparency and excellent communication, as well as intentional monitoring and evaluation of the partnership, not just the project or program. There must be recognition that partnerships can be unpredictable and unequal, especially if the end is not defined early on. Threats to equitable and effective partnerships include funding and co-funding disparities between partners from high-income and low-income countries, inequalities, unshared vision and priorities, skewed decision-making levels, and limited flexibility to minimize inequalities and make changes. Further, imbalances in power, privilege, position, income levels, and institutional resources create opportunities for exploitation of partners, particularly those in low-income countries, which widens the disparities and limits success and sustainability of partnerships. These challenges to effective partnering create the need for objective documentation of disparities at all stages, with key milestones to assess success and the environment to sustain the partnerships and their respective goals. Conclusions: Developing effective and sustainable partnerships requires a commitment to equality from the start by all partners and an understanding that there will be challenges that could derail otherwise well-intended partnerships. Guidelines and training on evaluation of partnerships exist and should be used, including generic indicators of equity, mutual benefit, and the added value of partnering. Key Takeaways: Effective partnerships in building global health leadership capacity require shared strategic vision and intentional monitoring and evaluation of goalsInequalities in partnerships may arise from disparities in infrastructure, managerial expertise, administrative and leadership capacity, as well as limited mutual benefit and mutual respectTo promote equitable and effective partnerships, it is critical to highlight and monitor key measures for success of partnerships at the beginning of each partnership and regularly through the lifetime of the partnership.We recommend that partnerships should have legal and financial laws through executed memoranda of understanding, to promote accountability and facilitate objective monitoring and evaluation of the partnership itself.More research is needed to understand better the contextual predictors of the broader influence and sustainability of partnership networks in global health leadership training.


Subject(s)
Global Health , International Cooperation , Leadership , Public-Private Sector Partnerships/organization & administration , Communication , Humans , Program Development/methods , Program Evaluation/methods , Stakeholder Participation
6.
Ann Glob Health ; 87(1): 61, 2021.
Article in English | MEDLINE | ID: covidwho-1325924

ABSTRACT

Objectives: The changing global landscape of disease and public health crises, such as the current COVID-19 pandemic, call for a new generation of global health leaders. As global health leadership programs evolve, many have incorporated experiential learning and mentoring (ELM) components into their structure. However, there has been incomplete consideration on how ELM activities are deployed, what challenges they face and how programs adapt to meet those challenges. This paper builds on the co-authors' experiences as trainees, trainers, organizers and evaluators of six global health leadership programs to reflect on lessons learned regarding ELM. We also consider ethics, technology, gender, age and framing that influence how ELM activities are developed and implemented. Findings: Despite the diverse origins and funding of these programs, all six are focused on training participants from low- and middle-income countries drawing on a diversity of professions. Each program uses mixed didactic approaches, practice-based placements, competency and skills-driven curricula, and mentorship via various modalities. Main metrics for success include development of trainee networks, acquisition of skills and formation of relationships; programs that included research training had specific research metrics as well. Common challenges the programs face include ensuring clarity of expectations of all participants and mentors; maintaining connection among trainees; meeting the needs of trainee cohorts with different skill sets and starting points; and ensuring trainee cohorts capture age, gender and other forms of diversity. Conclusions: ELM activities for global health leadership are proving even more critical now as the importance of effective individual leaders in responding to crises becomes evident. Future efforts for ELM in global health leadership should emphasize local adaptation and sustainability. Practice-based learning and established mentoring relationships provide the building blocks for competent leaders to navigate complex dynamics with the flexibility and conscientiousness needed to improve the health of global populations. Key Takeaways: Experiential learning and mentorship activities within global health leadership programs provide the hands-on practice and support that the next generation of global health leaders need to address the health challenges of our times.Six global health leadership programs with experiential learning and mentorship components are showcased to highlight differences and similarities in their approaches and capture a broad picture of achievements that can help inform future programs.Emphasis on inter-professional training, mixed-learning approaches and mentorship modalities were common across programs. Both individual capacity building and development of trainees' professional networks were seen as critical, reflecting the value of inter-personal connections for long-term leadership success.During program design, future programs should recognize the "frame" within which the program will be incorporated and intentionally address diversity-in all its forms-during recruitment as well as consider North-South ethics, leadership roles, hierarchies and transition plans.


Subject(s)
Education, Medical, Graduate/methods , Global Health/education , Leadership , Mentoring/methods , Problem-Based Learning/methods , Clinical Competence , Developing Countries , Education, Medical, Graduate/organization & administration , Humans , International Cooperation , Mentoring/organization & administration , Problem-Based Learning/organization & administration , Program Development/methods
7.
Mayo Clin Proc ; 96(5): 1250-1261, 2021 05.
Article in English | MEDLINE | ID: covidwho-1219872

ABSTRACT

The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.


Subject(s)
Antiviral Agents/administration & dosage , COVID-19 , Critical Pathways , Home Infusion Therapy , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Antibodies, Monoclonal/administration & dosage , COVID-19/epidemiology , COVID-19/therapy , Clinical Protocols , Critical Pathways/organization & administration , Critical Pathways/trends , Efficiency, Organizational , Home Infusion Therapy/methods , Home Infusion Therapy/standards , Humans , Intersectoral Collaboration , Organizational Culture , Program Development/methods , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Severity of Illness Index , Spike Glycoprotein, Coronavirus/antagonists & inhibitors , Spike Glycoprotein, Coronavirus/immunology , United States/epidemiology
8.
Acad Med ; 96(9): 1282-1290, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1216685

ABSTRACT

The term "health systems science" (HSS) has recently emerged as a unifying label for competencies in health care delivery and in population and community health. Despite strong evidence that HSS competencies are needed in the current and future health care workforce, heretofore the integration of HSS into medical education has been slow or fragmented-due, in part, to a lack of evidence that these curricula improve education or population outcomes. The recent COVID-19 pandemic and the national reckoning with racial inequities in the United States further highlight the time-sensitive imperative to integrate HSS content across the medical education continuum. While acknowledging challenges, the authors highlight the unique opportunities inherent in an HSS curriculum and present an elaborated curricular framework for incorporating health care delivery and population health into undergraduate medical education. This framework includes competencies previously left out of medical education, increases the scope of faculty development, and allows for evidence of effectiveness beyond traditional learner-centric metrics. The authors apply a widely adopted 6-step approach to curriculum development to address the unique challenges of incorporating HSS. Two examples-of a module on quality improvement (health care delivery) and of an introductory course on health equity (population and community health)-illustrate how the 6-step approach can be used to build HSS curricula. The Supplemental Digital Appendix (at http://links.lww.com/ACADMED/B106) outlines this approach and provides specific examples and resources. Adapting these resources within local environments to build HSS curricula will allow medical educators to ensure future graduates have the expertise and commitment necessary to effect health systems change and to advocate for their communities, while also building the much-needed evidence for such curricula.


Subject(s)
Curriculum , Delivery of Health Care , Education, Medical/methods , Population Health , Public Health/education , Systems Analysis , Curriculum/standards , Education, Medical/standards , Health Status Disparities , Healthcare Disparities , Humans , Program Development/methods , Program Development/standards , Program Evaluation , Social Determinants of Health , United States
9.
Nurs Adm Q ; 45(2): 152-158, 2021.
Article in English | MEDLINE | ID: covidwho-1078873

ABSTRACT

This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.


Subject(s)
COVID-19/nursing , Leadership , Mentoring/organization & administration , Nursing Staff, Hospital/psychology , COVID-19/epidemiology , Evidence-Based Nursing/organization & administration , Hospitals, Community/organization & administration , Humans , Job Satisfaction , Nursing Staff, Hospital/education , Pandemics , Program Development/methods , Quality Improvement , SARS-CoV-2
10.
J Transcult Nurs ; 32(2): 186-190, 2021 03.
Article in English | MEDLINE | ID: covidwho-1011114

ABSTRACT

In the midst of the current COVID-19 pandemic, telehealth or the remote delivery of mental health services via videoconferencing technology is experiencing exponential growth in utilization. Telehealth services provide mental healthcare providers the ability to deliver timely assessments, facilitate and leverage scarce resources, and maintain client connections in a time where social distancing is endorsed. The delivery of culturally appropriate psychiatric telehealth services is particularly relevant for diverse ethnic populations along with best practices to promote client-provider engagement and client satisfaction. The aim of this article is to provide an overview of psychiatric telehealth services and its functions and deliver insights into culturally appropriate practice strategies.


Subject(s)
Mental Disorders/therapy , Program Development/methods , Telemedicine/standards , COVID-19/prevention & control , COVID-19/transmission , Humans , Mental Disorders/psychology , Quarantine , Telemedicine/methods
11.
Am Psychol ; 75(9): 1376-1388, 2020 12.
Article in English | MEDLINE | ID: covidwho-1003293

ABSTRACT

In today's world of global migration and urbanization, millions of children are separated from parents. Their mental health and future competences as citizens depend on the quality of care from foster parents and group home staff in nonparental care settings. Caregivers are challenged by poor work conditions, too many children, and a lack of knowledge about care for traumatized children. How can our profession match this challenge by upscaling interventions? Digital designs for applications of psychology are growing, recently accelerated by the COVID-19 crisis. From 2008, the author developed a blended learning intervention. In partnerships with nongovernmental organizations and government agencies, care recommendations from an international network of researchers are transformed into start-up seminars for staff, followed by a 6-month online classroom education. Students learn and practice how to train local caregiver groups in attachment-based care, using training sessions developed in local languages, adjusted to culture. At present, the author's Fairstart Foundation educated 500 staff from partners in 26 countries, who have trained the caregivers of some 40,000 children. The theoretical, logistic and technical steps from research to daily caregiver-child practices are described, to inspire discussions of how online designs and international partnerships may benefit underserved populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Caregivers/education , Child Care , Child, Abandoned , Education, Distance , Foster Home Care , Group Homes , Program Development , Psychological Trauma/nursing , Teacher Training , Adult , COVID-19 , Child , Child Care/methods , Child Care/organization & administration , Child Care/standards , Child Care/statistics & numerical data , Child, Abandoned/statistics & numerical data , Education, Distance/methods , Education, Distance/organization & administration , Education, Distance/statistics & numerical data , Foster Home Care/methods , Foster Home Care/organization & administration , Foster Home Care/statistics & numerical data , Group Homes/organization & administration , Group Homes/statistics & numerical data , Humans , International Cooperation , Intersectoral Collaboration , Program Development/methods , Program Development/standards , Program Development/statistics & numerical data , Teacher Training/methods , Teacher Training/organization & administration , Teacher Training/statistics & numerical data
13.
J Trauma Stress ; 33(5): 634-642, 2020 10.
Article in English | MEDLINE | ID: covidwho-812677

ABSTRACT

In response to COVID-19, continued workforce training is essential to ensure that evidence-based treatments are available on the frontline to meet communities' ongoing and emerging mental health needs. However, training during a pandemic imposes many new challenges. This paper describes a multisite training and implementation pilot program, facets of which allowed for continued training despite the onset of the COVID-19 pandemic and subsequent social distancing guidelines. This virtual facilitated learning collaborative in Written Exposure Therapy, an evidence-based treatment for posttraumatic stress disorder, included virtual workshop training, phone-based clinical consultation, implementation-focused video calls for program leadership, and program evaluation. Data are presented about program enrollees and patient impact following the onset of COVID-19-related social distancing restrictions. Challenges, successes, and practical guidance are discussed to inform the field regarding training strategies likely to be durable in an uncertain, dynamic healthcare landscape.


Subject(s)
Coronavirus Infections/psychology , Education, Distance/organization & administration , Implosive Therapy/education , Pneumonia, Viral/psychology , Stress Disorders, Post-Traumatic/therapy , Betacoronavirus , COVID-19 , Evidence-Based Medicine/methods , Humans , Pandemics , Program Development/methods , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology , Writing
14.
Subst Abus ; 41(4): 413-418, 2020.
Article in English | MEDLINE | ID: covidwho-772854

ABSTRACT

The actions needed to mitigate the spread of the coronavirus 2019 (COVID-19) have forged rapid paradigm shifts across healthcare delivery. In a time of crisis, continued access to and delivery of medication for opioid use disorder (M-OUD) is essential to save lives. However, prior to COVID-19, large variability in M-OUD adoption existed across the Veteran Health Administration (VHA) and it is unknown whether the COVID-19 pandemic exacerbated this divide. For the past two years, our team worked with eight VHA facilities to enhance adoption of M-OUD through a multi-component implementation intervention. This commentary explores these providers' responses to COVID-19 and the subsequent impact on their progress toward increasing adoption of M-OUD. Briefly, the loosening of regulatory restrictions fostered accelerated adoption of M-OUD, rapid support for telehealth offered a mechanism to increase M-OUD access, and reevaluation of current practices surrounding M-OUD strengthened adoption. Overall, during the COVID-19 crisis, facilities and providers responded positively to the call for increased access to M-OUD and appropriate care of patients with OUD. The VHA providers' responses and continued progress in enhancing M-OUD amidst a crisis may, in part, be attributable to their participation in an implementation effort prior to COVID-19 that established resources, expert support, and a community of practice. We anticipate the themes presented are generalizable to other healthcare systems grappling to deliver care to patients with OUD during a crisis. We propose areas of future research and quality improvement to continue to provide access and high quality, life-saving care to patients with OUD.


Subject(s)
COVID-19 , Health Services Accessibility , Opiate Substitution Treatment/statistics & numerical data , Program Development/methods , Quality Improvement , United States Department of Veterans Affairs/organization & administration , Buprenorphine/therapeutic use , Humans , Opioid-Related Disorders/drug therapy , Pandemics , SARS-CoV-2 , United States
15.
Clin Neuropsychol ; 34(7-8): 1352-1366, 2020.
Article in English | MEDLINE | ID: covidwho-651984

ABSTRACT

Objectives: Emory University has modified its clinical practices across specialties in response to the 2020 COVID-19 pandemic to provide service delivery while maintaining patient, staff, and faculty safety. This report shares current solutions and workarounds associated with telehealth neuropsychology (teleNP) while also recognizing teleNP opportunities.Results: We modified many measures from our traditional assessment protocols so they could be administered through Zoom. To maximize quality control, formal how-to coversheets and manuals were developed for both training and task administration (i.e. navigating Zoom assessment interfaces, practicing adapted test instructions, and troubleshooting).Conclusions: TeleNP has been successfully used to answer referral questions regarding deep brain stimulation (DBS) candidacy in Parkinson's disease patients and presence of mild neurocognitive impairment in patients with subjective memory decline. Our current protocols will continue to evolve with greater experience and are not considered to be a finished product. Nevertheless, development of robust teleNP protocols should expand availability of neuropsychology in both clinical and research applications while simultaneously decreasing assessment burden associated with traveling - sometimes long distances - for diagnostic neuropsychological evaluation.


Subject(s)
Academic Medical Centers/trends , Betacoronavirus , Coronavirus Infections/therapy , Neuropsychology/trends , Pandemics , Pneumonia, Viral/therapy , Telemedicine/trends , Academic Medical Centers/methods , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Humans , Neuropsychological Tests , Neuropsychology/methods , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Program Development/methods , SARS-CoV-2 , Telemedicine/methods
17.
J Addict Med ; 14(5): e139-e141, 2020.
Article in English | MEDLINE | ID: covidwho-724342

ABSTRACT

: The COVID-19 pandemic has created an urgent need to expand access to substance use disorder (SUD) treatment through telehealth. A more permanent adoption of tele-SUD treatment options could positively alter the future of SUD treatment. We identify four steps that will help to ensure a broader transition to telehealth will be successful in improving the health outcomes of patients with SUDs. These steps are: (1) investing in telehealth infrastructure to enable health care providers and patients to use telehealth; (2) training and equipping providers to provide SUD treatment through telehealth; (3) providing patients with the financial and social support, hardware, and training necessary to use telehealth; (4) making temporary changes to telehealth law and regulation permanent. We believe these 4 steps will be critical to initiating SUD treatment for many persons that have yet to receive it, and for preserving SUD treatment continuity for millions of other patients both during and after the pandemic.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Program Development/methods , Substance-Related Disorders/therapy , Telemedicine , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
18.
Anesthesiology ; 133(5): 985-996, 2020 11 01.
Article in English | MEDLINE | ID: covidwho-709139

ABSTRACT

Preparedness measures for the anticipated surge of coronavirus disease 2019 (COVID-19) cases within eastern Massachusetts included the establishment of alternate care sites (field hospitals). Boston Hope hospital was set up within the Boston Convention and Exhibition Center to provide low-acuity care for COVID-19 patients and to support local healthcare systems. However, early recognition of the need to provide higher levels of care, or critical care for the potential deterioration of patients recovering from COVID-19, prompted the development of a hybrid acute care-intensive care unit. We describe our experience of implementing rapid response capabilities of this innovative ad hoc unit. Combining quality improvement tools for hazards detection and testing through in situ simulation successfully identified several operational hurdles. Through rapid continuous analysis and iterative change, we implemented appropriate mitigation strategies and established rapid response and rescue capabilities. This study provides a framework for future planning of high-acuity services within a unique field hospital setting.


Subject(s)
Betacoronavirus , Computer Simulation/standards , Coronavirus Infections/therapy , Healthcare Failure Mode and Effect Analysis/standards , Hospital Rapid Response Team/standards , Intensive Care Units/standards , Pneumonia, Viral/therapy , Boston/epidemiology , COVID-19 , Coronavirus Infections/epidemiology , Critical Care/methods , Critical Care/standards , Healthcare Failure Mode and Effect Analysis/methods , Humans , Pandemics , Pneumonia, Viral/epidemiology , Program Development/methods , Program Development/standards , Quality Improvement/standards , SARS-CoV-2
19.
Neurology ; 95(7): 305-311, 2020 08 18.
Article in English | MEDLINE | ID: covidwho-621584

ABSTRACT

The SARS-CoV-2 (COVID-19) pandemic has rapidly moved telemedicine from discretionary to necessary. Here, we describe how the Stanford Neurology Department (1) rapidly adapted to the COVID-19 pandemic, resulting in over 1,000 video visits within 4 weeks, and (2) accelerated an existing quality improvement plan of a tiered roll out of video visits for ambulatory neurology to a full-scale roll out. Key issues we encountered and addressed were related to equipment/software, provider engagement, workflow/triage, and training. On reflection, the key drivers of our success were provider engagement and dedicated support from a physician champion, who plays a critical role understanding stakeholder needs. Before COVID-19, physician interest in telemedicine was mixed. However, in response to county and state stay-at-home orders related to COVID-19, physician engagement changed completely; all providers wanted to convert a majority of visits to video visits as quickly as possible. Rapid deployment of neurology video visits across all its subspecialties is feasible. Our experience and lessons learned can facilitate broader utilization, acceptance, and normalization of video visits for neurology patients in the present as well as the much anticipated postpandemic era.


Subject(s)
Coronavirus Infections/therapy , Neurology/methods , Pneumonia, Viral/therapy , Telemedicine/methods , Videoconferencing/statistics & numerical data , Ambulatory Care Facilities/statistics & numerical data , Attitude of Health Personnel , Betacoronavirus , COVID-19 , Humans , Pandemics , Program Development/methods , SARS-CoV-2
20.
Emerg Med Australas ; 32(3): 511-514, 2020 06.
Article in English | MEDLINE | ID: covidwho-143068

ABSTRACT

OBJECTIVES: There is an urgency to support Australian ED clinicians with real-time tools as the COVID-19 pandemic evolves. The COVID-19 Emergency Department (COVED) Quality Improvement Project has commenced and will provide flexible and responsive clinical tools to determine the predictors of key ED-relevant clinical outcomes. METHODS: The COVED Project includes all adult patients presenting to a participating ED and meeting contemporary testing criteria for COVID-19. The dataset has been embedded in the electronic medical record and the COVED Registry has been developed. RESULTS: Outcomes measured include being COVID-19 positive and requiring intensive respiratory support. Regression methodology will be used to generate clinical prediction tools. CONCLUSION: This project will support EDs during this pandemic.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus , Electronic Health Records , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Program Development/methods , Public Health Surveillance/methods , Quality Improvement , Registries , Betacoronavirus , COVID-19 , Coronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Outbreaks/prevention & control , Emergency Service, Hospital , Female , Humans , Male , Outcome and Process Assessment, Health Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Public Health , Quality of Health Care , SARS-CoV-2 , Triage/methods
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