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1.
BMC Pregnancy Childbirth ; 22(1): 225, 2022 Mar 19.
Article in English | MEDLINE | ID: covidwho-1745478

ABSTRACT

OBJECTIVE: Exclusive breastmilk feeding during the delivery hospitalization, a Joint Commission indicator of perinatal care quality, is associated with longer-term breastfeeding success. Marked racial and ethnic disparities in breastfeeding exclusivity and duration existed prior to COVID-19. The pandemic, accompanied by uncertainty regarding intrapartum and postpartum safety practices, may have influenced disparities in infant feeding practices. Our objective was to examine whether the first wave of the COVID-19 pandemic in New York City was associated with a change in racial and ethnic disparities in exclusive breastmilk feeding during the delivery stay. METHODS: We conducted a cross-sectional study of electronic medical records from 14,964 births in two New York City hospitals. We conducted a difference-in-differences (DID) analysis to compare Black-white, Latina-white, and Asian-white disparities in exclusive breastmilk feeding in a pandemic cohort (April 1-July 31, 2020, n=3122 deliveries) to disparities in a pre-pandemic cohort (January 1, 2019-February 28, 2020, n=11,842). We defined exclusive breastmilk feeding as receipt of only breastmilk during delivery hospitalization, regardless of route of administration. We ascertained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection status from reverse transcription-polymerase chain reaction tests from nasopharyngeal swab at admission. For each DID model (e.g. Black-white disparity), we used covariate-adjusted log binomial regression models to estimate racial and ethnic risk differences, pandemic versus pre-pandemic cohort risk differences, and an interaction term representing the DID estimator. RESULTS: Exclusive breastmilk feeding increased from pre-pandemic to pandemic among white (40.8% to 46.6%, p<0.001) and Asian (27.9% to 35.8%, p=0.004) women, but not Black (22.6% to 25.3%, p=0.275) or Latina (20.1% to 21.4%, p=0.515) women overall. There was an increase in the Latina-white exclusive breastmilk feeding disparity associated with the pandemic (DID estimator=6.3 fewer cases per 100 births (95% CI=-10.8, -1.9)). We found decreased breastmilk feeding specifically among SARS-CoV-2 positive Latina women (20.1% pre-pandemic vs. 9.1% pandemic p=0.013), and no change in Black-white or Asian-white disparities. CONCLUSIONS: We observed a pandemic-related increase in the Latina-white disparity in exclusive breastmilk feeding, urging hospital policies and programs to increase equity in breastmilk feeding and perinatal care quality during and beyond this health emergency.


Subject(s)
Breast Feeding/ethnology , COVID-19/ethnology , Hospitalization , Adult , Breast Feeding/statistics & numerical data , COVID-19/epidemiology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Milk, Human , New York City , Perinatal Care , Quality Indicators, Health Care , SARS-CoV-2
2.
Isr J Health Policy Res ; 11(1): 9, 2022 01 31.
Article in English | MEDLINE | ID: covidwho-1662425

ABSTRACT

BACKGROUND: In 2020, the COVID-19 pandemic affected healthcare systems throughout the world, including the management of patients and compliance rates of quality indicators. OBJECTIVE: To measure the impact in Israel of the COVID-19 pandemic on the indicator-relevant caseload and compliance rates of the quality indicators reported by medical services providers within the Israeli National Program for Quality Indicators (NPQI). METHODS: Data was collected from the reports made to the NPQI by participating hospitals and medical service providers. The indicator results for the number of cases and compliance rates for 2019 were compared to those from 2020. We assessed and compared the results of the quality indicators in general hospitals, geriatric hospitals and departments, psychiatric hospitals and departments, emergency medical services (EMS), and Mother and Baby health centers. RESULTS: We found a decrease in measurable cases in 2020 relative to 2019, especially in geriatric hospitals. In most indicators, compliance rates rose in 2020. Few indicators had lower compliance rates associated with COVID-19 pandemic regulations. CONCLUSIONS AND POLICY IMPLICATIONS: Routine medical activity decreased in Israel in 2020 in comparison to 2019, as reflected by a decrease in cases, but compliance rates were better in most indicators. The results of our study imply that the functioning of healthcare quality measurement programs should not be interrupted during a pandemic. This not only allows measuring of the healthcare system's performance during a crisis, but also may assist in maintaining a high level of healthcare quality.


Subject(s)
COVID-19 , Quality Indicators, Health Care , Aged , Humans , Israel/epidemiology , Pandemics , SARS-CoV-2
3.
J Gen Intern Med ; 37(5): 1161-1168, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1653718

ABSTRACT

BACKGROUND: Access to primary care was hindered by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: Evaluate changes in health screening rates before and during the pandemic. DESIGN: Retrospective analysis of health maintenance and disease management screening rates among primary care patients before and during the pandemic. PARTICIPANTS: Over 150,000 patients of a large, academic health system. MAIN MEASURES: Six quality measures were analyzed: colon cancer, breast cancer, cervical cancer, diabetes Hgb A1C, diabetes eye, and diabetes nephropathy monitoring. Based on US Preventative Services Task Force screening guidelines, we determined which patients were due for at least one of the quality measures. We tracked completion rates during three time periods: pre-pandemic (January 1-March 3, 2020), stay-at-home (March 4-May 8, 2020), and phased reopening (May 9-July 8, 2020). Differences in quality measure completion rates were evaluated using mixed-effects logistic regression models. KEY RESULTS: Compared to pre-pandemic rates, completion of all health screenings declined during the stay-at-home period: mammograms (OR: 0.34; 95% CI: 0.31-0.37), cervical cancer (OR: 0.83; 95% CI: 0.76-0.91), colorectal cancer (OR: 0.25; 95% CI: 0.23-0.28), diabetes eye (OR: 0.34; 95% CI: 0.29-0.41), diabetes Hgb A1c (OR: 0.41; 95% CI: 0.37-0.46), and diabetes nephropathy (OR: 0.46, 95% CI: 0.41-0.53). During phased reopening, completion of all quality measures increased compared to the stay-at-home period, except for cervical cancer screening (OR: 0.83; 95% CI: 0.76-0.92). There was a persistent reduction in completion of all quality measures, except for diabetic nephropathy monitoring (OR: 0.99; 95% CI: 0.89-1.09), during phased reopening compared to pre-pandemic. CONCLUSIONS: Healthcare screening rates were reduced during the early part of the COVID-19 pandemic and did not fully recover to pre-pandemic rates by July 2020. Future research should aim to clarify the long-term impacts of delayed health screenings. New interventions should be considered for expanding remote preventative health services.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Uterine Cervical Neoplasms , COVID-19/epidemiology , Early Detection of Cancer , Female , Humans , Pandemics/prevention & control , Primary Health Care , Quality Indicators, Health Care , Retrospective Studies
5.
Environ Res ; 204(Pt B): 112071, 2022 03.
Article in English | MEDLINE | ID: covidwho-1433207

ABSTRACT

There is an increasing evidence that meteorological (temperature, relative humidity, dew) and air quality indicators (PM2.5, PM10, NO2, SO2, CO) are affecting the COVID-19 transmission rate and the number of deaths in many countries around the globe. However, there are contradictory results due to limited observations of these parameters and absence of conclusive evidence on such relationships in cold or hot arid tropical and subtropical desert climate of Gulf region. This is the first study exploring the relationships of the meteorological (temperature, relative humidity, and dew) and air quality indicators (PM10,CO, and SO2) with daily COVID-19 infections and death cases for a period of six months (1st March to August 31, 2020) in six selected cities of the Kingdom of Saudi Arabia by using generalized additive model. The Akaike information criterion (AIC) was used to assess factors affecting the infections rate and deaths through the selection of best model whereas overfitting of multivariate model was avoided by using cross-validation. Spearman correlation indicated that exponentially weighted moving average (EWMA) temperature and relative humidity (R > 0.5, P < 0.0001) are the main variables affecting the daily COVID-19 infections and deaths. EWMA temperature and relative humidity showed non linear relationships with the number of COVID-19 infections and deaths (DF > 1, P < 0.0001). Daily COVID-19 infections showed a positive relationship at temperature between 23 and 34.5 °C and relative humidity ranging from 30 to 60%; a negative relationship was found below and/or above these ranges. Similarly, the number of deaths had a positive relationship at temperature ˃28.7 °C and with relative humidity ˂40%, showing higher number of deaths above this temperature and below this relative humidity rate. All air quality indicators had linear relationships with the number of COVID-19 infections and deaths (P < 0.0001). Hence, variation in temperature, relative humidity and air pollution indicators could be important factors influencing the COVID-19 spread and mortality. Under the current scenario with rising temperature and relative humidity, the number of cases is increasing, hence it justifies an active government policy to lessen COVID-19 infection rate.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Air Pollution/statistics & numerical data , Cities , Humans , Humidity , Quality Indicators, Health Care , SARS-CoV-2 , Saudi Arabia/epidemiology , Temperature
6.
Cerebrovasc Dis ; 50(2): 185-199, 2021.
Article in English | MEDLINE | ID: covidwho-1348201

ABSTRACT

BACKGROUND: Posterior circulation stroke is characterized by poor prognosis because its optimal thrombolysis "time window" is always missed. After mechanical thrombectomy (MT), the recanalization rate of posterior circulation obstruction is significantly increased, but prognosis remains poor. To best manage patients, prognostic factors are needed to inform MT triaging after posterior circulation stroke. METHODS: A systematic literature search was done for the period through April 2020. Studies included those with posterior circulation stroke cases that underwent MT. The primary outcome measure in this study was the modified Rankin Scale on day 90. RESULTS: No outcome differences were found in gender, atrial fibrillation, smoking, and coronary artery disease (OR = 1.07, 95% CI: 0.90-1.28; OR = 1.02, 95% CI: 0.82-1.26; OR = 1.26, 95% CI: 0.94-1.68; and OR = 0.84, 95% CI: 0.58-1.22, respectively). Hypertension, diabetes mellitus, and previous stroke correlated with poorer prognosis (OR = 0.61, 95% CI: 0.48-0.77; OR = 0.60, 95% CI: 0.50-0.73; and OR = 0.74, 95% CI: 0.55-0.99, respectively). However, hyperlipidemia correlated with better prognosis (OR = 1.28, 95% CI: 1.04-1.58). CONCLUSION: Our analysis indicates that hypertension, diabetes mellitus, or previous stroke correlate with poorer outcomes. Intriguingly, hyperlipidemia correlates with better prognosis. These factors may help inform triage decisions when considering MT for posterior circulation stroke patients. However, large, multicenter, randomized controlled trials are needed to validate these observations.


Subject(s)
COVID-19 , Ischemic Stroke/therapy , Outcome and Process Assessment, Health Care/trends , Patient Admission/trends , Practice Patterns, Physicians'/trends , Thrombectomy/trends , Aged , Aged, 80 and over , Female , Hospital Mortality/trends , Humans , Ischemic Stroke/diagnosis , Ischemic Stroke/mortality , Male , Middle Aged , Quality Indicators, Health Care/trends , Recovery of Function , Referral and Consultation/trends , Retrospective Studies , Risk Assessment , Risk Factors , Thrombectomy/adverse effects , Thrombectomy/mortality , Time Factors , Time-to-Treatment/trends , Treatment Outcome
7.
J Stroke Cerebrovasc Dis ; 30(10): 106035, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1347731

ABSTRACT

OBJECTIVES: Most data on telestroke utilization come from single academic hub-and-spoke telestroke networks. Our objective was to describe characteristics of telestroke consultations among a national sample of telestroke sites on one of the most commonly used common vendor platforms, prior to the COVID-19 public health emergency. MATERIALS AND METHODS: A commercial telestroke vendor provided data on all telestroke consultations by two specialist provider groups from 2013-2019. Kendall's τ ß nonparametric test was utilized to assess time trends. Generalized linear models were used to assess the association between hospital consult utilization and alteplase use adjusting for hospital characteristics. RESULTS: Among 67,736 telestroke consultations to 132 spoke sites over the study period, most occurred in the emergency department (90%) and for stroke indications (final clinical diagnoses: TIA 13%, ischemic stroke 39%, hemorrhagic stroke 2%, stroke mimics 46%). Stroke severity was low (median NIHSS 2, IQR 0-6). Alteplase was recommended for 23% of ischemic stroke patients. From 2013 to 2019, times from ED arrival to NIHSS, CT scan, imaging review, consult, and alteplase administration all decreased (p<0.05 for all), while times from consult start to alteplase recommendation and bolus increased (p<0.01 for both). Transfer was recommended for 8% of ischemic stroke patients. Number of patients treated with alteplase per hospital increased with increasing number of consults and hospital size and was also associated with US region in unadjusted and adjusted analyses. Longer duration of hospital participation in the network was associated with shorter hospital median door-to-needle time for alteplase delivery (39 min shorter per year, p=0.04). CONCLUSIONS: Among spoke sites using a commercial telestroke platform over a seven-year time horizon, times to consult start and alteplase bolus decreased over time. Similar to academic networks, duration of telestroke participation in this commercial network was associated with faster alteplase delivery, suggesting practice improves performance.


Subject(s)
COVID-19 , Fibrinolytic Agents/administration & dosage , Practice Patterns, Physicians'/trends , Remote Consultation/trends , Stroke/surgery , Thrombolytic Therapy/trends , Time-to-Treatment/trends , Tissue Plasminogen Activator/administration & dosage , Aged , Aged, 80 and over , Databases, Factual , Female , Humans , Male , Middle Aged , Quality Improvement/trends , Quality Indicators, Health Care/trends , Stroke/diagnosis , Time Factors , Treatment Outcome , United States
8.
J Nurs Care Qual ; 37(1): 47-53, 2022.
Article in English | MEDLINE | ID: covidwho-1334300

ABSTRACT

BACKGROUND: Influenza vaccinations are a preventive health quality measure. Home telehealth nursing staff interventions can reduce influenza disease burden and complications. PURPOSE: To improve seasonal flu vaccine rates using novel home telehealth clinical and technology interventions. METHODS: A pre- and postintervention concurrent cohort study for 513 outpatients was conducted. Interventions included automated 2-way patient messaging using remote monitoring equipment, a new note template to record vaccination status in the electronic health record, and flu vaccine patient education. RESULTS: Interventions resulted in vaccination rates of 70.4% for Veterans ages 19 to 65 years, and 81.7% for Veterans 66 years and older, exceeding national, regional, and local Veterans Administration targets. CONCLUSIONS: Two-way messaging and standardized documentation increased rates. Declinations persisted despite education. Reasons included fear of side effects, and rarely leaving home due to the COVID-19 pandemic. Nursing interventions can increase influenza vaccination quality measures for primary care home telehealth patients.


Subject(s)
COVID-19 , Influenza, Human , Telemedicine , Adult , Aged , Cohort Studies , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Middle Aged , Pandemics , Quality Indicators, Health Care , SARS-CoV-2 , Vaccination , Young Adult
9.
Ann Ig ; 33(5): 513-517, 2021.
Article in English | MEDLINE | ID: covidwho-1317344

ABSTRACT

Abstract: Starting from the minimum requirements indicated by Lombardy Region, a validation checklist has been developed by experts in design, healthcare layout planning, hygiene and public health, planning and compliance, in order to provide managers of COVID-19 massive vaccination centers with a useful and easy-to-use tool to ensure quality, safety and efficiency of the different activities performed.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Community Health Centers/organization & administration , Mass Vaccination/organization & administration , SARS-CoV-2 , Validation Studies as Topic , COVID-19 Vaccines/supply & distribution , Checklist , Community Health Centers/standards , Efficiency, Organizational , Facility Design and Construction , Humans , Hygiene , Italy , Patient Safety , Quality Assurance, Health Care , Quality Indicators, Health Care
10.
Biochem Med (Zagreb) ; 31(2): 020713, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1290399

ABSTRACT

INTRODUCTION: Following a pandemic, laboratory medicine is vulnerable to laboratory errors due to the stressful and high workloads. We aimed to examine how laboratory errors may arise from factors, e.g., flexible working order, staff displacement, changes in the number of tests, and samples will reflect on the total test process (TTP) during the pandemic period. MATERIALS AND METHODS: In 12 months, 6 months before and during the pandemic, laboratory errors were assessed via quality indicators (QIs) related to TTP phases. QIs were grouped as pre-, intra- and postanalytical. The results of QIs were expressed in defect percentages and sigma, evaluated with 3 levels of performance quality: 25th, 50th and 75th percentile values. RESULTS: When the pre- and during pandemic periods were compared, the sigma value of the samples not received was significantly lower in pre-pandemic group than during pandemic group (4.7σ vs. 5.4σ, P = 0.003). The sigma values of samples transported inappropriately and haemolysed samples were significantly higher in pre-pandemic period than during pandemic (5.0σ vs. 4.9σ, 4.3σ vs. 4.1σ; P = 0.046 and P = 0.044, respectively). Sigma value of tests with inappropriate IQC performances was lower during pandemic compared to the pre-pandemic period (3.3σ vs. 3.2σ, P = 0.081). Sigma value of the reports delivered outside the specified time was higher during pandemic than pre-pandemic period (3.0σ vs. 3.1σ, P = 0.030). CONCLUSION: In all TTP phases, some quality indicators improved while others regressed during the pandemic period. It was observed that preanalytical phase was affected more by the pandemic.


Subject(s)
COVID-19/epidemiology , Laboratories, Hospital/statistics & numerical data , Quality Indicators, Health Care/statistics & numerical data , COVID-19/pathology , COVID-19/virology , Diagnostic Errors/statistics & numerical data , Humans , Pandemics , Quality Indicators, Health Care/standards , SARS-CoV-2/isolation & purification , Turkey/epidemiology
12.
Thorac Cardiovasc Surg ; 69(4): 294-307, 2021 06.
Article in English | MEDLINE | ID: covidwho-1281759

ABSTRACT

Based on a longtime voluntary registry, founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS) in 1980, well-defined data of all cardiac, thoracic and vascular surgery procedures performed in 78 German heart surgery departments during the year 2020 are analyzed. Under the more than extraordinary conditions of the ongoing worldwide coronavirus disease 2019 pandemic, a total of 161,817 procedures were submitted to the registry. A total of 92,809 of these operations are summarized as heart surgery procedures in a classical sense. The unadjusted in-hospital survival rate for the 29,444 isolated coronary artery bypass grafting procedures (relationship on-/off-pump 3.6:1) was 97.2%. For the 35,469 isolated heart valve procedures, (17,471 transcatheter interventions included), the survival rate was 96.7%. Concerning short- and long-term circulatory support, a total of 2,852 extracorporeal life support/extracorporeal membrane oxygenation implantations, respectively, 843 assist device implantations (left/right/biventricular assist device, total artificial device), were registered. In 2020, the number of isolated heart transplantations increased to 340, a rise of 2.1% compared with the previous year. The isolated lung transplantations amounted to 291, a decrease of 6.4%.This annually updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, constitutes advancements in heart medicine, and represents a basis for quality management for all participating institutions. In addition, the registry demonstrates that the provision of cardiac surgery in Germany is up to date, appropriate, and nationwide patient treatment is guaranteed all the time.


Subject(s)
COVID-19/epidemiology , Cardiac Surgical Procedures/statistics & numerical data , Heart Diseases/surgery , Quality Indicators, Health Care , Registries , Societies, Medical , Thoracic Surgery , Comorbidity , Germany/epidemiology , Heart Diseases/epidemiology , Humans , Retrospective Studies , Risk Factors , SARS-CoV-2
14.
Ann Ig ; 33(5): 513-517, 2021.
Article in English | MEDLINE | ID: covidwho-1266915

ABSTRACT

Abstract: Starting from the minimum requirements indicated by Lombardy Region, a validation checklist has been developed by experts in design, healthcare layout planning, hygiene and public health, planning and compliance, in order to provide managers of COVID-19 massive vaccination centers with a useful and easy-to-use tool to ensure quality, safety and efficiency of the different activities performed.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Community Health Centers/organization & administration , Mass Vaccination/organization & administration , SARS-CoV-2 , Validation Studies as Topic , COVID-19 Vaccines/supply & distribution , Checklist , Community Health Centers/standards , Efficiency, Organizational , Facility Design and Construction , Humans , Hygiene , Italy , Patient Safety , Quality Assurance, Health Care , Quality Indicators, Health Care
16.
J Am Geriatr Soc ; 69(8): 2070-2078, 2021 08.
Article in English | MEDLINE | ID: covidwho-1247240

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has severely affected nursing home residents. Given the continued high incidence of COVID-19, and the likelihood that new variants and other infectious agents may cause future outbreaks, we sought to understand the relationship of nursing home quality ratings and measures of COVID-19 outbreak severity and persistence. DESIGN: We analyzed nursing home facility-level data on COVID-19 cases and deaths, county-level COVID-19 rates, and nursing home data from the Centers for Medicare & Medicaid Services (CMS), including ratings from the CMS Nursing Home Five-Star Quality Rating System. We used regression analysis to examine the association between star ratings and cumulative COVID-19 incidence and mortality as well as persistent high resident incidence. SETTING: All nursing homes in the CMS COVID-19 Nursing Home Dataset reporting data that passed quality assurance checks for at least 20 weeks and that were included in the January 2021 Nursing Home Care Compare update. PARTICIPANTS: Residents of the included nursing homes. MEASUREMENTS: Cumulative resident COVID-19 incidence and mortality through January 10, 2021; number of weeks with weekly resident incidence of COVID-19 in the top decile nationally. RESULTS: As of January 10, 2021, nearly all nursing homes (93.6%) had reported at least one case of COVID-19 among their residents, more than three-quarters (76.9%) had reported at least one resident death, and most (83.5%) had experienced at least 1 week in the top decile of weekly incidence. In analyses adjusted for facility and county-level characteristics, we found generally consistent relationships between higher nursing home quality ratings and lower COVID-19 incidence and mortality, as well as with fewer high-incidence weeks. CONCLUSION: Nursing home quality ratings are associated with COVID-19 incidence, mortality, and persistence. Nursing homes receiving five-star ratings, for overall quality as well as for each domain, had lower COVID-19 rates among their residents.


Subject(s)
COVID-19/transmission , Centers for Medicare and Medicaid Services, U.S./statistics & numerical data , Nursing Homes/statistics & numerical data , Quality Indicators, Health Care/statistics & numerical data , COVID-19/epidemiology , COVID-19/mortality , Humans , Incidence , United States/epidemiology
18.
Ann Vasc Surg ; 76: 1-9, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1174100

ABSTRACT

INTRODUCTION: The novel coronavirus SARS-CoV-2 (COVID-19) has spread rapidly since it was identified. We sought to understand its effects on vascular surgery practices stratified by VASCON surgical readiness level and determine how these effects have changed during the course of the pandemic. METHODS: All members of the Vascular and Endovascular Surgery Society were sent electronic surveys questioning the effects of COVID-19 on their practices in the early pandemic in April (EP) and four months later in the pandemic in August (LP) 2020. RESULTS: Response rates were 206/731 (28%) in the EP group and 108/731 (15%) in the LP group (P < 0.0001). Most EP respondents reported VASCON levels less than 3 (168/206,82%), indicating increased hospital limitations while 6/108 (6%) in the LP group reported this level (P < 0.0001). The EP group was more likely to report a lower VASCON level (increased resource limitations), and decreased clinic, hospital and emergency room consults. Despite an increase of average cases/week to pre-COVID-19 levels, 46/108 (43%) of LP report continued decreased compensation, with 57% reporting more than 10% decrease. Respondents in the decreased compensation group were more likely to have reported a VASCON level 3 or lower earlier in the pandemic (P = 0.018). 91/108(84%) of LP group have treated COVID-19 patients for thromboembolic events, most commonly acute limb ischemia (76/108) and acute DVT (76/108). While the majority of respondents are no longer delaying the vascular surgery cases, 76/108 (70%) feel that vascular patient care has suffered due to earlier delays, and 36/108 (33%) report a backlog of cases caused by the pandemic. CONCLUSIONS: COVID-19 had a profound effect on vascular surgery practices earlier in the pandemic, resulting in continued detrimental effects on the provision of vascular care as well as compensation received by vascular surgeons.


Subject(s)
COVID-19 , Delivery of Health Care/trends , Practice Patterns, Physicians'/trends , Surgeons/trends , Vascular Surgical Procedures/trends , Adult , Delivery of Health Care/economics , Fee-for-Service Plans/trends , Female , Health Care Surveys , Humans , Income/trends , Male , Middle Aged , Practice Patterns, Physicians'/economics , Quality Indicators, Health Care/trends , Surgeons/economics , Time Factors , Vascular Surgical Procedures/adverse effects , Vascular Surgical Procedures/economics
20.
Am J Med Qual ; 36(2): 73-83, 2021.
Article in English | MEDLINE | ID: covidwho-1172660

ABSTRACT

The health care sector has made radical changes to hospital operations and care delivery in response to the coronavirus disease (COVID-19) pandemic. This article examines pragmatic applications of simulation and human factors to support the Quadruple Aim of health system performance during the COVID-19 era. First, patient safety is enhanced through development and testing of new technologies, equipment, and protocols using laboratory-based and in situ simulation. Second, population health is strengthened through virtual platforms that deliver telehealth and remote simulation that ensure readiness for personnel to deploy to new clinical units. Third, prevention of lost revenue occurs through usability testing of equipment and computer-based simulations to predict system performance and resilience. Finally, simulation supports health worker wellness and satisfaction by identifying optimal work conditions that maximize productivity while protecting staff through preparedness training. Leveraging simulation and human factors will support a resilient and sustainable response to the pandemic in a transformed health care landscape.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/organization & administration , Hospital Administration/standards , Simulation Training/organization & administration , Cost Savings , Delivery of Health Care/economics , Delivery of Health Care/standards , Humans , Job Satisfaction , Pandemics , Patient Safety/standards , Population Health , Quality Indicators, Health Care , SARS-CoV-2 , Simulation Training/standards , Workflow
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