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Virtual Daily Rounding for COVID-19 Facility Outbreaks: A Standardized Telehealth-Centered Approach May Reduce Hospital Transfers and Mortality.
Archbald-Pannone, Laurie; Harris, Drew; Steele, Rebecca; Kaur, Jasveen; Albero, Kim; Mutter, Justin; Cattell-Gordon, David; Rheuban, Karen.
  • Archbald-Pannone L; Division of General, Geriatric, Hospital & Palliative Medicine, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
  • Harris D; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.
  • Steele R; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
  • Kaur J; Karen S. Rheuban Center for Telehealth, University of Virginia, Charlottesville Virginia, USA.
  • Albero K; Karen S. Rheuban Center for Telehealth, University of Virginia, Charlottesville Virginia, USA.
  • Mutter J; Division of Outreach, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA.
  • Cattell-Gordon D; Division of General, Geriatric, Hospital & Palliative Medicine, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
  • Rheuban K; Karen S. Rheuban Center for Telehealth, University of Virginia, Charlottesville Virginia, USA.
Telemed J E Health ; 27(8): 915-918, 2021 08.
Article in English | MEDLINE | ID: covidwho-1276127
ABSTRACT

Background:

Residents of nursing homes are among the most vulnerable to COVID-19. There is no standardized approach for integration with hospitals for outbreak response. Previously, we described collaboration between a hospital and regional facilities. As a component of our COVID-19 Outbreak Response, we describe the impact of virtual daily rounds as an efficient and effective tool for facility outbreak in Central Virginia.

Methods:

At this facility, 82 (60%) residents were infected. Our team rapidly deployed technology to support staff at the facility. Virtual daily rounds created a systematic approach for patient care. The goals of virtual daily rounds include (1) efficiently facilitating HIPAA-compliant communication between nursing and all licensed independent providers, (2) rapid identification of clinical decline, (3) facilitation of care escalation, (4) facilitating bidirectional transfers, and (5) rapid and efficient identification of patients appropriate for telemedicine pulmonary consultation.

Results:

The outbreak remained active 6 weeks; 82 of 136 (60%) residents were infected, and 36 (44%) COVID-19 positive residents were seen by telemedicine consultation. Fifty-seven (70%) residents remained in-facility for treatment. Twenty-one residents died (15%); 10 in facility, 11 in hospital. Of those seen in telemedicine consultation, 24 (69%) remained on the treat-in-place protocol with goal-concordant care. These hospitalization and mortality rates are significantly lower than similar outbreaks reported. Discussion and

Conclusion:

We have since instituted this system at seven other facilities. A model of virtual daily rounding holds promise for decreasing mortality/hospitalization in this vulnerable population through systematically identifying patients most appropriate for telemedicine and cultivating close collaboration between hospitals and nursing homes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / COVID-19 Type of study: Prognostic study / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Telemed J E Health Journal subject: Medical Informatics / Health Services Year: 2021 Document Type: Article Affiliation country: Tmj.2021.0108

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / COVID-19 Type of study: Prognostic study / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Telemed J E Health Journal subject: Medical Informatics / Health Services Year: 2021 Document Type: Article Affiliation country: Tmj.2021.0108