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MAKING AN IMPACT ON THE COVID PANDEMIC
Journal of General Internal Medicine ; 37:S600-S601, 2022.
Article in English | EMBASE | ID: covidwho-1995851
ABSTRACT
STATEMENT OF PROBLEM/QUESTION When hospitals and skilled nursing facilities (SNF) were impacted during the COVID surge, what healthcare delivery model can be used to increase hospital bed capacity while maintaining quality care for marginalized patients with no access to a SNF? DESCRIPTION OF PROGRAM/INTERVENTION Background - Santa Clara Valley Medical Center is the second largest public safety net healthcare system in California. During the COVID surge, our hospitals experienced a significant demand for hospital beds. At this time, SNFs were impacted and did not accept patients with barriers in discharge planning.

Problem:

How to safely discharge non-acute patients with no accepting SNF to increase hospital bed capacity. Intervention Develop a post-acute care team (PACT) for marginalized, non-acute patients. These patients were initially hospitalized for severe medical conditions but could not be safely discharged once stabilized. During the COVID surge, Santa Clara County operationalized a 36-bed, lowacuity hospital called DePaul Health Center (DPHC) through an emergency state-issued alternative care license. DPHC implemented a novel healthcare model for post-acute transitions of vulnerable, non-acute patients during a resource-constrained time period. Of the 131 admissions to DPHC, 42% had unstable housing, 29% had active substance use, and 100% had no accepting SNFs. The operationalization involved - Training volunteer outpatient providers to work in an inpatient setting with COVID-positive patients. - Building a referral model to include all hospitals in our county. - Transition of care services including direct transition to drug treatment programs, linkage to medical respites, COVID vaccinations, specialty care followup, and medication delivery/teaching at bedside. MEASURES OF SUCCESS - Number of hospital bed days saved. - Number of additional potential hospital admissions. - Implementation of high-quality inpatient services for non-acute patients. FINDINGS TO DATE Over six months, DPHC admitted 127 patients across three county hospitals. DPHC allowed for a potential 446 additional hospital admissions (based on 2232 potential bed days saved and an average hospital LOS of 5 days per hospital admission). KEY LESSONS FOR DISSEMINATION - Establishing a post-acute care team addresses structural inequities prevalent in our healthcare system for marginalized patients. - Incorporating a post-acute care team improves access to SNF for marginalized patients.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article