Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers.
J Hosp Med
; 15(8): 483-488, 2020 08.
Article
in English
| MEDLINE | ID: covidwho-721647
ABSTRACT
IMPORTANCE Although intensive care unit (ICU) adaptations to the coronavirus disease of 2019 (COVID-19) pandemic have received substantial attention , most patients hospitalized with COVID-19 have been in general medical units. OBJECTIVE:
To characterize inpatient adaptations to care for non-ICU COVID-19 patients.DESIGN:
Cross-sectional survey.SETTING:
A network of 72 hospital medicine groups at US academic centers. MAIN OUTCOMEMEASURES:
COVID-19 testing, approaches to personal protective equipment (PPE), and features of respiratory isolation units (RIUs).RESULTS:
Fifty-one of 72 sites responded (71%) between April 3 and April 5, 2020. At the time of our survey, only 15 (30%) reported COVID-19 test results being available in less than 6 hours. Half of sites with PPE data available reported PPE stockpiles of 2 weeks or less. Nearly all sites (90%) reported implementation of RIUs. RIUs primarily utilized attending physicians, with few incorporating residents and none incorporating students. Isolation and room-entry policies focused on grouping care activities and utilizing technology (such as video visits) to communicate with and evaluate patients. The vast majority of sites reported decreases in frequency of in-room encounters across provider or team types. Forty-six percent of respondents reported initially unrecognized non-COVID-19 diagnoses in patients admitted for COVID-19 evaluation; a similar number reported delayed identification of COVID-19 in patients admitted for other reasons.CONCLUSION:
The COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of RIUs and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Infection Control
/
Coronavirus Infections
/
Clinical Laboratory Techniques
/
Academic Medical Centers
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Hosp Med
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS