6 Reducing unnecessary patient isolation on general medicine units

ABSTRACT

6 Figure 1Current state process map[Figure omitted. See PDF]Abstract 6 Figure 2Fishbone barriers to removal[Figure omitted. See PDF]Abstract 6 Figure 3Driver diagram and priority matrix[Figure omitted. See PDF]Abstract 6 Figure 4Criteria and decision support tool[Figure omitted. See PDF]ResultsWe completed eight appropriateness audits (n=212 patients) at two hospitals between December 2019 – March 2020. During user testing, eight physicians applied the new criteria and decision-support tool to five mock cases at 92% (37/40) fidelity. After implementing changes, mean precaution appropriateness increased from 30% (24/80) to 64% (85/132), (p<0.001). Out of 35 physicians surveyed, 22 (63%) were aware of new criteria;of those, 19 (86%) found the new criteria useful. However, there was no special-cause variation in DC precautions >5 days.ConclusionsDiscontinuing prolonged DC precautions is important to conserve vital resources, especially during the COVID-19 pandemic. We reduced these incidents by implementing standard discontinuation criteria and a decision support tool. Our next step is to adapt these tools to standardize precaution removal for COVID-19 patients.