Hospital Ward Adaptation During the COVID-19 Pandemic: A National Survey of Academic Medical Centers

Auerbach, Andrew D.; O’Leary, Kevin J.; Greysen, S. Ryan; Harrison, James D.; Kripalani, Sunil; Ruhnke, Gregory W.; Vasilevskis, Eduard E.; Maselli, Judith; Fang, Margaret C.; Herzig, Shoshana J.; Lee, Tiffany; Schnipper, Jeffrey L.

doi:10.12788/jhm.3476

Cited by 48 publications

(63 citation statements)

References 8 publications

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“…Marked reduction of in person visits, stockpile of PPE and use of respiratory isolation units have been reported. Remarkably, in one study 46% of practitioners reported examples of non-COVID-19 diagnoses in patients admitted for COVID-19 evaluation and vice versa highlighting the challenges induced by the virus to the health care system [235] .…”

Section: Surveysmentioning

confidence: 99%

“…In the third and final subcategory we find surveys targeting both patients and practitioners in a variety of specializations. From remote management of geriatric patients with heart conditions [232] and the effects of NPIs on transplant recipients/donors [233] to the changes adopted by several hospitals in academic centers [235] , hearing and emergency care [231] , [234] . Overall the observations on patients point to the interim efficacy of telemedicine and to high level of awareness about the risk of infection.…”

Section: Surveysmentioning

confidence: 99%

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Non-pharmaceutical interventions during the COVID-19 pandemic: A review

2021

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Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travels bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 348 articles written by more than 2518 of authors in the first 12 months of the emergency. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities.

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Section: Surveysmentioning

confidence: 99%

Section: Surveysmentioning

confidence: 99%

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

2021

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“…The pandemic caused by the coronavirus disease of 2019 (COVID-19) has placed unprecedented strain on hospitals around the world. Recent research on COVID-19 care delivery has focused on challenges related to critical care capacity (ICU beds, ventilators, and providers) 1 and staffing for general medical wards, 2 particularly in the early phase of the pandemic (March–June 2020). 3 This period was characterized by massive surges that overwhelmed health systems in population centers like Wuhan, China 4 or New York City in the USA 5 or entire regions such as Lombardy in Italy.…”

Section: Introductionmentioning

confidence: 99%

Discharge Practices for COVID-19 Patients: Rapid Review of Published Guidance and Synthesis of Documents and Practices at 22 US Academic Medical Centers

et al. 2021

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Background There are currently no evidence-based guidelines that provide standardized criteria for the discharge of COVID-19 patients from the hospital. Objective To address this gap in practice guidance, we reviewed published guidance and collected discharge protocols and procedures to identify and synthesize common practices. Design Rapid review of existing guidance from US and non-US public health organizations and professional societies and qualitative review using content analysis of discharge documents collected from a national sample of US academic medical centers with follow-up survey of hospital leaders Setting and Participants We reviewed 65 websites for major professional societies and public health organizations and collected documents from 22 Academic Medical Centers (AMCs) in the US participating in the HOspital MEdicine Reengineering Network (HOMERuN). Results We synthesized data regarding common practices around 5 major domains: (1) isolation and transmission mitigation; (2) criteria for discharge to non-home settings including skilled nursing, assisted living, or homeless; (3) clinical criteria for discharge including oxygenation levels, fever, and symptom improvement; (4) social support and ability to perform activities of daily living; (5) post-discharge instructions, monitoring, and follow-up. Limitations We used streamlined methods for rapid review of published guidance and collected discharge documents only in a focused sample of US academic medical centers. Conclusion AMCs studied showed strong consensus on discharge practices for COVID-19 patients related to post-discharge isolation and transmission mitigation for home and non-home settings. There was high concordance among AMCs that discharge practices should address COVID-19-specific factors in clinical, functional, and post-discharge monitoring domains although definitions and details varied. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06711-x.

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“…Since its emergence in December 2019, the rapid spread of coronavirus disease 2019 (COVID-19) has necessitated the expansion and transformation of healthcare facilities worldwide to accommodate the constantly increasing numbers of patients. This situation has provided a potential ground for the transmission of nosocomial infections [ 1 ]. Candida auris is a multidrug-resistant fungal pathogen with the capability for nosocomial transmission.…”

mentioning

confidence: 99%