SEekingAnsweRs forCareHomes during the COVID-19 pandemic (COVID SEARCH)

Spilsbury, Karen; Devi, Reena; Griffiths, Alys Wyn; Akrill, Cyd; Astle, Anita; Goodman, Claire; Gordon, Adam L; Hanratty, Barbara; Hodkinson, Peter; Marshall, Fiona; Meyer, Julienne; Thompson, Carl

doi:10.1093/ageing/afaa201

Cited by 44 publications

(47 citation statements)

References 6 publications

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“…Recently there has been evidence that care homes may be prepared to work in a more concerted way as a sector when they engage with research networks(28) and in regional improvement programmes(29). The findings presented here build on those from other studies conducted during the pandemic(19) which showed have shown the preparedness of care home providers to work together not only to provide peer-support, but also advice and expertise, and even critical supplies.…”

Section: Discussionsupporting

confidence: 78%

“…We supplemented this by asking professional care and research networks to publicise the study using social media and electronic mailing lists. We chose to focus on managers new to research because many care home managers that we had routinely interacted with in the past through our research had engaged with online support forums alongside senior clinicians and academics(19). We considered that such experiences were likely to be atypical and we wished to explore broader accounts of how care homes responded to the pandemic.…”

Section: Methodsmentioning

confidence: 99%

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Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

Marshall

Gordon

Gladman

et al. 2020

Preprint

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BackgroundFrom late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition to accommodating new guidelines and policies, staff had to adjust to rapid reconfiguration of services external to the home that they would normally depend upon for support. This study examined the complex interdependencies of support as staff responded to COVID-19. The aim was to inform more effective responses to the ongoing pandemic, and to improve understanding of how to work with care home staff and organisations after the pandemic has passed.MethodsTen managers of registered care homes in the East Midlands of England were interviewed by videoconference or phone about their experiences of the crisis from a structured organisational perspective. Analysis used an adapted organisational framework analysis approach with a focus on social ties and interdependencies between organisations and individuals.ResultsThree key groups of interdependencies were identified: care processes and practice; resources; and governance. Care home staff had to deliver care in innovative ways, making high stakes decisions in circumstances defined by: fluid ties to organisations outside the care home; multiple, sometimes conflicting, sources of expertise and information; and a sense of deprioritisation by authorities. Organisational responses to the pandemic by central government resulted in resource constraints and additional work, and sometimes impaired the ability of staff and managers to make decisions. Local communities, including businesses, third-sector organisations and individuals, were key in helping care homes overcome challenges. Care homes, rather than competing, were found to work together to provide mutual support. Resilience in the system was a consequence of dedicated and resourceful staff using existing local networks, or forging new ones, to overcome barriers to care.ConclusionsThis study identified how interdependency between care home organisations, the surrounding community, and key statutory and non-statutory organisations beyond their locality, shaped decision making and care delivery during the pandemic. Recognising these interdependencies, and the expertise shown by care home managers and staff as they navigate them, is key to providing effective healthcare in care homes as the pandemic progresses, and as the sector recovers afterwards.

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Section: Discussionsupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

Marshall

Gordon

Gladman

et al. 2020

Preprint

Self Cite

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“…Between July and August 2020, care home staff members were contacted through a national online COVID-19 peer-support group for care home managers and staff [ 8 ] and then recruited to take part in semi-structured interviews. Purposive sampling was used to ensure the opinions elicited were representative of a range of organisational factors (care home size, residential/nursing, independent operator/chain) that have been shown to influence the severity of outbreaks during the pandemic [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

COVID-19 testing in English care homes and implications for staff and residents

et al. 2021

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Introduction Care home residents are at high risk of dying from COVID-19. Regular testing, producing rapid and reliable results is important in this population because infections spread quickly, and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests (POCTs). Methods Ten staff from eight care homes, purposively sampled to reflect care organisational attributes that influence outbreak severity, underwent a semi-structured remote videoconference interview. Transcripts were analysed using process mapping tools and framework analysis focussing on perceptions about, gaps within, and needs arising from, current pathways. Results Four main steps were identified in testing: infection prevention, preparatory steps, swabbing procedure, and management of residents. Infection prevention was particularly challenging for mobile residents with cognitive impairment. Swabbing and preparatory steps were resource-intensive, requiring additional staff resource. Swabbing required flexibility and staff who were familiar to the resident. Frequent approaches to residents were needed to ensure they would participate at a suitable time. After-test management varied between sites. Several homes reported deviating from government guidance to take more cautious approaches, which they perceived to be more robust. Conclusion Swab-based testing is organisationally complex and resource-intensive in care homes. It needs to be flexible to meet the needs of residents and provide care homes with rapid information to support care decisions. POCT could help address gaps but the complexity of the setting means that each technology must be evaluated in context before widespread adoption in care homes.

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“…The second, in 2007, proposed a classification of 5 levels [ 4 ]. And the more recent one, in 2009, developed a 6-level classification [ 5 ], and has been recently used in relevant research [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

A Clinical Decision Support System (KNOWBED) to Integrate Scientific Knowledge at the Bedside: Development and Evaluation Study

Martínez-García¹,

Naranjo-Saucedo²,

Rivas-González³

et al. 2021

JMIR Med Inform

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Background The evidence-based medicine (EBM) paradigm requires the development of health care professionals’ skills in the efficient search of evidence in the literature, and in the application of formal rules to evaluate this evidence. Incorporating this methodology into the decision-making routine of clinical practice will improve the patients’ health care, increase patient safety, and optimize resources use. Objective The aim of this study is to develop and evaluate a new tool (KNOWBED system) as a clinical decision support system to support scientific knowledge, enabling health care professionals to quickly carry out decision-making processes based on EBM during their routine clinical practice. Methods Two components integrate the KNOWBED system: a web-based knowledge station and a mobile app. A use case (bronchiolitis pathology) was selected to validate the KNOWBED system in the context of the Paediatrics Unit of the Virgen Macarena University Hospital (Seville, Spain). The validation was covered in a 3-month pilot using 2 indicators: usability and efficacy. Results The KNOWBED system has been designed, developed, and validated to support clinical decision making in mobility based on standards that have been incorporated into the routine clinical practice of health care professionals. Using this tool, health care professionals can consult existing scientific knowledge at the bedside, and access recommendations of clinical protocols established based on EBM. During the pilot project, 15 health care professionals participated and accessed the system for a total of 59 times. Conclusions The KNOWBED system is a useful and innovative tool for health care professionals. The usability surveys filled in by the system users highlight that it is easy to access the knowledge base. This paper also sets out some improvements to be made in the future.

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SEekingAnsweRs forCareHomes during the COVID-19 pandemic (COVID SEARCH)

Cited by 44 publications

References 6 publications

Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

Care homes, their communities, and resilience in the face of the COVID-19 pandemic: interim findings from a qualitative study

COVID-19 testing in English care homes and implications for staff and residents

A Clinical Decision Support System (KNOWBED) to Integrate Scientific Knowledge at the Bedside: Development and Evaluation Study

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