What the COVID-19 Pandemic Can Teach Us About Resource Stewardship and Quality in Health Care

Abstract

The coronavirus disease 2019 pandemic has forever changed how we view health care service delivery. Although there are undoubtedly some unintended consequences that will result from current health care service reallocation, it provides a unique opportunity to consider how to deliver quality care currently, and after the pandemic. In the context of lessons learned, moving forward some of what was previously routine could remain reserved for more exceptional circumstances. To determine what is "routine," what is "essential," and what is "exceptional," it is necessary to view medical decisions within the paradigm of highquality care. The Institute for Healthcare Improvement definition of the dimensions of quality is based on whether the care is safe, effective, patient-centered, timely, efficient, and equitable. This type of stewardship has been applied to many interventions already deemed unnecessary by organizations such as the Choosing Wisely initiative, but the coronavirus disease 2019 pandemic provides a lens from which to consider other aspects of care. The following will provide examples from Allergy/Immunology that outline how we can reconsider what quality means in the postecoronavirus disease health care system.

Gut microbiota imbalance in colorectal cancer patients, the risk factor of COVID-19 mortality

“…Previous studies found that gender is also a risk factor for COVID-19 [ 34 , 35 ]. Abundance of gut microbiota of Female vs.…”

What can we learn from the SARS-COV-2 pandemic about the value of specific radiological examinations?

“…The approach demonstrates how we can learn from the pandemic and it supplements other ways to identify low value care. The approach is also recognized and applied in many other fields [ 39 – 48 ] to identify and reduce a range of low-value services.…”

Separating Fact from Fiction in the Diagnosis and Management of Food Allergy

“…The pandemic has provided the opportunity to reconsider how healthcare quality is defined moving forward, and there are several reasons why a wait and see approach, in certain contexts, is reasonable. 68 As mentioned, during the pandemic, the most salient reason is to keep children out of the ED, both owing to healthcare resource allocation and infection risk. 67,69 However, there are other reasons to consider this option that extend beyond pandemic circumstances.…”