American journal of medical quality : the official journal of the American College of Medical Quality
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Although significant attention has been allocated to hospital management of COVID-19 patients during this pandemic, less discussed is the management of ambulatory patients. This has resulted in a challenge for ambulatory care providers in the management of COVID-19, particularly in areas with high disease prevalence. ⋯ This includes guidance on various COVID-19 management topics: clinical assessment algorithms, guidance on patient tracking, and the importance of engaging in partnerships with other provider types. Sharing these experiences in the clinical management of COVID-19 may benefit other ambulatory providers in earlier stages of the COVID-19 pandemic.
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The COVID-19 pandemic has forced the health care industry to develop dynamic protocols to maximize provider safety as aerosolizing procedures, specifically intubation, increase the risk of contracting SARS-CoV-2. The authors sought to create a quality improvement framework to ensure safe practices for intubating providers, and describe a multidisciplinary model developed at an academic tertiary care facility centered on rapid-cycle improvements and real-time gap analysis to track adherence to COVID-19 intubation safety protocols. ⋯ This study captured 68 intubations in suspected COVID-19 patients and demonstrated high personal protective equipment compliance at the institution, but also identified areas for process improvement. Overall, the authors posit that an interdisciplinary workgroup and the integration of standardized processes can be used to enhance intubation safety among providers during the COVID-19 pandemic.
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During the coronavirus disease 2019 (COVID-19) pandemic, the study institution recognized the importance of providing preoperative COVID-19 testing and symptom screening to ensure patient safety. A multidisciplinary quality improvement team used Define, Measure, Analyze, Improve, and Control methodology to understand the issues, identify solutions, and streamline patient flow. The existing preoperative evaluation (POE) clinic was utilized as a centralized entity to provide COVID-19 testing, symptom screening, and infection prevention education in addition to routine preoperative medical optimization. ⋯ Of the 593 asymptomatic patients screened by the POE clinic, 2 were found to have positive results. These patients had their surgeries postponed until proper recovery. The study institution has extended this new process to all surgical patients, warranting facility readiness for the resumption of elective surgery.