1
|
Keegan D, Heffernan E, Clarke B, Deasy C, O'Donnell C, Crowley P, Hughes A, Murphy AW, Masterson S. Tools and methods for evaluating the change to health service delivery due to pandemics or other similar emergencies: A rapid evidence review. EVALUATION AND PROGRAM PLANNING 2024; 102:102378. [PMID: 37856938 DOI: 10.1016/j.evalprogplan.2023.102378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023]
Abstract
The novel coronavirus, SARS-CoV-2 and its associated disease COVID-19, were declared a pandemic in March 2020. Countries developed rapid response activities within their health services to prevent spread of the virus and protect their populations. Evaluating health service delivery change is vital to assess how adapted practices worked, particularly during times of crisis. This review examined tools and methods that are used to evaluate health service delivery change during pandemics and similar emergencies. Five databases were searched, including PubMed, CENTRAL, Embase, CINAHL, and PsycINFO. The SPIDER tool informed the inclusion criteria for the articles. Articles in English and published from 2002 to 2020 were included. Risk of bias was assessed using the Mixed-Methods Appraisal Tool (MMAT). A narrative synthesis approach was used to analyse the studies. Eleven articles met the inclusion criteria. Many evaluation tools, methods, and frameworks were identified in the literature. Only one established tool was specific to a particular disease outbreak. Others, including rapid-cycle improvement and PDSA cycles were implemented across various disease outbreaks. Novel evaluation strategies were common across the literature and included checklists, QI frameworks, questionnaires, and surveys. Adherence practices, experience with telehealth, patient/healthcare staff safety, and clinical competencies were some areas evaluated by the tools and methods. Several domains, including patient/practitioner safety and patient/practitioner experience with telemedicine were also identified in the studies.
Collapse
Affiliation(s)
- Dylan Keegan
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Dublin, Ireland; Discipline of General Practice, Clinical Science Institute, School of Medicine, University of Galway, Galway, Ireland.
| | - Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, University of Galway, Galway, Ireland; National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK; Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, UK.
| | - Bridget Clarke
- National Ambulance Service, Health Service Executive, Dublin, Ireland.
| | - Conor Deasy
- National Ambulance Service, Health Service Executive, Dublin, Ireland; Emergency Department, Cork University Hospital, Cork, Ireland; University College Cork, Cork, County Cork, Ireland.
| | - Cathal O'Donnell
- National Ambulance Service, Health Service Executive, Dublin, Ireland.
| | - Philip Crowley
- National Quality Improvement Team, Health Service Executive, Dublin, Ireland.
| | - Angela Hughes
- National Quality Improvement Team, Health Service Executive, Dublin, Ireland.
| | - Andrew W Murphy
- Discipline of General Practice, Clinical Science Institute, School of Medicine, University of Galway, Galway, Ireland; HRB Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland.
| | - Siobhán Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, University of Galway, Galway, Ireland; National Ambulance Service, Health Service Executive, Dublin, Ireland.
| |
Collapse
|
2
|
Cortese G, Sorbello M, Di Giacinto I, Cedrone M, Urdaneta F, Brazzi L. Human Factors and Airway Management in COVID-19 Patients: The Perfect Storm? J Clin Med 2022; 11:jcm11154271. [PMID: 35893372 PMCID: PMC9330625 DOI: 10.3390/jcm11154271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients’ airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the “take home lesson” that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.
Collapse
Affiliation(s)
- Gerardo Cortese
- Department of Anaesthesia, Intensive Care and Emergency, AOU Città della Salute e della Scienza, Corso Dogliotti 14, 10126 Turin, Italy; (G.C.); (L.B.)
| | - Massimiliano Sorbello
- Anesthesia and Intensive Care, AOU Policlinico San Marco, 95121 Catania, Italy
- Correspondence:
| | - Ida Di Giacinto
- Anesthesia and Intensive Care, Mazzoni Hospital, 63100 Ascoli Piceno, Italy;
| | - Martina Cedrone
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy;
| | - Felipe Urdaneta
- Department of Anesthesiology, North Florida/South Georgia Veteran Health Systems, University of Florida, Gainesville, FL 32608, USA;
| | - Luca Brazzi
- Department of Anaesthesia, Intensive Care and Emergency, AOU Città della Salute e della Scienza, Corso Dogliotti 14, 10126 Turin, Italy; (G.C.); (L.B.)
- Department of Surgical Sciences, University of Turin, 10126 Turin, Italy;
| |
Collapse
|
3
|
Al Shabeeb RQ, Lee E, El Shatanofy M, Mulcahy CF, Sherman ML, Heinz ER, Yamane DP. Impact of COVID-19 specific simulation training in improving intubators' level of comfort during intubations of COVID-19 patients - Results from a USA national survey. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022; 43:17-22. [PMID: 38620697 PMCID: PMC8784652 DOI: 10.1016/j.tacc.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022]
Abstract
Background Tracheal intubation is a hazardous aerosolizing procedure with a potential risk of spreading SAR-CoV-2 between patients and physicians. Aim The purpose of this study was to explore the impact of COVID-19 specific simulation training in improving provider level of comfort during the intubation of COVID-19 patients. Methods In this cross-sectional national study, an electronic survey was disseminated using a snowball sample approach to intubators from 55 hospitals across the United States. The survey assessed providers' comfort of intubating and fear of contracting the virus during COVID-19 intubations. Results A total of 329 surveys from 55 hospitals were analyzed. Of 329 providers, 111 providers (33.7%) reported participating in simulation training. Of those, 86 (77.5%) reported that the simulation training helped reduce their fear of intubating COVID-19 patients. Providers in the simulation training group also reported a higher level of comfort level with intubating both general patients (median [range] no-simulation training group 9 [3-10], simulation training group 9 [6-10]; p = 0.015) and COVID-19 patients (no-ST 8 [1-10], ST group 9 [4-10]; p < 0.0005) than providers in the no-simulation training group. Conclusions Our study suggests that COVID-19 specific intubation simulation training promotes provider comfort. Simulation training may be implemented as part of airway management training during the current and novel pandemic situations.
Collapse
Affiliation(s)
- Reem Qabas Al Shabeeb
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Esther Lee
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Western University of Health Sciences, Pomona, CA, USA
| | - Muhammad El Shatanofy
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Collin F Mulcahy
- Division of Otolaryngology - Head & Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Marian L Sherman
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Eric R Heinz
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - David P Yamane
- Department of Anesthesiology and Critical Care, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| |
Collapse
|
4
|
Fernandes SF, Trigueiro JG, Barreto MAF, Carvalho REFLD, Silva MRFD, Moreira TMM, Costa MVD, Freitas RJMD. Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review. Rev Esc Enferm USP 2021; 55:e20210207. [PMID: 34807228 DOI: 10.1590/1980-220x-reeusp-2021-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. METHOD this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals; Concept = interprofessional relationships; Context = health services) and respective search strategies. RESULTS fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration; 2 - Collaborative practice; 3 - Interprofessional work; 4 - Interactive and interprofessional learning. CONCLUSION the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marcelo Viana da Costa
- Universidade Federal do Rio Grande do Norte, Escola Multicampi de Ciências Médicas, Departamento de Medicina, Caicó, RN, Brazil
| | | |
Collapse
|
5
|
Cronin JA, Saha A, Bhattarai S, Fink A, Fahey L, Shah R. Quality Improvement Education in the Era of COVID-19: A Pivot Toward Virtual Education. Pediatr Qual Saf 2021; 6:e418. [PMID: 34235348 PMCID: PMC8225379 DOI: 10.1097/pq9.0000000000000418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/10/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jessica A Cronin
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| | - Anit Saha
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| | - Sopnil Bhattarai
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| | - Alia Fink
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| | - Lisbeth Fahey
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| | - Rahul Shah
- Division of Quality and Safety, Children's National Hospital, Washington, D.C
| |
Collapse
|