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Please summerize the given abstract to a title | instruction | 0 | 77,241 | 26 | 231,313 |
Finding the Right Balance: An Evidence-Informed Guidance Document to Support the Re-Opening of Canadian Nursing Homes to Family Caregivers and Visitors during the COVID-19 Pandemic | output | 1 | 77,241 | 26 | 231,314 |
Abstract During the first few months of the COVID-19 pandemic, Canadian nursing homes implemented strict no-visitor policies to reduce the risk of introducing COVID-19 in these settings. There are now growing concerns that the risks associated with restricted access to family caregivers and visitors have started to outweigh the potential benefits associated with preventing COVID-19 infections. Many residents have sustained severe and potentially irreversible physical, functional, cognitive, and mental health declines. As Canada emerges from its first wave of the pandemic, nursing homes across the country have cautiously started to reopen these settings, yet there is broad criticism that emerging visitor policies are overly restrictive, inequitable and potentially harmful. We reviewed the nursing home visitor policies for Canada’s ten provinces and three territories as well as international policies and reports on the topic to develop evidence-informed, data-driven and expert-reviewed guidance for the re-opening of Canadian nursing homes to family caregivers and visitors. | input | 2 | 77,241 | 26 | 231,315 |
Please summerize the given abstract to a title | instruction | 0 | 77,312 | 26 | 231,526 |
Emergently planned exclusive hub-and-spoke system in the epicenter of the first wave of COVID-19 pandemic in Italy: the experience of the largest COVID-19-free ICU hub for time-dependent diseases | output | 1 | 77,312 | 26 | 231,527 |
BACKGROUND: Lombardy was the epicenter in Italy of the first wave of COVID-19 pandemic. To face the contagion growth, from March 8 to May 8 2020, a regional law re-designed the hub-and-spoke system for time-dependent diseases to better allocate resources for COVID-19 patients. METHODS: We report the reorganization of the major hospital in Lombardy during COVID-19 pandemic, including the rearrangement of its ICU beds to face COVID-19 pandemic and fulfill its role as extended hub for time-dependent diseases while preserving transplant activity. To highlight the impact of the emergently planned hub-and-spoke system, all patients admitted to a COVID-19-free ICU hub for trauma, neurosurgical emergencies and stroke during the two-month period were retrospectively collected and compared to 2019 cohort. Regional data on organ procurement was retrieved. Observed-to-expected (OE) in-ICU mortality ratios were computed to test the impact of the pandemic on patients affected by time-dependent diseases. RESULTS: Dynamic changes in ICU resource allocation occurred according to local COVID-19 epidemiology/trends of patients referred for time-dependent diseases. The absolute increase of admissions for trauma, neurosurgical emergencies and stroke was roughly two-fold. Patients referred to the hub were older and characterized by more severe conditions. An increase in crude mortality was observed, though OE ratios for in-ICU mortality were not statistically different when comparing 2020 vs. 2019. An increase in local organ procurement was observed, limiting the debacle of regional transplant activity. CONCLUSIONS: We described the effects of a regional emergently planned hub-and-spoke system for time-dependent diseases settled in the epicenter of COVID-19 pandemic in Italy. | input | 2 | 77,312 | 26 | 231,528 |
Please summerize the given abstract to a title | instruction | 0 | 77,367 | 26 | 231,691 |
Staffing and Capacity Planning for SARS-CoV-2 Monoclonal Antibody Infusion Facilities: A Performance Estimation Calculator Based on Discrete-Event Simulations | output | 1 | 77,367 | 26 | 231,692 |
BACKGROUND: The COVID-19 pandemic has significantly stressed healthcare systems. The addition of monoclonal antibody (mAb) infusions, which prevent severe disease and reduce hospitalizations, to the repertoire of COVID-19 countermeasures offers the opportunity to reduce system stress but requires strategic planning and use of novel approaches. Our objective was to develop a web-based decision-support tool to help existing and future mAb infusion facilities make better and more informed staffing and capacity decisions. MATERIALS AND METHODS: Using real-world observations from three medical centers operating with federal field team support, we developed a discrete-event simulation model and performed simulation experiments to assess performance of mAb infusion sites under different conditions. RESULTS: 162,000 scenarios were evaluated by simulations. Our analyses revealed that it was more effective to add check-in staff than to add additional nurses for middle-to-large size sites with ≥2 infusion nurses; that scheduled appointments performed better than walk-ins when patient load was not high; and that reducing infusion time was particularly impactful when load on resources was only slightly above manageable levels. DISCUSSION: Physical capacity, check-in staff, and infusion time were as important as nurses for mAb sites. Health systems can effectively operate an infusion center under different conditions to provide mAb therapeutics even with relatively low investments in physical resources and staff. CONCLUSION: Simulations of mAb infusion sites were used to create a capacity planning tool to optimize resource utility and allocation in constrained pandemic conditions, and more efficiently treat COVID-19 patients at existing and future mAb infusion sites. | input | 2 | 77,367 | 26 | 231,693 |
Please summerize the given abstract to a title | instruction | 0 | 77,405 | 26 | 231,805 |
Fifteen-minute consultation: Recognition of sickle cell crises in the paediatric emergency department | output | 1 | 77,405 | 26 | 231,806 |
Children with sickle cell disease can develop life-threatening and painful crises that require prompt assessment and efficient management by healthcare professionals in the emergency or acute care setting. Due to migration patterns and improved survival rates in high-prevalence countries, there is an increased tendency to encounter these patients across the UK. These factors warrant regular revisions in sickle cell crisis management, along with education for medical personnel and patients to improve clinical care and patient management. The focus of this article is on the initial assessment and management of acute paediatric sickle cell complications in the emergency setting. Specific case studies, including acute pain crises, trauma, splenic sequestration, aplastic crises, acute chest syndrome, infection, avascular necrosis, osteomyelitis and stroke, are discussed. Due to the current COVID-19 pandemic, we have also reviewed specific concerns around this patient group. | input | 2 | 77,405 | 26 | 231,807 |
Please summerize the given abstract to a title | instruction | 0 | 77,724 | 26 | 232,762 |
Description of an Integrated and Dynamic System to Efficiently Deal with a Raging COVID-19 Pandemic Peak | output | 1 | 77,724 | 26 | 232,763 |
Background: To describe an innovative and functional method to deal with the increased COVID-19 pandemic-related intensive care unit bed requirements. Methods: We describe the emergencial creation of integrated system of internistic ward, step-down unit and intensive care unit, physically located in reciprocal vicinity at the same floor. The run under the control of a single intensive care staff, sharing clinical protocols and informatic system, following a single director supervision. The intention was to create a dynamic and flexible system, allowing for rapid and fluid patient admission/discharge, depending on the requirements due to the third Italian peak of COVID-19 pandemic in March 2021. Results: 142 COVID-19 patients and 66 non-COVID-19 patients were admitted, no critical patient was left unadmitted and no COVID-19 severe patients referring to our centre had to be redirected to other hospitals due to bed saturation. This system allowed shorter hospital length-of-stay in general wards (5.9 ± 4 days) than in other internistic COVID-19 wards and an overall mortality in line with those reported in literature despite the peak raging. Conclusion: This case report shows the feasibility and the efficiency of this dynamic model of hospital rearrangement to deal with COVID-19 pandemic peaks. | input | 2 | 77,724 | 26 | 232,764 |
Please summerize the given abstract to a title | instruction | 0 | 77,795 | 26 | 232,975 |
Factors driving availability of COVID-19 convalescent plasma: Insights from a demand, production, and supply model | output | 1 | 77,795 | 26 | 232,976 |
BACKGROUND: COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs. METHODS: We developed a detailed simulation model of CCP donor recruitment, collection, production, and distribution processes. We ran our model using varying epidemic trajectories from 11 U.S. states and with key input parameters drawn from wide ranges of plausible values to identify key drivers of ability to scale collections capacity and meet demand for CCP. RESULTS: Utilization of available CCP collections capacity followed increases in COVID-19 hospital discharges with a lag. Utilization never exceeded 75% of available capacity in most simulations. Demand was met for most of the simulation period in most simulations, but a substantial portion of demand went unmet during early, sharp increases in hospitalizations. For epidemic trajectories that included multiple epidemic peaks, second wave demand could generally be met due to stockpiles established during the decline from an earlier peak. Apheresis machine capacity (number of machines) and probability that COVID-19 recovered individuals are willing to donate were the most important supply-side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks. CONCLUSIONS: Epidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success. | input | 2 | 77,795 | 26 | 232,977 |
Please summerize the given abstract to a title | instruction | 0 | 78,009 | 26 | 233,617 |
Health workforce protection and preparedness during the COVID-19 pandemic: a tool for the rapid assessment of EU health systems | output | 1 | 78,009 | 26 | 233,618 |
This article is dedicated to the WHO International Year of Health and Care Workers in 2021 in recognition of their commitment during the COVID-19 pandemic. The study aims to strengthen health workforce preparedness, protection and ultimately resilience during a pandemic. We argue for a health system approach and introduce a tool for rapid comparative assessment based on integrated multi-level governance. We draw on secondary sources and expert information, including material from Denmark, Germany, Portugal and Romania. The results reveal similar developments across countries: action has been taken to improve physical protection, digitalization and prioritization of healthcare worker vaccination, whereas social and mental health support programmes were weak or missing. Developments were more diverse in relation to occupational and organizational preparedness: some ad-hoc transformations of work routines and tasks were observed in all countries, yet skill-mix innovation and collaboration were strongest in Demark and weak in Portugal and Romania. Major governance gaps exist in relation to education and health integration, surveillance, social and mental health support programmes, gendered issues of health workforce capacity and integration of migrant healthcare workers (HCW). There is a need to step up efforts and make health systems more accountable to the needs of HCW during global public health emergencies. | input | 2 | 78,009 | 26 | 233,619 |
Please summerize the given abstract to a title | instruction | 0 | 78,100 | 26 | 233,890 |
Rapid Development and Utilization of a Clinical Intelligence Dashboard for Frontline Clinicians to Optimize Critical Resources During Covid-19 | output | 1 | 78,100 | 26 | 233,891 |
Introduction: The COVID-19 pandemic has created an unprecedented situation where sudden and prolonged surges of critically ill patients have disrupted healthcare systems worldwide A major concern for hospitals worldwide is how to best manage large numbers of COVID-19 infected and non-infected patients, while still maintaining high-quality clinical care. Aim: This manuscript describes the system development, collaborative efforts and the challenges encountered in developing an in-house clinical intelligence dashboard. Methods: Through a longitudinal, interdepartmental collaboration, a COVID-19 clinical intelligence dashboard was created using Microsoft Power BI and Cerner Computer Language (CCL) to demonstrate clinical severity of patients and patient location in a single screen. A color-coding schema was applied to produce a red highlight for patients whose condition is deteriorating, whether due to increasing oxygen demand or worsening laboratory values. An additional function enabled users to drill down into the patient's clinical and laboratory parameters for the past 5 days, and ultimately to the respective patient chart for further assessment. Results: The development of an in-house clinical intelligence dashboard is a feasible, effective tool to allow frontline clinicians to monitor patient status in multiple wards and proactively intervene as clinically necessary and transfer patients to the appropriate level of care. Comparing the 30 days before and 30 days after the implementation of the dashboard, the percentage of patients who required urgent intubation or cardiac resuscitation on the general medical ward, rather than a critical care setting, declined by over 50% (8 out of 34, 33% vs. 7 out of 55, 13%; two-tailed p < 0.05 by Fisher's exact test; OR 3.43; CI 1.07 to 10.95). Conclusion: The dashboard has enabled physicians to efficiently assess patient volumes and case severity to prioritize clinical care and appropriately allocate scarce resources. The dashboard can be replicated by developing healthcare systems that are continuing to grapple with the pandemic. | input | 2 | 78,100 | 26 | 233,892 |
Please summerize the given abstract to a title | instruction | 0 | 78,248 | 26 | 234,334 |
A Closer Look at Women's Health Centers: Historical Lessons and Future Aims. | output | 1 | 78,248 | 26 | 234,335 |
Women's Health Centers (WHC) have evolved over the last few decades as comprehensive centers for women's health care. This article reviews the history and evaluation of WHC, as well as opportunities for women's health training. Prior studies comparing WHC with traditional primary care and obstetrics/gynecology clinics have found that WHC offer at least similar levels of preventative care, may increase access to care for a more diverse patient population, and improve patient/provider relationship satisfaction. WHC also increase women's health providers' education and research opportunities. There is still a gap in women's health education and training, although residency and fellowship programs have aimed to address this through women's health tracks and fellowships. The coronavirus disease 2019 (COVID-19) pandemic and its negative impact on women's access to care have further highlighted the potential of WHC to meet women's health care demands. WHC can provide comprehensive, convenient, and single-site care for women. The increased opportunities for women's health training through WHC give rise to more representation in leadership and investment in women's health. New research is needed to reassess and further evaluate health outcomes of WHC compared with traditional care models. | input | 2 | 78,248 | 26 | 234,336 |
Please summerize the given abstract to a title | instruction | 0 | 78,255 | 26 | 234,355 |
Adapting cleft care protocols in low- and middle-income countries during and after COVID-19: a process-driven review with recommendations | output | 1 | 78,255 | 26 | 234,356 |
Objective: A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptions to cleft care protocols during and after COVID as a priority learning area of need. Design: A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptions to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organisations involved in comprehensive cleft care. Results: Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinised and COVID adaptions, specifically in the pre and peri-operative periods, were highlighted. Second, surgical operations and access to services were prioritized according to their relationship to functional outcomes and time-sensitivity. The operations assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft services assigned the highest priority were new-born assessments, paediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. Conclusions: A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings. | input | 2 | 78,255 | 26 | 234,357 |
Please summerize the given abstract to a title | instruction | 0 | 78,279 | 26 | 234,427 |
"You know, we can change the services to suit the circumstances of what is happening in the world": a rapid case study of the COVID-19 response across city centre homelessness and health services in Edinburgh, Scotland | output | 1 | 78,279 | 26 | 234,428 |
BACKGROUND: The COVID-19 pandemic has necessitated unprecedented changes in the way that health, social, and housing services are delivered to individuals experiencing homelessness and problem substance use. Protecting those at high risk of infection/transmission, whilst addressing the multiple health and social needs of this group, is of utmost importance. This study aimed to document the impact of the COVID-19 pandemic on individuals who were experiencing homelessness in one city centre in Scotland, and how services adapted in response. METHODS: Semi-structured interviews were conducted with individuals with lived/living experience of homelessness (n = 10), staff within onethird sector service (n = 5), and external professionals (n = 5), during April-August 2020, using a rapid case study design. These were audio-recorded, fully transcribed, and analysed using Framework. Analysis was informed by inclusion health and equity-orientated approaches to meeting the needs of people with multiple and complex needs, and emerging literature on providing harm reduction in the context of COVID-19. RESULTS: Those with lived/living experience of homelessness and problem substance use faced a range of additional challenges during the pandemic. Mental health and use of substances were affected, influenced by social isolation and access to services. A range of supports were provided which flexed over the lockdown period, including housing, health and social care, substance use treatment, and harm reduction. As well as documenting the additional risks encountered, findings describe COVID-19 as a 'path-breaking' event that created opportunities to get evidence into action, increase partnership working and communication, to proactively address risks. CONCLUSIONS: This rapid case study has described the significant impact of the COVID-19 pandemic on a group of people experiencing homelessness and problem substance use within one city centre in Scotland and provides a unique lens on service/professional responses. It concludes with lessons that can inform the international and ongoing response to this pandemic. It is vital to recognise the vision and leadership that has adapted organisational responses in order to reduce harms. We must learn from such successes that were motivated both by compassion and care for those vulnerable to harms and the desire to provide high-quality, evidence-based, harm reduction services. | input | 2 | 78,279 | 26 | 234,429 |
Please summerize the given abstract to a title | instruction | 0 | 78,361 | 26 | 234,673 |
The Privatization of the Italian National Health System and its Impact on Health Emergency Preparedness and Response: The COVID-19 Case | output | 1 | 78,361 | 26 | 234,674 |
Hospitals play a critical role in providing essential care during emergencies; however, this essential care can overwhelm the functional capacity of health systems. In Italy, substantial cuts in funding have drastically reduced the resources of the National Health Service (NHS) and contributed to the expansion of the private health sector which, unlike the public health system, does not have the capacity to deal with a health emergency such as coronavirus disease 2019 (COVID-19). The purpose of this article is to show how the privatization of the NHS contributed to making Italy more vulnerable and unprepared to tackle the COVID-19 pandemic. The available capacity and resources in the public and private emergency services systems in Italy are compared, including a focus on the numbers of hospital staff, hospitals, and hospital beds. The reduced funding and subsequent shortfalls in services in the NHS are reasons why extreme measures were needed to increase these resources during the COVID-19 pandemic. A public NHS in Italy would be better prepared for future health emergencies. The lessons learned from the COVID-19 pandemic can help to inform future health systems strategies, to halt the current financial decline and performance loss of national health systems, and to enable better preparation for future health emergencies. | input | 2 | 78,361 | 26 | 234,675 |
Please summerize the given abstract to a title | instruction | 0 | 78,392 | 26 | 234,766 |
Recognising the important role of nurses in general practice | output | 1 | 78,392 | 26 | 234,767 |
Medical Director of Primary Care, NHS England and NHS Improvement Dr Nikki Kanani shares her thoughts on the role GPNs have played throughout the COVID-19 pandemic | input | 2 | 78,392 | 26 | 234,768 |
Please summerize the given abstract to a title | instruction | 0 | 78,522 | 26 | 235,156 |
Management and patient safety of complex elderly patients in primary care during the COVID-19 pandemic in the UK-Qualitative assessment | output | 1 | 78,522 | 26 | 235,157 |
OBJECTIVES: The study aims to investigate GPs' experiences of how UK COVID-19 policies have affected the management and safety of complex elderly patients, who suffer from multimorbidity, at the primary care level in North West London (NWL). DESIGN: This is a service evaluation adopting a qualitative approach. SETTING: Individual semi-structured interviews were conducted between 6 and 22 May 2020, 2 months after the introduction of the UK COVID-19 Action Plan, allowing GPs to adapt to the new changes and reflect on their impact. PARTICIPANTS: Fourteen GPs working in NWL were interviewed, until data saturation was reached. OUTCOME MEASURES: The impact of COVID-19 policies on the management and safety of complex elderly patients in primary care from the GPs' perspective. RESULTS: Participants' average experience was fourteen years working in primary care for the NHS. They stated that COVID-19 policies have affected primary care at three levels, patients' behaviour, work conditions, and clinical practice. GPs reflected on the impact through five major themes; four of which have been adapted from the Safety Attitudes Questionnaire (SAQ) framework, changes in primary care (at the three levels mentioned above), involvement of GPs in policy making, communication and coordination (with patients and in between medical teams), stressors and worries; in addition to a fifth theme to conclude the GPs' suggestions for improvement (either proposed mitigation strategies, or existing actions that showed relative success). A participant used an expression of "infodemic" to describe the GPs' everyday pressure of receiving new policy updates with their subsequent changes in practice. CONCLUSION: The COVID-19 pandemic has affected all levels of the health system in the UK, particularly primary care. Based on the GPs' perspective in NWL, changes to practice have offered opportunities to maintain safe healthcare as well as possible drawbacks that should be of concern. | input | 2 | 78,522 | 26 | 235,158 |
Please summerize the given abstract to a title | instruction | 0 | 78,659 | 26 | 235,567 |
Guidelines and best practice recommendations on reproductive health services provision amid COVID-19 pandemic: scoping review | output | 1 | 78,659 | 26 | 235,568 |
BACKGROUND: Policymakers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available guidelines, consensus statements, the standard of practice, and practice recommendations on reproductive health service provision during the COVID-19 pandemics. METHODS: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health. We looked for practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE, and Google Scholar. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion. RESULTS: A total of 21 records were included in the review. Identified recommendations were classified into thematic areas. The records addressed approaches to antenatal care, labour and delivery, postnatal care, safe abortion, contraception, gender-based violence, and artificial reproduction. CONCLUSIONS: There were consistent consensus statements and recommendations that there should be access to sexual and reproductive health services like antenatal care (ANC), postnatal care (PNC), contraception service, safe abortion care, and clinical management of rape survivors during the COVID-19 pandemics with the concerted effort of service re-organization. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine and community/home-based care or self-care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-10346-2. | input | 2 | 78,659 | 26 | 235,569 |
Please summerize the given abstract to a title | instruction | 0 | 78,782 | 26 | 235,936 |
Should age matter in COVID-19 triage? A deliberative study | output | 1 | 78,782 | 26 | 235,937 |
The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and 'anticipatory triage' likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public's moral intuitions. Our study aimed to explore general public views in the UK on the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public (n=22). Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected 'fair innings' and 'life projects' principles as justifications for age-based allocation. They were also wary of the 'maximise life-years' principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This 'triad' of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. | input | 2 | 78,782 | 26 | 235,938 |
Please summerize the given abstract to a title | instruction | 0 | 78,811 | 26 | 236,023 |
Helping healthcare teams save lives during COVID-19: Insights and countermeasures from team science. | output | 1 | 78,811 | 26 | 236,024 |
As the COVID-19 pandemic has ravaged the United States, health care teams are on the frontlines of this global crisis, often navigating harrowing conditions at work, such as a lack of personal protective equipment and staffing shortages, and distractions at home, including worries about elderly relatives or making childcare arrangements. While the nature and severity of stressors impacting health care teams are in many ways unprecedented, decades of psychological research exploring teamwork in extreme contexts can provide insights to understand and improve outcomes for teams in a crisis. This review highlights the psychological principles that apply to teams in a crisis and illustrates how psychologists can use this knowledge to improve teamwork for medical teams in the midst of the COVID-19 pandemic., The review also provides a glimpse toward the future, noting both how psychologists can help health care teams recover and rebound, as well as how additional research can improve psychologists' understanding of teamwork in times of crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved). | input | 2 | 78,811 | 26 | 236,025 |
Please summerize the given abstract to a title | instruction | 0 | 78,828 | 26 | 236,074 |
Rural community pharmacies’ preparedness for and responses to COVID-19 | output | 1 | 78,828 | 26 | 236,075 |
BACKGROUND: Few studies have documented rural community pharmacy disaster preparedness. OBJECTIVES: To: (1) describe rural community pharmacies’ preparedness for and responses to COVID-19 and (2) examine whether responses vary by level of pharmacy rurality. METHODS: A convenience sample of rural community pharmacists completed an online survey (62% response rate) that assessed: (a) demographic characteristics; (b) COVID-19 information source use; (c) interest in COVID-19 testing; (d) infection control procedures; (e) disaster preparedness training, and (f) medication supply impacts. Descriptive statistics were calculated and differences by pharmacy rurality were explored. RESULTS: Pharmacists used the CDC (87%), state health departments (77%), and state pharmacy associations (71%) for COVID-19 information, with half receiving conflicting information. Most pharmacists (78%) were interested in offering COVID-19 testing but needed personal protective equipment and training to do so. Only 10% had received disaster preparedness training in the past five years. Although 73% had disaster preparedness plans, 27% were deemed inadequate for the pandemic. Nearly 70% experienced negative impacts in medication supply. There were few differences by rurality level. CONCLUSION: Rural pharmacies may be better positioned to respond to pandemics if they had disaster preparedness training, updated disaster preparedness plans, and received regular policy guidance from professional bodies. | input | 2 | 78,828 | 26 | 236,076 |
Please summerize the given abstract to a title | instruction | 0 | 78,895 | 26 | 236,275 |
Family Presence for Patients with Severe Acute Brain Injury and the Influence of the COVID-19 Pandemic. | output | 1 | 78,895 | 26 | 236,276 |
Objectives: The global COVID-19 pandemic made strict visitation policies necessary. We explored the experiences of family members of patients with severe acute brain injury focusing on the impact of family presence in the hospital. Methods: Semistructured interviews (February 2018-April 2020) were audiotaped, transcribed, and analyzed using thematic analysis. Results: We interviewed family members of 19 patients with stroke, traumatic brain injury, or cardiac arrest; five interviews occurred after initiation of restrictive visitation policies. Four key themes highlight the role of visitation on family's ability to (1) cope by being at the bedside, (2) protect and advocate for the patient, (3) build trust with clinicians, and (4) receive emotional support in the intensive care unit. After visitation restrictions, families found ways to communicate and support virtually and wished for proactive communication from clinicians. Conclusions: Family presence at patient's bedside fulfills important needs. Visitation restrictions require hospitals to be creative and inclusive to help maintain these connections. | input | 2 | 78,895 | 26 | 236,277 |
Please summerize the given abstract to a title | instruction | 0 | 79,009 | 26 | 236,617 |
Imagining a world without low-value services: progress, barriers, and the path forward | output | 1 | 79,009 | 26 | 236,618 |
Low-value services are a major problem in the US health care system. We believe that the coronavirus disease 2019 pandemic's unprecedented impact on the health system, and society writ large, offers an opportunity to reshape the conversation and incentives around low-value services. This article explores current barriers to and opportunities for accelerating progress toward high-value care delivery. We examine how financial and nonfinancial incentives, uncertainty in clinical decision-making, and insufficient partnering with patients and families contribute to the delivery of low-value care. We then explore potential solutions, including making it easier for clinicians to forgo low-value services and providing them with actionable information to make those decisions, expanding payer efforts to develop "value report cards," developing measures that map the adverse health and economic effects of low-value services, and training clinicians and health care leaders to engage in conversations with patients about the personal medical, financial, and psychological harms of low-value services. | input | 2 | 79,009 | 26 | 236,619 |
Please summerize the given abstract to a title | instruction | 0 | 79,028 | 26 | 236,674 |
Supporting the Healthcare Workforce in Response to the COVID-19 Pandemic | output | 1 | 79,028 | 26 | 236,675 |
ARS-CoV-2, a new coronavirus disease first identified in 2019 (COVID-19), is responsible for the pandemic that is presently straining the Illinois’ healthcare workforce and is expected to continue doing so for the next several years. Prior pandemics and disasters have demonstrated that the scope of responsibilities for all types of healthcare workers evolves as a disaster unfolds, from meeting surging needs by prioritizing patient care, to re-balancing activities as each surge waxes and wanes, to recovery and mitigation, and finally to preparing for future disasters. This report presents a high-level summary of the current and expected impact of the COVID-19 pandemic on the healthcare workforce and makes a series of recommendations about how to minimize the adverse impact of the COVID-19 pandemic on healthcare workers and their families in Illinois, now and over time. The report draws on well-established frameworks for response to pandemics and disasters distilled from a body of research and practice. We conclude that focused supportive actions are necessary to facilitate work responsibilities under new pressures—people, information, process, technology, equipment, space—and to promote personal wellness—physical and psychosocial. Many steps taken to ensure public and workforce safety have also introduced economic challenges that must be addressed in order to sustain these efforts to support the workforce throughout the response and recovery phases of the pandemic. Key supports for individual providers, such as hazard pay provided by employers or government1 and free hotel rooms or meals provided by private companies,2 have already begun in many places across the country, but applying these at scale remains a challenge. We include two case studies showing it is possible to respond to real needs of workers even in the midst of a pandemic, if institutions are committed, creative and nimble. CONCLUSION: EXTEND WHAT WORKS Some of the innovations highlighted in the case studies above may be promising statewide if they can be brought to scale, shared across the industry, and made sustainable. For example, hospitals that have significant human capital have developed protocols for insuring worker safety. By contrast, home healthcare workers, who have been deemed essential in Illinois and many states, say they lack sufficient information about ensuring their own safety and the safety of their clients. While trade groups can assist with best practices, adapting detailed protocols developed by hospitals with greater in-house capacity can help workers who work for smaller companies. Just as reimbursement rules have been modified to allow for telemedicine services, policymakers and insurers should explore whether similar flexibility is possible for community health services. Increasing coverage for their services will help vitally important community health workers to assist persons in need.20 Coordination and sharing of information (e.g., best practices, operational manuals) can reduce the costs to healthcare organizations that face tremendous strain now. The Illinois Department of Public Health (IDPH) promulgates best practices for public health efforts but is actively managing a pandemic. Ideally in partnership with IDPH, the new Illinois Innovation Network (IIN)21 with its 15 hubs, drawing on the expertise of 12 universities, provides an existing architecture for transferring knowledge learned at UI Health and other Chicago hospitals to hospitals across the state, including Illinois’ vital critical access hospitals. IIN is also helping with development of the healthcare workforce across the state. Some innovations may improve the way healthcare is delivered going forward. For example, changes in reimbursement for telehealth may provide the necessary conditions to serve as model of care for some patients and some conditions moving forward. Also, the efforts to provide temporary housing to workers seeks to allay the strain from long hours in high-pressure conditions. Policymakers should ask whether each innov tion and recommendation above can lead to sustainable chan | input | 2 | 79,028 | 26 | 236,676 |
Please summerize the given abstract to a title | instruction | 0 | 79,033 | 26 | 236,689 |
Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa | output | 1 | 79,033 | 26 | 236,690 |
Cape Town is currently one of the hotspots for COVID-19 on the African continent The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19 Facilities were re-organised to have 'screening and streaming' at the entrance and patients were separated into hot and cold streams Both streams had 'see and treat' stations for the rapid treatment of minor ailments Patients in separate streams were then managed further If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers Community health workers also engaged in community-based screening and testing Initial evaluation of PHC preparedness was generally good However, a number of key issues were identified Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter Managers had to actively address the anxiety and fears of the primary care workforce Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time | input | 2 | 79,033 | 26 | 236,691 |
Please summerize the given abstract to a title | instruction | 0 | 79,050 | 26 | 236,740 |
Lessons from the frontlines: a junior doctor's experience of the first wave of the COVID-19 pandemic in a resource-limited setting | output | 1 | 79,050 | 26 | 236,741 |
COVID-19 has stressed healthcare systems across the globe. We present the experience of an intern medical officer working in a tertiary care hospital during the first wave of the pandemic in Sri Lanka. Her narrative describes how the stress of the pandemic brought into sharp focus the strengths and weaknesses in the health system. We suggest some strategies to improve our health services as the world faces the second wave and an uncertain future. These include structural changes in healthcare services at institutional and national levels, focused educational programmes for healthcare professionals to impart generic skills of disaster management, and the development of telehealth services and computerisation of health systems. We believe that we must maintain this focus to ensure that our patients can be guaranteed quality healthcare in the future. | input | 2 | 79,050 | 26 | 236,742 |
Please summerize the given abstract to a title | instruction | 0 | 79,064 | 26 | 236,782 |
Transport of COVID-19 and other highly contagious patients by helicopter and fixed-wing air ambulance: a narrative review and experience of the Swiss air rescue Rega | output | 1 | 79,064 | 26 | 236,783 |
BACKGROUND: The current COVID-19 pandemic highlights the challenges air ambulance services are facing when transporting highly infectious patients for several hours in enclosed spaces. This overview provides an example of a standard operating procedure (SOP) for infection prevention measures in HEMS missions during the COVID-19 pandemic. Furthermore, we describe different methods used by several organizations in Europe and the experience of the Swiss air rescue organization Rega in transporting these patients. Possible benefits of the use of small patient isolation units (PIU) are discussed, including the fact that accompanying medical personnel do not need to wear personal protective equipment (PPE) during the transport but can still maintain full access to the patient. Rega has developed and patented its own PIU. This device allows spontaneously breathing or mechanically ventilated patients to be transported in pressurized jet cabins, small helicopters and ambulance vehicles, without the need to change between transport units. This PIU is unique, as it remains air-tight even when there is a sudden loss of cabin pressure. CONCLUSION: A wide variety of means are being used for the aeromedical transport of infectious patients. These involve isolating either the patient or the medical crew. One benefit of PIUs is that the means of transport can be easily changed without contaminating the surroundings and while still allowing access to the patient. | input | 2 | 79,064 | 26 | 236,784 |
Please summerize the given abstract to a title | instruction | 0 | 79,115 | 26 | 236,935 |
Community engagement during COVID: A field report from seven CTSAs | output | 1 | 79,115 | 26 | 236,936 |
INTRODUCTION: Prior to the COVID pandemic, many CTSAs employed face-to-face interactions to conduct most of their community engagement (CE) activities. During the COVID pandemic, such engagement had to be curtailed and alternatives needed to be formulated. In addition, Community Engaged Research (CEnR) teams refocused their efforts to address this public health crisis. METHODS: To obtain a general understanding of how CTSAs have conducted CE and CEnR during the COVID pandemic, we invited seven CTSA CE leaders to provide brief field reports of their activities during the pandemic. This included how their approaches to CE and CEnR were modified during the COVID-19 pandemic and key lessons learned. RESULTS: We found that despite numerous challenges, all seven CTSAs CE cores were able to successfully carry out CE and CEnR. We also found that the fundamental principles of meaningful and authentic stakeholder engagement were of paramount importance during the pandemic. Through virtual approaches, all sites had considerable success in maintaining CE in during the COVID pandemic. They also leveraged existing bi-directional community partnerships to carry out meaningful and impactful research. This included both new COVID CEnR and also innovative approaches to sustain prior non-COVID research. CONCLUSIONS: These findings suggest that academic-community partnerships must be fostered and sustained over the many years so that when such crises emerge, all partners can build on existing trust and mutual respect. The lessons learned and the new tools and approaches developed would be key in addressing any such future public health emergencies. | input | 2 | 79,115 | 26 | 236,937 |
Please summerize the given abstract to a title | instruction | 0 | 79,117 | 26 | 236,941 |
Medical leadership in the NHS during the COVID-19 pandemic | output | 1 | 79,117 | 26 | 236,942 |
Amid the global COVID-19 pandemic, adaptation of healthcare systems, with strong medical leadership, has been integral to coping with the ever-changing situation. This article is based on the personal experiences of doctors in the NHS and insights into the frontline response to this situation. It reflects on leadership dilemmas and strategies implemented to overcome them, with a focus on systems thinking and adaptive leadership. | input | 2 | 79,117 | 26 | 236,943 |
Please summerize the given abstract to a title | instruction | 0 | 79,189 | 26 | 237,157 |
Barriers to hospital electronic public health reporting and implications for the COVID-19 pandemic | output | 1 | 79,189 | 26 | 237,158 |
We sought to identify barriers to hospital reporting of electronic surveillance data to local, state, and federal public health agencies and the impact on areas projected to be overwhelmed by the COVID-19 pandemic. Using 2018 American Hospital Association data, we identified barriers to surveillance data reporting and combined this with data on the projected impact of the COVID-19 pandemic on hospital capacity at the hospital referral region level. Our results find the most common barrier was public health agencies lacked the capacity to electronically receive data, with 41.2% of all hospitals reporting it. We also identified 31 hospital referral regions in the top quartile of projected bed capacity needed for COVID-19 patients in which over half of hospitals in the area reported that the relevant public health agency was unable to receive electronic data. Public health agencies' inability to receive electronic data is the most prominent hospital-reported barrier to effective syndromic surveillance. This reflects the policy commitment of investing in information technology for hospitals without a concomitant investment in IT infrastructure for state and local public health agencies. | input | 2 | 79,189 | 26 | 237,159 |
Please summerize the given abstract to a title | instruction | 0 | 79,218 | 26 | 237,244 |
Model for ethical triaging of electroconvulsive therapy patients during the COVID-19 pandemic | output | 1 | 79,218 | 26 | 237,245 |
Electroconvulsive therapy (ECT) is an essential treatment for severe mental illnesses such as depression with suicidality and catatonia. However, its availability is being threatened by resource limitations and infection concerns due to the COVID-19 pandemic. This may necessitate the triage of patients for ECT but there is no established ethical framework to prioritise patients. We offer an application of an ethical framework for use of scare medical resources in the ECT setting. | input | 2 | 79,218 | 26 | 237,246 |
Please summerize the given abstract to a title | instruction | 0 | 79,222 | 26 | 237,256 |
The need for innovation in deathcare leadership | output | 1 | 79,222 | 26 | 237,257 |
Purpose The purpose of this viewpoint essay is to examine deathcare leadership during the COVID-19 pandemic and recommend innovations to employ a more human-centric approach Design/methodology/approach This viewpoint essay uses scholarly and popular literature to explore deathcare practices during the ongoing COVID-19 pandemic and to identify limitations of existing mass fatality management policies Findings Deathcare leadership in the USA lacks a human-centric approach Rationalistic mass fatality management during COVID-19 left families struggling with grief and mourning because many burial rituals could not take place This essay suggests a humanistic approach to death management through leadership innovations as a remedy to this problem Such leadership innovations can improve responses to deathcare during this ongoing pandemic and future public health emergencies Originality/value This essay offers practical improvements to make deathcare more human-centric | input | 2 | 79,222 | 26 | 237,258 |
Please summerize the given abstract to a title | instruction | 0 | 79,224 | 26 | 237,262 |
Clinical Informatics during the COVID-19 Pandemic: Lessons Learned and Implications for Emergency Department and Inpatient Operations | output | 1 | 79,224 | 26 | 237,263 |
In response to a pandemic, hospital leaders can use clinical informatics to aid clinical decision-making, virtualizing medical care, coordinating communication, and defining workflow and compliance. Clinical informatics procedures need to be implemented nimbly, with governance measures in place to properly oversee and guide novel patient care pathways, diagnostic and treatment workflows, and provider education and communication. The authors’ experience recommends: (1) creating flexible ordersets that adapt to evolving guidelines that meet needs across specialties (2) enhancing and supporting inherent telemedicine capability (3) electronically enabling novel workflows quickly and suspending non-critical administrative or billing functions in the EHR and (4) using communication platforms based on tiered urgency that do not compromise security and privacy. | input | 2 | 79,224 | 26 | 237,264 |
Please summerize the given abstract to a title | instruction | 0 | 79,340 | 26 | 237,610 |
Short Term Home Oxygen Therapy for COVID-19 patients: The COVID-HOT algorithm | output | 1 | 79,340 | 26 | 237,611 |
Innovative solutions are required to effectively address the unprecedented surge of demand on our healthcare systems created by the COVID-19 pandemic. Home treatment and monitoring of patients who are asymptomatic or mildly symptomatic can be readily implemented to ameliorate the health system burden while maintaining safety and effectiveness of care. Such endeavor requires careful triage and coordination, telemedicine and technology support, workforce and education, as well as robust infrastructure. In the understandable paucity of evidence-based, protocolized approaches toward HOT for COVID-19 patients, our group has created the current document based on the cumulative experience of members of the Joint ACAIM-WACEM COVID-19 Clinical Management Taskforce. Utilizing available evidence-based resources and extensive front-line experience, the authors have suggested a pragmatic pathway for providing safe and effective home oxygen therapy in the community setting. | input | 2 | 79,340 | 26 | 237,612 |
Please summerize the given abstract to a title | instruction | 0 | 79,408 | 26 | 237,814 |
COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary | output | 1 | 79,408 | 26 | 237,815 |
Delivering lung cancer care during the COVID-19 pandemic has posed significant and ongoing challenges. There is a lack of published COVID-19 and lung cancer evidence-based reviews, including for the whole patient pathway. We searched for COVID-19 and lung cancer publications and brought together a multidisciplinary group of stakeholders to review and comment on the evidence and challenges. A rapid review of the literature was undertaken up to 28 October 2020, producing 144 papers, with 113 full texts screened. We focused on new primary data collection (qualitative or quantitative evidence) and excluded case reports, editorials and commentaries. Following exclusions, 15 published papers were included in the review and are summarised. They included one qualitative paper and 14 quantitative studies (surveys or cohort studies), with a total of 2295 lung cancer patients data included (mean study size 153 patients; range 7–803). Review of current evidence and commentary included awareness and help-seeking; lung cancer screening; primary care assessment and referral; diagnosis and treatment in secondary care, including oncology and surgery; patient experience and palliative care. Cross-cutting themes and challenges were identified using qualitative methods for patients, healthcare professionals and service delivery, with a clear need for continued studies to guide evidence-based decision-making. | input | 2 | 79,408 | 26 | 237,816 |
Please summerize the given abstract to a title | instruction | 0 | 79,435 | 26 | 237,895 |
An Australian diagnostic microbiology surge response to the COVID-19 pandemic | output | 1 | 79,435 | 26 | 237,896 |
Diagnostic microbiology services form a critical component of the response to infectious disease outbreaks. Like previous respiratory virus pandemics, the COVID-19 pandemic has placed significant strains on the standing capacity of laboratories around the world. In this case study, we describe the surge response required by our laboratory to meet the fluctuating demand for SARS-CoV-2 in our regional pathology service in Western Sydney, Australia between March and May 2020. While the overall number of SARS-CoV-2 PCR positive cases was relatively low compared to other Australian local health districts, testing numbers were highly unpredictable and changed on a weekly basis as local outbreaks were detected. As with other laboratories, numerous other challenges were also faced during this period, including the requirement to introduce a new and unaccredited diagnostic PCR assay for SARS-CoV-2, local and global shortages of reagents for sampling and sample processing, and a significant institutional SARS-CoV-2 outbreak in our laboratory catchment area. A successful service delivery during this period could only be maintained by a dynamic whole-of-laboratory and organizational response including (1) operational changes to the hours of service and the expansion of diagnostic testing at our laboratory site and other sites within our organization (2) careful management of specialist staff and re-training and recruitment of additional staff (3) changes to laboratory workflows to improve SARS-CoV-2 PCR test turnaround time and to accommodate limits to precious laboratory reagents; (4) clear communication within our laboratory and the NSW Health Pathology organization; and (5) collaborative co-ordination and support by NSW Health Pathology. | input | 2 | 79,435 | 26 | 237,897 |
Please summerize the given abstract to a title | instruction | 0 | 79,509 | 26 | 238,117 |
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