{"id":1246,"date":"2021-06-01T22:23:12","date_gmt":"2021-06-01T22:23:12","guid":{"rendered":"https:\/\/www.hospitalinnovate.org\/covid19\/?p=1246"},"modified":"2021-06-01T22:50:16","modified_gmt":"2021-06-01T22:50:16","slug":"1-are-hospitals-providing-clinical-guidance-on-covid-19-to-their-frontline-worker","status":"publish","type":"post","link":"https:\/\/www.hospitalinnovate.org\/covid19\/2021\/06\/01\/1-are-hospitals-providing-clinical-guidance-on-covid-19-to-their-frontline-worker\/","title":{"rendered":"1. Are hospitals providing clinical guidance on COVID-19 to their frontline workers? And if so, how is this guidance developed and disseminated?"},"content":{"rendered":"<p>[vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; equal_height=&#8221;yes&#8221; content_placement=&#8221;bottom&#8221; css=&#8221;.vc_custom_1600728786278{margin-top: 0px !important;border-bottom-width: 4px !important;padding-top: 0px !important;padding-right: 20px !important;padding-bottom: 0px !important;padding-left: 20px !important;background-color: #f2f2f2 !important;border-bottom-color: #2c5d73 !important;border-bottom-style: solid !important;}&#8221;][vc_column width=&#8221;2\/3&#8243; css=&#8221;.vc_custom_1599247143020{padding-right: 20px !important;padding-left: 10px !important;}&#8221;][vc_custom_heading text=&#8221;Clinical Pathways&#8221; font_container=&#8221;tag:h2|text_align:left|color:%23f7941d&#8221; use_theme_fonts=&#8221;yes&#8221; css=&#8221;.vc_custom_1622586025985{margin-top: 0px !important;padding-top: 40px !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_column_text]<\/p>\n<p style=\"text-align: right;\"><a href=\"https:\/\/www.hospitalinnovate.org\/covid19\/\">Home<\/a> \/ <a href=\"https:\/\/www.hospitalinnovate.org\/covid19\/clinical-pathways-and-documentation\/clinical-pathways-overview\/\">Clinical Pathways<\/a> \/ <a href=\"https:\/\/www.hospitalinnovate.org\/covid19\/clinical-pathways-and-documentation\/clinical-pathways-overview\/key-clinical-questions\/\">Key Clinical Questions<\/a><\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221; gap=&#8221;20&#8243;][vc_column width=&#8221;3\/4&#8243; css=&#8221;.vc_custom_1599596059091{padding: 20px !important;}&#8221;][vc_custom_heading source=&#8221;post_title&#8221; use_theme_fonts=&#8221;yes&#8221;][vc_column_text]<\/p>\n<ul>\n<li><strong>A resounding yes<\/strong>: Nearly all (98%) institutions provide some form of guidance on the evaluation and management of COVID-19.<\/li>\n<li><strong>Stakeholders involved<\/strong>: The majority of institutions generate guidance through highly multidisciplinary teams including Infectious Disease (94%), Infection Control (84%), Hospital Medicine (84%), Critical Care (76%), Pulmonology (57%), and Emergency Medicine (45%).<\/li>\n<li><strong>Update frequency<\/strong>: Guidance is most commonly updated as needed (59%) or multiple times per month (37%).<\/li>\n<li><strong>Dissemination<\/strong>: The vast majority of sites provide guidance through a combination of methods, including email (84%), an institutional website (82%), a group wiki or document sharing site (57%), and training sessions for providers about to go on service (53%). In addition, the majority integrate clinical guidance with the electronic medical record (EMR) in the form of COVID-19-specific order sets (73%), note templates (65%), and best practice alerts (55%).<\/li>\n<li><strong>Single source of truth<\/strong>: In addition to the multimodal approach above, the vast majority (84%) of sites have \u201ca single source of truth\u201d where frontline providers can efficiently access current recommendations. This was most commonly implemented as an institution-wide website, although a significant portion of Hospital Medicine groups have developed their own hospitalist-specific resource.<\/li>\n<li><strong>Recommendations \/ takeaways<\/strong>: Clear and accessible guidelines are a vital tool to improve standardization of care and to help frontline providers synthesize large amounts of emerging data. Multidisciplinary input is likely necessary to improve buy-in. We were surprised that email was the most widely used modality for dissemination, and instead we recommend implementing a \u201csingle source of truth\u201d and integrating guidance with the EMR in the form of order sets and note templates in order to improve ease-of-use for busy frontline providers, though the need for frequent updates may be difficult to manage at many sites.<\/li>\n<\/ul>\n<p><strong>Limitations of the survey \/ areas for future study<\/strong>: This study collected data from surveys rather than direct artifact review, given the diversity of tools utilized even at individual sites. In addition, we only obtained 1 survey response from each institution, typically from a hospital medicine leader. Therefore, we were unable to ascertain which modes of dissemination were most effective or preferred by frontline providers.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1600127223223{border-top-width: 1px !important;border-right-width: 1px !important;border-bottom-width: 1px !important;border-left-width: 4px !important;padding-top: 20px !important;padding-right: 20px !important;padding-bottom: 20px !important;padding-left: 20px !important;border-left-color: #2c5d73 !important;border-left-style: solid !important;border-right-color: #2c5d73 !important;border-right-style: solid !important;border-top-color: #2c5d73 !important;border-top-style: solid !important;border-bottom-color: #2c5d73 !important;border-bottom-style: solid !important;border-radius: 4px !important;}&#8221;][vc_raw_html]JTVCdWx0aW1hdGVfcG9zdF9saXN0JTIwaWQlM0QlMjIxMjQ4JTIyJTVE[\/vc_raw_html][vc_wp_custommenu nav_menu=&#8221;26&#8243; el_class=&#8221;subNavButton&#8221; title=&#8221;Clinical Pathways&#8221;][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221;][vc_column][cesis_line_divider width=&#8221;&#8221;][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nineteen percent of protocols recommended standard pharmacologic VTE prophylaxis dosing for all COVID-19 patients regardless of estimated VTE risk. Ten percent recommended&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25],"tags":[],"_links":{"self":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/1246"}],"collection":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/comments?post=1246"}],"version-history":[{"count":5,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/1246\/revisions"}],"predecessor-version":[{"id":1274,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/1246\/revisions\/1274"}],"wp:attachment":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/media?parent=1246"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/categories?post=1246"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/tags?post=1246"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}