Peterson Center on Healthcare
New Normal: A State Plan to Re-Open Society
How do you return to some function in society in the midst of COVID-19? In this talk I will discuss how Colorado plans to re-open societal function in a stepwise, logical fashion. I volunteered to help my home state during COVID-19 and was assigned to lead a group called New Normal. I will present the work my team put together to restart the state’s economy while minimizing the risk inherent in allowing people to re-congregate.
Nursing Insight and COVID-19
As a discipline, nursing is governed by both empirical truths and social relevance and value orientations. The unprecedented changes brought on by COVID-19 have challenged this governance that is embodied in direct, bedside care of patients. This presentation will briefly discuss the impact of these challenges on Nursing Insight – a portfolio of three different projects that use labor and delivery nurse practice data to inform quality improvement. It will highlight how practice and policy adaptations differentially impact nursing in comparison to physicians. Issues of accountability, safety and quality of care will be raised. With many unanswered questions ahead, we will demonstrate the continued value of investing in and empowering nurses within the health care team to lead and manage the provision of high-quality patient-centered care. This body of work will be of use to the wide range of stakeholders who support the evidence, applicability and values central to the profession during this public health challenge.
Primary Care: Flattening the Curve While the System Manages the Peak
Defense strategies against COVID-19, such as sheltering in place and social distancing, coupled with patient fears, have put restrictions on essential primary care services. Failing to provide these services results in greater demand on hospitals and emergency departments. This presentation will share how 16 Brigham Health primary health care sites responded to the COVID-19 challenge to protect patients and staff, provide quality care, and steward scarce resources with solutions like targeted mobile outreach, virtual visits, drive-up testing sites, and virtual primary care clinics, and share how the COVID-19 response can be an inflection point in the adoption of key strategies like team-based care, targeted outreach, and virtual care.
Health Science Specialist,
VA Boston Healthcare System
Harvard Medical School
Development of a COVID-19 Cognitive Aid to Support Operating Room Personnel
COVID-19 precautions and risks are complicating surgical procedures, burdening already taxed surgical teams with additional cognitive load. Team members must quickly process multiple protocol changes to ensure safety of both the patient and the team. This presentation will discuss the development of a COVID-19-specific cognitive aid, the COVID-19 Surgery Support System (CSSS), to support operating room (OR) personnel. The tool will integrate COVID-19-specific considerations into existing OR process models to create context-sensitive checklists to provide real-time guidance during procedures. We are identifying COVID-19-specific considerations through novel protocols developed by surgical departments, feedback from subject-matter experts, and interviews with end users. Our hope is that this will reduce the cognitive load on surgical teams even as new directives arise and improve patient safety.
“When is it going to end?” – Community insights from 4 Indian states
Noora Health’s primary COVID-19 goal is to drive positive behavior change for at-risk communities. Noora Health is collaborating closely with government stakeholders and non-profit partners to mobilize an optimal health systems response by creating and disseminating high quality, culturally contextualized, and multilingual health behavior change materials. To ensure our materials accurately meet community needs across India, we conducted phone surveys with over 2,100 community members and healthcare workers across four Indian states. This presentation willI discuss our insights into risk perception, common prevention strategies, social distancing behavior, and preferred information mediums, as well as how these learnings can be integrated into the design and development of Noora’s content and response.
Medical Director of Quality and Population Health,
AltaMed Health Services
Associate Faculty, Division of Global Health Equity,
Brigham and Women’s Hospital
How the largest FQHC in America Navigated COVID to Address Health Equity
Safety-net health systems play an essential role in the US health care system by providing care to low-income and vulnerable populations. The COVID-19 pandemic has amplified the historically poor health outcomes and inferior quality care these groups experience. As the nation’s largest federally qualified health center, serving Los Angeles and Orange Counties, we share our experiences using a population health systems of care approach to addressing COVID-19 and ensuring the preventive and chronic care for the population we serve. The COVID-19 pandemic has presented safety net health systems with extraordinary challenges, but has also provided us a transformative moment to develop systems of care that address historic inequities.
Associate Professor of Surgery and Community Health Sciences,
University of Calgary
Managing and Navigating Safe Systems Through COVID-19
Health care systems have needed to urgently develop contingency plans to address a surge in critically ill patients during the COVID-19 crisis. These plans require stewardship of human, material, and capacity resources. The crisis has required redeployment of providers to new roles or new sites of care, and reconsideration of when and how to reallocate resources after the COVID-19 surge has subsided to address the needs of patients whose care has been delayed. Clear frameworks and recommendations for addressing these resource management considerations do not exist. This presentation will describe efforts of Ariadne Labs’ Safe Surgery and Safe Systems program to determine best practices in redeployment of the health care workforce to meet the surge of critical patients, rapid onboarding of redeployed clinicians, and restarting routine surgical care post-COVID-19.
The Serious Illness Care Program’s COVID-19 Toolkit – A Rapid Response to an Evolving Pandemic
The COVID-19 pandemic has highlighted weaknesses of the health care system that now urgently threatens the well-being of millions. One such weakness is clinician-patient communication. Based on our six years of learning with health care systems about how to ensure access for seriously ill patients to timely communication about their prognosis, goals, and priorities, we believe that a systematic response can equip health care systems to ensure the highest quality care to the most people, facilitate the most efficient use of resources, and respond to the psychological needs of their workforce. This presentation will share the Serious Illness Care Program’s approach to developing a communication and implementation toolkit in response to the COVID-19 pandemic, including rapid progression through the Ariadne Arc of Design, Test, and Spread. It will describe early response to this toolkit in multiple settings and reflect on lessons learned for rapid system level responses to health system needs in a time of crisis.
MASS Design Group
Redesigning Hospital Spaces on the Fly to Protect Healthcare Workers
COVID-19 has posed an unprecedented challenge to global health systems. Hospitals have scrambled to repurpose and convert spaces, but in order to continue providing safe and effective care, they must ensure that health care workers remain healthy. A team of clinicians and designers from Mount Sinai Hospital, MASS Design Group, and Ariadne Labs came together to identify spatial interventions to mitigate infection risk among health care workers. This collaboration leverages MASS’ lessons designing for global epidemics and evidence-based research experience; Ariadne’s public health innovation pathway and knowledge-sharing model; and Mount Sinai’s position on the frontlines of the NYC epidemic to offer a glimpse of COVID-19 capacity planning. Learn more about our rapid response spatial study, and simple interventions we identified to protect health care workers.
Global Learnings in Adapting Health Systems for Pandemic Response
Sometimes the answers that we seek are just in a different language or culture. During the COVID-19 pandemic, the United States has had the advantage of seeing the crisis unfold in several other countries in Asia and Europe. By studying outlier countries, we identified and compared key strategies to increase health system capacity, prevent nosocomial infections, and protect health care workers and patients. We conducted a rapid set of interviews with frontline providers and health system leaders as well as a systematic review of country and hospital-level protocols from South Korea, Italy, and Japan. Additionally, we partnered with a team of global volunteers to crowdsource the translation of the South Korean COVID-19 playbook, contact tracing strategies, and drive-through/walk-through screening center guides into four languages. In a rapidly evolving global crisis, benchmarking protocols and performance against other countries coupled with translations of health systems strategies can enable best practices to be spread more swiftly and at scale.