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Improving management of hospitalised patients with COVID-19: algorithms and tools for implementation and measurement.

Authors
  • Salem, Ahmed1, 2
  • Elamir, Hossam3
  • Alfoudri, Huda4
  • Shamsah, Mohammed4
  • Abdelraheem, Shams5
  • Abdo, Ibtissam6
  • Galal, Mohammad6
  • Ali, Lamiaa6, 7
  • 1 Anaesthesia and Intensive Care Department, Sabah Al Ahmad Urology Centre, Ministry of Health, Sabah, Kuwait. , (Kuwait)
  • 2 Anaesthesia and Intensive Care Department, Faculty of Medicine, Banha University, Benha, Egypt. , (Egypt)
  • 3 Quality and Accreditation Directorate, Ministry of Health, Safat, Kuwait [email protected] , (Kuwait)
  • 4 Anaesthesia, Critical Care and Pain Management Department, Adan Hospital, Ministry of Health, Hadiya, Kuwait. , (Kuwait)
  • 5 Critical Care Department, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK.
  • 6 Quality and Accreditation Directorate, Ministry of Health, Safat, Kuwait. , (Kuwait)
  • 7 Public Health Department, Fayoum University Faculty of Medicine, Fayoum, Egypt. , (Egypt)
Type
Published Article
Journal
BMJ open quality
Publication Date
Nov 01, 2020
Volume
9
Issue
4
Identifiers
DOI: 10.1136/bmjoq-2020-001130
PMID: 33199287
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The COVID-19 pandemic represents an unprecedented challenge to healthcare systems and nations across the world. Particularly challenging are the lack of agreed-upon management guidelines and variations in practice. Our hospital is a large, secondary-care government hospital in Kuwait, which has increased its capacity by approximately 28% to manage the care of patients with COVID-19. The surge in capacity has necessitated the redeployment of staff who are not well-trained to manage such conditions. There was a great need to develop a tool to help redeployed staff in decision-making for patients with COVID-19, a tool which could also be used for training. Based on the best available clinical knowledge and best practices, an eight member multidisciplinary group of clinical and quality experts undertook the development of a clinical algorithm-based toolkit to guide training and practice for the management of patients with COVID-19. The team followed Horabin and Lewis' seven-step approach in developing the algorithms and a five-step method in writing them. Moreover, we applied Rosenfeld et al's five points to each algorithm. A set of seven clinical algorithms and one illustrative layout diagram were developed. The algorithms were augmented with documentation forms, data-collection online forms and spreadsheets and an indicators' reference sheet to guide implementation and performance measurement. The final version underwent several revisions and amendments prior to approval. A large volume of published literature on the topic of COVID-19 pandemic was translated into a user-friendly, algorithm-based toolkit for the management of patients with COVID-19. This toolkit can be used for training and decision-making to improve the quality of care provided to patients with COVID-19. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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