Throughout the world, different regions are at varying phases of the COVID-19 pandemic. While some countries are starting to see confirmed cases and deaths fall others, such as Brazil who at the start of June recorded 29,280 new confirmed cases, are only just reaching their peak1. Regardless of their phase, healthcare organisations must begin to anticipate, and plan for, the subsequent stages of their response strategy.
Recent developments have resulted in the easing of isolation restrictions throughout Europe therefore, healthcare organisations need to prepare for, and manage, the more long-term consequences of the global pandemic. Coronavirus disruption has created a backlog of Cancer treatments, surgeries, consultations and referrals. According to Cancer Research UK more than 2 million people are currently awaiting Cancer treatment due a scale back of services since March2. Research conducted in May by the CovidSurg Collaborative, used predictive modelling to estimate that approximately 72.3 per cent of planned surgeries will be cancelled globally through the peak period of COVID-193. Between March 11 and April 21, 2020, 42 per cent fewer patients were admitted to the Department of Veteran Affairs (VA) inpatient facilities in the US compared with the preceding 6 weeks, including for conditions generally requiring emergency treatment, despite their continuation of service4.
Therefore, when normal practice resumes, workloads will not be eased and, in many departments, will increase dramatically. To combat this, healthcare systems will need to evolve in order to provide a way forward, not just a way through, as the predictability of future outbreaks is near impossible to quantify at the moment.
Standardisation of patient care
Healthcare operates on the premise of high quality of care and patient safety, regardless of the circumstances. Even before COVID-19, we were experiencing challenging times in healthcare provision. For instance, the impacts associated with an ageing population and an increased prevalence of non-communicable diseases, accounting for 41 million deaths each year, which is equivalent to 71 per cent of all deaths globally according to the World Health Organisation5. Therefore, it remains vital, that knowledge-drive care is standardised across healthcare organisations and aligned in order to improve patient outcomes and alleviate pressures on healthcare systems both before, during and after the current pandemic.
The pandemic put pressure on healthcare organizations and highlighted the importance of two key elements of robust safe systems: the ability to implement processes that drive safety and the enablement of safe decision making through a robust structure driven by knowledge. The result of this equation is reduction of unwarranted variation that could potentially lead to patient harm.
Empowering knowledge with technology
Amid the global pandemic, there has been a significant increase in the adoption of digital technologies which have proved critical in supporting us in the fight against COVID-19. In times of crisis, the robustness and preparedness of a healthcare system is tested. The use of relevant evidence-based information, through solutions that adopt technology to prevent errors, is key to fostering safe systems.
Additionally, COVID fatigue is taking an enormous toll on healthcare workers and, as the pandemic has progressed, clinicians and healthcare professionals have had to navigate numerous policy changes, diagnostic discrepancies and treatment developments, which have been hard to manage. The interoperability of these new systems enables HCPs to stay up to date with the latest scientific information alongside improving the efficiency of clinicians’ workflows, documenting patient records, providing access to standardised order sets and decision support solutions. These resources have been translated and adopted globally enabling clinicians to make best use of valuable time and resources, in order to alleviate pressure on HCPs.
Patient education in a world of fake news
During times of uncertainty, misinformation is widespread and such content can have devastating consequences. Past outbreaks, such as Ebola and Zika virus, have shown that ‘fake news’ often gains more traction than accurate information, and it appears COVID-19 has followed this trend. Media coverage throughout this pandemic has been littered with inaccurate health tips and constant speculation around government plans. Past research has highlighted that many people are concerned about their ability to separate what’s real and what’s fake online. A Digital News Report published by Reuters Institute in 2019 outlined that a staggering 85 per cent of Brazilians say they are worried about online misinformation6. Therefore, it is vital we encourage greater awareness of trusted news sources and highlight the importance of relevant and accurate scientific information in a time of crisis.
While health literacy remains a challenge for the majority of patient populations, there is an increasing number of resources available to support breaking barriers of communication with patients, such as patient-centred evidence-based information leaflets. These educational resources are a vital tool to equalize the communication between patients and HCP’s. Informative content must be delivered in a format that allows patients to revisit what they have learned to further highlight the risks, side effects and benefits of treatments. This will help to effectively manage patients by aiming to reduce the number of re-admissions and sustain the delivery of quality patient care, as education is a key point of chronic disease management.
A platform for change
More than ever, this pandemic has highlighted that data, information and actionable content can save lives. Transformation of care facilities, such as the UK Nightingale hospitals, have highlighted the importance of accessible EHR systems at every point of care. New alert networks and methods have been put in place to classify COVID-19 patients and support doctors and nurses in the decision-making process. In order to help shape the future of healthcare and elevate the efficiency and productivity of healthcare systems, we should consider the sustainable implementation of such resources that deliver a better experience for patients and HCPs.
The key to delivering high quality patient care is to look at all the elements of the quality of care and patient safety holistically, as opposed to focusing on individual parts. This allows healthcare organisations to deliver that safe, high-quality care and patient safety, with a well-rounded care package in and beyond a pandemic. This reinforces the value of standardisation of care and resources globally, as we navigate the reality of COVID-19, a valuable lesson for the industry going forward.
1 John Hopkins University of Medicine, Coronavirus Resource Center, COVID-19 Global Map. Available at: https://coronavirus.jhu.edu/map.html
2 Cancer Research UK, Over 2 million people in backlog for cancer care. Available at: https://www.cancerresearchuk.org
3 COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgery recovery plans. Published online May 11, 2020. Doi:10.1002/bjs.11746
4 Baum A, Schwartz MD. Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic. JAMA. Published online June 05, 2020. doi:10.1001/jama.2020.9972
5 World Health Organisation, Noncommunicable diseases. June 01,2018. Available at https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
6 University of Oxford, What does our past research say about Covid–19 and concerns of misinformation. Available at http://www.ox.ac.uk/coronavirus-research/what-does-our-past-research-say-about-covid-19-and-concerns-misinformation-archive
Elsevier’s COVID-19 Healthcare Hub has provided support to the medical community during this crisis and beyond. Free-to-access toolkits include evidence-based clinical overviews, drug monographs, care plans, order sets, procedure videos and patient information leaflets. These resources have been utilised by clinicians and HCPs globally to sustain the delivery of Quality Care and Patient Safety and support clinical decision making. Elsevier’s Clinical Best Practice Council have developed a COVID-19 On-Demand Webinar Series which has been accessed by HCP’s and used as a strategic and practical support tool which outlines how to leverage our knowledge resources and deliver COVID-19 evidence-based care from a crisis through to a routine model of care delivery.
Quality, Patient Safety and Innovation Manager and member of Clinical Best Practice Council