Infectious Disease Commons^™

Expanding Care Coordination Scope To Support Covid-19 Population, Kate Behan, Cpho, Laura Gontz, Rn, Shawn Thurber, Rn, Christin Kyriss, Rn

Health Equity and Quality Improvement (HEQI) Summit

Covid-19 has caused overwhelming surges of cases in urban areas across the world. To assist with difficult discharges, as well as avoid unnecessary readmissions and ED visits, the care coordination team has created a comprehensive follow up care pathway across the enterprise to support our COVID-19 patients. This care pathway looks to assist Covid patients by reinforcing self-care management, providing education and supporting adherence with scheduled follow up with a primary care provider.

Technology was leveraged to interact virtually with patients who are quarantined at home. Jefferson Abington and Jefferson Northeast partnered with DinaCare to utilize their texting platform to …

John Covid-19 Employee Exposure Tracking, Michael Saris

Health Equity and Quality Improvement (HEQI) Summit

We iteratively built a data entry and dashboarding platform that has enabled JOHN to track over 2,500 employees exposed to COVID-19 or at high risk of exposure to COVID-19.

Intelligence Reporting In The Face Of Covid-19: Informing Our Response Efforts, Jamie D. Garden

Health Equity and Quality Improvement (HEQI) Summit

How might we provide successful intelligence?

1. Gather all relevant information from all possible sources available (academia, news, social media, human intelligence, etc.)
2. Sort intelligence based on relevance and credibility.
3. Identify trends, indicators, vulnerabilities, and warnings.
4. Assess opportunity analysis.

The Tjuh Hospital Medicine Covid19 Emergency Taskforce: A Guiding Light During The Surge Of Spring 2020, Rebecca Jaffe, Md, Alan Kubey, Md, Gretchen Diemer, Md, Michele Decastro, Lily Ackermann, Md, Christopher Haines, Md, Jesse Edwards, Md, René Daniel, Catriona Harrop, Md, Jonathan Woo, Md, Jack Stewart, Md

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

In mid March 2020 a highly infectious and deadly disease appeared in Philadelphia that no American physician had ever treated before. The challenge of disseminating reliable and relevant information about a novel and dangerous pathogen across practice areas cannot be understated.

Usual practices for communication and leadership are not designed to manage this kind of challenge.

Qr-Code Based Just-In-Time Platform For Perioperative Covid Guidelines, David F. Nelson, Md, Mba, Anna L. Rabinowitz, Md

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

When the COVID-19 Pandemic arrived in Philadelphia in March 2020, leadership at Thomas Jefferson University Hospital began a process of quickly authoring and updating a multitude of clinical guidelines, PPE (personal protective equipment) usage protocols, and surgical care standards in rapid succession.

The scope and scale of perioperative care at TJUH, which is made up of the Departments of Anesthesiology, Surgery, and Perioperative Nursing, means that a large and diverse number of individuals need timely access to a curated collection of resources that are specifically relevant to emergency airway management, urgent surgical care, testing, and recovery.

Large …

Home Telemonitoring Of Covid Patients By Medical Students At The Christiana Care Virtual Practice, Thomas Marconi, Jr, Chelsea Richards

Health Equity and Quality Improvement (HEQI) Summit

SARS-Cov2 arrived in Delaware on March 11, 2020. By March 22, 2020, stay at home orders were in place1. During this time, CareVio, a subsidiary of ChristianaCare, was tasked with developing a strategy to monitor the Delaware community. CareVio repurposed Twistle – a telemonitoring application utilized to distribute symptom related surveys and conduct text message conversations for follow up. This service had the capability to act as a virtual information desk and triage patients to be seen by virtual practice providers or the emergency department. Patient monitoring via Twistle was initiated on March 18, 2020 and medical students from Sidney …

Maintaining Powered Air-Purifying Respirator (Papr) Supply Through Repair Of Damaged Hose Units By 3d Printing, Dante Varotsis, Robert Ries, Michelle Ho, Kathryn Linder, Jordan Kurzum, Robert Pugliese, Pharmd, Bon Ku, Md, Mpp, Matt Fields, Md, Morgan Hutchinson, Md

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

• Powered air-purifying respirators (PAPRs) are a type of Personal Protective Equipment (PPE) that serves an essential line of defense against the spread of COVID-19 and other airborne pathogens.
• Demand for PAPRs are at a premium during a time where supply chains have been disrupted.
• The hose component of the 3M™ Air-Mate™ PAPR has a fragile interface with the hood, leading to damage and rendering the PAPR unit unsafe for continued use.
• PAPR units are on backorder, as are their components.
• Given the acute need for functional PAPRs other approaches for repair were explored.

Initiatives In Anesthesia Workspace Hygiene During Covid-19: The Gray Airway Basin And The Epic Hand Hygiene Event, Anna Rabinowitz, Kent Berg, Daniel Casey, Dietrich Gravenstein

Health Equity and Quality Improvement (HEQI) Summit

What’s the Problem?

The COVID-19 Pandemic has highlighted the need for anesthesia providers to decrease workspace contamination, particularly during and after airway management.

Delineation of “clean” and “dirty” spaces in the anesthesia workplace has been historically challenging, but the heightened awareness of microbial contamination presents a new opportunity to effect behavioral change among staff.

Irradiation Of N95 Masks For Their Sterilization And Reuse During The Covid19 Pandemic, Tara Tyson, Phd, Alex Kubli, Ms, Matthew Mistro, Ms, Karen Mooney, Phd, Amy Harrison, Phd, Adam Dicker, Md, Phd

Health Equity and Quality Improvement (HEQI) Summit

Research Objective

We sought to investigate the feasibility of irradiation for N95 mask sterilization.

A Strategy For Deploying Large-Scale Volunteer Continuous Bag Valve Tube (Bvt) Ventilation, Robert Ries, Erin Jennings, Michael Velez, Caroline Komlo, Morgan Hutchinson, Md, Robert Pugliese, Pharmd, Bon Ku, Md, Mpp, Matt Fields, Md

Health Equity and Quality Improvement (HEQI) Summit

Part 1: Hospital Guide

The hospital guide outlines steps and considerations for the healthcare system to successfully implement a manual ventilation strategy

Part 2: Online BVT Training Module

We created an online articulate evidence based training module for safe and effective Bag-Valve-Tube (BVT) ventilation for medical and nonmedical providers.

Nursing And Provider Safety Checklist For Covid-19 Patients, Michele Decastro, Msn, Crnp, Jennifer Zak, Bs, Rn, Pccn, Andrew Thum, Msn, Ml, Rn-Cc, Ccctm, Kristine Meagher, Rn, Msn, Acns-Bc

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

As increasing numbers of Covid-19 patients were admitted to the hospital, multiple Med-Surg and Telemetry units were needed to provide care. All healthcare providers noted difficulty in communicating patient plans of care across multiple units and multiple teams. Providers, Clinical Nurses, and Nursing leadership all noted differences in processes for care and communication among units and teams.

Expansion And Conversion Of Family Medicine And Neurohospitalist Services Into Covid-19 Services, Zachary Klock, Md, Aimee Mcmullin, Md, Jesse Edwards, Md, Christopher Haines, Md

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

• During the COVID-19 pandemic, there was an anticipated increase in the number of patients admitted with COVID-19.
• To meet the increased number of admitted patients, additional providers and teams were needed to care for hospitalized patients during the pandemic.
• Pre-existing teams needed to find ways to expand (in the case of the Family Medicine service) and repurpose (in the case of the Neurohospitalist service) in order to care for an increased number of patients.

Covid: Decoded - A Website, Blog, And Social Media Page With Resources And Information For The Public, Jessica Smith, Taylor Jones, Madeline Norris, Benjamin Meyers, Christopher Haines, Md

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

Information about COVID19 in the news and on social media platforms is overwhelming, confusing, riddled with jargon and sometimes straight up wrong. Makig it easy for the public to misinterpret facts or simply accept headlines and infographics at facevalue without checking with primary and/or reputable sources.

The nature of social media also allows for a perpetuation of this misinformation without recourse. Recall the one article floating around Facebook reporting that gargling salt/vinegar water could help prevent COVID19. We needede a source of simplified, reliable information about the pandemic for people outside of the health professions.

Medical students …

Development And Implementation Of A Covid-19 Specific Peri-Operative Workflow For Anesthesia Providers, Alexander Olson, David Maguire, David Gratch, Dietrich Gravenstein, Michael Mahla, Anna Rabinowitz

Health Equity and Quality Improvement (HEQI) Summit

What's the Problem?

• Needed to develop and clarify the use of PPE in the COVID-19 era
• New considerations for infection control in OR
• Unique airway equipment and filter placement considerations
• Potential shortages of equipment and medications, need for conservation
• Need to incorporate human factors principles into protocol release and procedural compliance

We realized that there was no standard protocol for these functions existing in a visually compelling graphic form for wide distribution throughout anesthesia care areas, and sought to create one.

Avoid, Delay, Shorten. Results Of Radiation Oncology’S Covid19 Patient Exposure Risk Mitigation Guidelines, Alex Kubli, Ms, Lilya Babinski, Bs, Angelia Landers, Phd, Christian Fernandez, Md, Amy Harrison, Phd

Health Equity and Quality Improvement (HEQI) Summit

We implemented evidence-based COVID19 guidelines on 3/16/20 to minimize patient exposure risks by avoiding, delaying, and shortening patient treatments when possible.

We analyzed the effectiveness of our COVID guidelines by comparing the number of new patient starts and number of treatments before and after implementation.

Our department successfully decreased patient exposure risk by reducing new prescription starts, rates of longer treatment courses, and overall number of treatment encounters in an evidence-based approach.

Sars-Cov-2 Testing Guidelines For Patients Admitted To Mrh For Inpatient Rehabilitation, Deborah Cassidy, Do, Roger Liu, Do, Malav Shah, Md, Kyle Hummerston, Do, Jeanne Doherty, Md

Health Equity and Quality Improvement (HEQI) Summit

We implemented a clinical algorithmic approach with an emphasis on symptoms and risk to stratify patients into 3 groups:

• Acutely Ill COVID Rule Out/PUI
• Stable COVID Rule Out/PUI
• COVID OBS

The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College Of Academic International Medicine-World Academic Council Of Emergency Medicine Multidisciplinary Covid-19 Working Group Consensus Paper., Stanislaw P. Stawicki, Rebecca Jeanmonod, Andrew C. Miller, Lorenzo Paladino, David F. Gaieski, Anna Q. Yaffee, Annelies De Wulf, Joydeep Grover, Thomas J. Papadimos, Christina Bloem, Sagar C. Galwankar, Vivek Chauhan, Michael S. Firstenberg, Salvatore Di Somma, Donald Jeanmonod, Sona M. Garg, Veronica Tucci, Harry L. Anderson, Lateef Fatimah, Tamara J. Worlton, Siddharth P Dubhashi, Krystal S. Glaze, Sagar Sinha, Ijeoma Nnodim Opara, Vikas Yellapu, Dhanashree Kelkar, Ayman El-Menyar, Vimal Krishnan, S. Venkataramanaiah, Yan Leyfman, Hassan Ali Saoud Al Thani, Prabath Wb Nanayakkara, Sudip Nanda, Eric Cioè-Peña, Indrani Sardesai, Shruti Chandra, Aruna Munasinghe, Vibha Dutta, Silvana Teixeira Dal Ponte, Ricardo Izurieta, Juan A. Asensio, Manish Garg

Department of Emergency Medicine Faculty Papers

What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this …

A Rare Presentation Of Coronavirus Disease 2019 (Covid-19) Induced Viral Myositis With Subsequent Rhabdomyolysis., Qian Zhang, Khine S. Shan, Artem Minalyan, Conor O'Sullivan, Travis Nace

Abington Jefferson Health Papers

A 38-year-old gentleman with no significant past medical history but had recent COVID-19 exposure presented to the hospital with the chief complaints of fever, shortness of breath, and generalized myalgia. He was unfortunately found to be severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive. Laboratory findings showed creatine kinase (CK) >42,670 U/L along with elevated inflammatory markers and unremarkable creatinine, cardiac troponin level. The cause of his rhabdomyolysis was discovered to be due to COVID-19 as he had no evidence of other viral infections, strenuous exercise, seizure, or other nontraumatic exertional etiologies. He received aggressive fluid resuscitation while we trended …

Clinical Features, Diagnosis And Management Of Covid-19 Patients In The Outdoor Setting, Bushra Jamil

Department of Medicine

In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, …

Covid-19, Colleagues, Confusion, And Conversations, Nathanael R. Sanchez M.D., Katherine S. Lee , M.D., Karen Weaver M.D.

Clinical Research in Practice: The Journal of Team Hippocrates

During the COVID-19 pandemic, doctors in a community hospital reflect on their decision-making regarding treatment options for COVID-19. Whether to use hydroxychloroquine is the treatment discussed in most detail.

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

Our Multi-Pandemic, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

Application of systems thinking to identify and understand complex problems and to discover innovative ways to intervene has been advocated separately within public health, education, finance, and many other spheres of society. We need it now for the multi-pandemic.

No Double Trouble: How To Reopen The Economy., Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

This policy introduces a measure of choice, consonant with our culture. Those younger than 65 can make their own personal tradeoffs between heath and livelihood, while older people, knowing that the virus will be spreading more quickly through the population will be even more cautious, thus preventing their early deaths. We return decisions to people while ensuring that the sum total of decisions does not overwhelm our hospitals. One felicitous result of this policy is that the virus will spread more quickly through the healthier population. This means that when the elderly re-engage in social life they will encounter fewer …

Systems View Of Coronavirus, Sung Won Paek, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

No one envisioned the kinds of problems that emerged from the novel coronavirus nor had anyone considered its interactive scope. Now is the time to begin to redesign our processes and systems so that when confronted again we can cope and navigate better. Everyone needs to be a partner in these redesigns and each of the health, social, educational, and other systems must be integrated because it is their interconnections that coproduce and give meaning to our lives.

Emerging Therapeutic Strategies For Covid-19 Patients, Shudong Zhu, Xialing Guo, Kyla Geary, Dianzheng Zhang

PCOM Scholarly Works

Over 100,000 cases of COVID-19 patients infected with the novel coronavirus SARS-COV-2 have been reported worldwide in approximately 2 months, resulting in over 3000 deaths. Potential therapeutic strategies, including remdesivir, chloroquine phosphate, abidol, lopinavir/ritonavir, plasma, antibody, vaccine and stem cells are discussed in this review. With the number of patients increasing daily, there is an urgent need for effective therapeutic intervention.

Our Wicked Problem, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

The Coronavirus is more than a health problem. It is a “wicked” problem disrupting work, education, travel, politics, financial indicators, and more. This label came about in 1973 to help describe a special class of situations that are volatile, uncertain and ambiguous, often difficult to recognize, and difficult or impossible to solve because of incomplete, contradictory, and changing requirements. There is no clear problem definition due to interdependencies so the problem cannot be fully understood until after the solution comes about.

Our Invisible Enemy, Larry M. Starr, Darshi Mody

School of Continuing and Professional Studies Coronavirus Papers

The novel coronavirus is invisible to the eye because it is microscopic measuring 80-160 nanometers in size; a nanometer is one billionth of a meter.

While we cannot see it in the air or on a surface, millions of us have seen the virus in full color when we discuss it on the local and national TV news, in articles and stories online, and in print media. This is because the virus is routinely pictured and used to attract us to the information being presented. The paradox is that millions of people can now recognize this invisible enemy.

Repeatedly presenting …

Disruptive Effects Of The Coronavirus – Errors Of Commission And Of Omission?, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

It is increasingly evident that the coronavirus disease, COVID-19, is more than a health problem; it is and will continue to adversely affect work and workplaces, education, families and social engagements, political and environmental dimensions, and financial indicators. Apart from its health ramifications, the crisis is revealing serious challenges in the global supply chain. Those difficulties are, at least in part, consequences of unwise, short-sighted business decisions made over the course of decades to outsource and downsize.

Pandemic Lockdown Must Fail: Save Lives Without Crippling The Economy, Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

In the following working paper, I want to make a plea for what I am calling a “reverse quarantine”—quarantining people who are over 65 (who number 52 million), before they get sick. We need to complement this policy with federally funded and locally organized efforts to support seniors in place, drawing on the wellsprings of American pragmatism, the capacity to respond in emergencies, American volunteerism, and neighbor-to-neighbor assistance. We can’t turn quarantine into imprisonment. We must work as hard as we can to create a psychological sense of community at a moment when, paradoxically, social distancing is driving us apart. …

Be Covid Safe, Opeyemi Akinrinsola, Abigail Corkum, Karyn Furcolo, Christina Gareis, Dorothy Tang

Foundations of Public Health - Infographics

No abstract provided.