Insights From Rapid Deployment of a 'Virtual Hospital' as Standard Care During the COVID-19 Pandemic
| العنوان: | Insights From Rapid Deployment of a 'Virtual Hospital' as Standard Care During the COVID-19 Pandemic |
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| المؤلفون: | Ryan L. Brown, Carly Rivet, Matthew Sullivan, Marc A. Kowalkowski, Pamela McCreary, Todd Dunn, Colleen Hole, Stephanie L. Taylor, Kranthi Sitammagari, Andrew McWilliams, Stephanie Murphy, Zeev Neuwirth, Thomas Batchelor, Shih-Hsiung Chou, James T. Kearns, Tony Hinson |
| المصدر: | Annals of Internal Medicine |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, MEDLINE, Personnel Staffing and Scheduling, 01 natural sciences, law.invention, Workflow, 03 medical and health sciences, Young Adult, 0302 clinical medicine, law, Home Health Nursing, Acute care, Health care, Pandemic, Internal Medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, 0101 mathematics, Prospective cohort study, Pandemics, Aged, Monitoring, Physiologic, Original Research, Mechanical ventilation, Inpatient care, business.industry, SARS-CoV-2, 010102 general mathematics, Patient Acuity, COVID-19, General Medicine, Middle Aged, Intensive care unit, Southeastern United States, Telemedicine, Hospitalization, Emergency medicine, Female, business |
| الوصف: | Pandemics, including the COVID-19 pandemic, disrupt traditional health care operations by overwhelming system resource capacity. This article describes the development and rapid deployment of a virtual hospital program within a large health care system and their early caring for patients with COVID-19. Background: Pandemics disrupt traditional health care operations by overwhelming system resource capacity but also create opportunities for care innovation. Objective: To describe the development and rapid deployment of a virtual hospital program, Atrium Health hospital at home (AH-HaH), within a large health care system. Design: Prospective case series. Setting: Atrium Health, a large integrated health care organization in the southeastern United States. Patients: 1477 patients diagnosed with coronavirus disease 2019 (COVID-19) from 23 March to 7 May 2020 who received care via AH-HaH. Intervention: A virtual hospital model providing proactive home monitoring and hospital-level care through a virtual observation unit (VOU) and a virtual acute care unit (VACU) in the home setting for eligible patients with COVID-19. Measurements: Patient demographic characteristics, comorbid conditions, treatments administered (intravenous fluids, antibiotics, supplemental oxygen, and respiratory medications), transfer to inpatient care, and hospital outcomes (length of stay, intensive care unit [ICU] admission, mechanical ventilation, and death) were collected from electronic health record data. Results: 1477 patients received care in either the AH-HaH VOU or VACU or both settings, with a median length of stay of 11 days. Of these, 1293 (88%) patients received care in the VOU only, with 40 (3%) requiring inpatient hospitalization. Of these 40 patients, 16 (40%) spent time in the ICU, 7 (18%) required ventilator support, and 2 (5%) died during their hospital admission. In total, 184 (12%) patients were ever admitted to the VACU, during which 21 patients (11%) required intravenous fluids, 16 (9%) received antibiotics, 40 (22%) required respiratory inhaler or nebulizer treatments, 41 (22%) used supplemental oxygen, and 24 (13%) were admitted as an inpatient to a conventional hospital. Of these 24 patients, 10 (42%) required ICU admission, 1 (3%) required a ventilator, and none died during their hospital admission. Limitation: Generalizability is limited to patients with a working telephone and the ability to comply with the monitoring protocols. Conclusion: Virtual hospital programs have the potential to provide health systems with additional inpatient capacity during the COVID-19 pandemic and beyond. Primary Funding Source: Atrium Health. |
| تدمد: | 1539-3704 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::175eb459f3d9e0ab6060b53d2bc0e068 https://pubmed.ncbi.nlm.nih.gov/33175567 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....175eb459f3d9e0ab6060b53d2bc0e068 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15393704 |
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