Becker's Hospital Review

94 CMO / CARE DELIVERY After 'baptism by fire,' hospitals say they're better prepared to treat COVID-19 By Mackenzie Bean P hysicians and leaders at many U.S. hos- pitals say they are feeling better prepared to respond to a potential second wave of COVID-19 cases, according to e Wall Street Journal. Physicians told the publication they have a better understanding of COVID-19 and how to treat it, including which patients need to be ventilated and when patients can be dis- charged. Leaders said they also have a better sense of which treatments and supplies are needed to treat COVID-19 patients and are stockpiling them in case of future surges. is spring "was ultimately baptism by fire," Donald Landry, MD, physician-in-chief of NewYork-Presbyterian/Columbia University Irving Medical Center in New York City, told the Journal. Armed with new treatment knowl- edge, this fall should be very different for hos- pitals and physicians, he said. "Obviously this can get out of control — we don't have a magic bullet for it yet — but your prospects are actually very good," Dr. Landry told the Journal. Hospitals and physicians pointed to decreas- ing death rates and lower intensive care unit patient volumes as evidence that these changes are leading to better outcomes. For example, the death rate for COVID-19 patients hospi- talized at Providence, R.I.-based Lifespan fell from nearly 19 percent in March to 14 per- cent from June through August, according to Mitchell Levy, MD, director of the medical intensive care unit at Lifespan's Rhode Island Hospital in Providence. Improved outcomes may also be due to declin- ing COVID-19 patient volumes, which allow physicians to spend more time with patients, along with the fact that more virus patients have been younger and healthier than in the spring, hospitals and physicians said. Patients are also coming into the hospital earlier for care, which allows physicians to treat them be- fore their condition worsens. n What coronavirus recovery centers have learned from treating 'long-haulers' By Anuja Vaidya S everal health systems in New York and New Jersey have established care centers for COVID-19 patients who recover from the disease but continue to experience symptoms, and they have discovered that these patients require ongoing, multispecialty care, according to MedPage Today. Health systems, including Mount Sinai Health System in New York City and Edison, N.J.-based Hackensack Meridian Health, opened COVID-19 recovery centers for patients facing long-term complications from the disease, dubbed "long-haulers." These patients continue to experience symptoms, including fa- tigue, shortness of breath and joint pain, in the months after they recover from the virus. Patients at Hackensack Meridian Health's COVID Recovery Center receive per- sonalized care treatment plans from primary care physicians and are connect- ed with specialists, including pulmonologists, cardiologists and neurologists, program chair Laurie Jacobs, MD, told MedPage Today. Zijian Chen, MD, who oversees Mount Sinai's COVID-19 recovery program also told the publication that post-COVID-19 recovery, patients require care from several specialists. "We have almost every medical specialty working with the program," he said. Patients often come in with lung injury issues and require rehabilitation to "re- gain lung elasticity," Jeffrey Fine, MD, who provides care at Rusk Rehabilita- tion at NYU Langone Health in New York City, told MedPage Today. They also come in with neurologic issues, such as cognitive impairment or neuropathy. "They may not require a formal cardiac or pulmonary rehab, but they still need to work on focus, attention and reconditioning," Dr. Fine said. Patients coming into these recovery centers are not necessarily those who have been hospitalized after contracting COVID-19. Some never went to a hospital, while others had long hospital stays and inpatient rehabilitation, MedPage To- day reported. The centers also offer mental healthcare services, to help patients cope with the mental toll of the illness and its long-lasting ramifications. n Medical errors increase by nearly 20% around daylight savings, study finds By Gabrielle Masson I n the days following the switch to daylight saving time, human mistakes tied to patient safety-related incidents increased by almost 20 percent, according to a study in the Journal of General Internal Medicine. Researchers analyzed voluntarily reported data from Rochester, Minn.-based Mayo Clinic that occurred seven days before and after the spring and fall time changes for 2010-17. Patient safety-related incidents included defective systems, equipment failure or human error. Researchers didn't report significant differences in overall errors in the weeks before and after the time changes. However, when analyzing human error only, they found the number of human errors increased by a statistically significant 18.7 percent after daylight saving in the spring. Most of the errors involved med- ications, such as administering the wrong dose or wrong drug. n

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