Quality of hospital emergency department care for patients with COVID-19 during the first wave in 2020 : the CALUR-COVID-19 study
OBJECTIVES: To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence.
MATERIAL AND METHODS: We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in March and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups.
RESULTS: Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P .001) and in 30% of patients in the later period vs 37% in the earlier period (P = .04). Adherence to the following indicators was better in the later part of the wave: monitoring of oxygen saturation (100% vs 99%, P = .035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P .001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P .001). No differences related to age groups were found.
CONCLUSION: Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias - 34(2022), 5 vom: 20. Okt., Seite 369-376 |
| Sprache: |
Englisch |
|---|
| Weiterer Titel: |
Estudio CALUR-COVID-19: calidad asistencial en urgencias del proceso de atención a pacientes con COVID-19 durante el primer pico pandémico de 2020 |
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| Beteiligte Personen: |
Jiménez, Sònia [VerfasserIn] |
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| Anmerkungen: |
Date Completed 12.10.2022 Date Revised 18.10.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347331521 |
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| 245 | 1 | 0 | |a Quality of hospital emergency department care for patients with COVID-19 during the first wave in 2020 |b the CALUR-COVID-19 study |
| 246 | 3 | 3 | |a Estudio CALUR-COVID-19: calidad asistencial en urgencias del proceso de atención a pacientes con COVID-19 durante el primer pico pandémico de 2020 |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 12.10.2022 | ||
| 500 | |a Date Revised 18.10.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence | ||
| 520 | |a MATERIAL AND METHODS: We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in March and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups | ||
| 520 | |a RESULTS: Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P .001) and in 30% of patients in the later period vs 37% in the earlier period (P = .04). Adherence to the following indicators was better in the later part of the wave: monitoring of oxygen saturation (100% vs 99%, P = .035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P .001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P .001). No differences related to age groups were found | ||
| 520 | |a CONCLUSION: Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19. | |
| 650 | 4 | |a Calidad asistencial. | |
| 650 | 4 | |a Clinical safety. | |
| 650 | 4 | |a Emergency department. | |
| 650 | 4 | |a Health care quality. | |
| 650 | 4 | |a Pandemia. | |
| 650 | 4 | |a Pandemics. | |
| 650 | 4 | |a Seguridad clínica. | |
| 650 | 4 | |a Servicio de urgencias. | |
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| 650 | 7 | |a Hydroxychloroquine |2 NLM | |
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| 650 | 7 | |a Ritonavir |2 NLM | |
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| 700 | 1 | |a Miró, Òscar |e verfasserin |4 aut | |
| 700 | 1 | |a Alquézar-Arbé, Aitor |e verfasserin |4 aut | |
| 700 | 1 | |a Piñera, Pascual |e verfasserin |4 aut | |
| 700 | 1 | |a Jacob, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Llorens, Pere |e verfasserin |4 aut | |
| 700 | 1 | |a García-Lamberechts, Eric Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Martín-Sánchez, Francisco Javier |e verfasserin |4 aut | |
| 700 | 1 | |a González Del Castillo, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Burillo-Putze, Guillermo |e verfasserin |4 aut | |
| 700 | 0 | |a Red de investigación SIESTA |e verfasserin |4 aut | |
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