At the end of 2019, a novel virus was identified as the cause of a cluster of pneumonia cases in the Chinese city of Wuhan. As we now know, the COVID-19 outbreak spread to include over 80,000 cases in China and an increasing number of cases in other countries, prompting the World Health Organization (WHO) to declare Coronavirus or COVID-19 (initially called 2019-nCoV) a public health emergency of international concern.
The timeline of its spread has been rapid:
On Jan 20, 2020, China declared the disease a second-class infectious disease but introduced management measures for a first-class infectious disease (considered the most dangerous category of infection). Most areas of the country adopted public health first-level response measures (considered the highest level of response). In the face of the rapidly spreading disease and a large number of infected people, there is an urgent need for effective infection prevention and control measures.
By March 2, 2020, some 80,026 confirmed cases had been reported in China, causing 2,009 deaths, and the epidemic had spread to 25 countries around the world.
Amid the rapid responses by healthcare organizations, social and television media are also swiftly reporting on the virus’ spread, with an unfortunate side effect of some generating fear and misinformation. The result: Today there is a new global frontier to navigate in tracking and treating the virus. But healthcare Quality and Performance Improvement professionals are poised to demonstrate how their facility is providing safe, effective, and efficient care in response to COVID-19, making this their time to lead.
Help for Healthcare Quality Professionals
As a quality professional, your healthcare organization’s administrators and the community at large rely on your expertise and experience for recommendations and guidance. Likewise, healthcare organizations both in the U.S. and abroad now face the challenges of executing protocols they have prepared for and practiced. Efforts to control the COVID-19 epidemic and others will require an evidence-based, multi-factored approach.
Address the big questions
Your preparation and prevention efforts now turn into action. Generate and share responses to the biggest questions resulting from the COVID-19 outbreak, including:
How are you preventing the spread of viruses in your facility and demonstrating that you did prevent additional cases?
How are you preventing risk and liability if there is an infection in your facility, if patients contract it there, or if they were not seen in a timely manner or at all?
What is the response if patients panic or accuse your facility of not treating them timely or well?
How are you reducing panic and fear in your community? Are you a part of a collaborative effort in doing so? How will you demonstrate that effort to payers for increased reimbursement?
How do patients and their families perceive their safety and care in your facility?
How are you treating your staff and the fears they may have, especially with regard to care for staff and scheduling coverage needs?
Are you using virtual medicine as much as possible and how?
While COVID-19 presents big challenges, it also presents significant opportunities to remain or become the facility of choice with patients and payers. A well-handled scenario portrays your organization as having executed on its plan to make patients and providers feel safe. This is your time to shine! Your providers and staff are doing many heroic and wonderful things to provide a safe, positive patient experience full of comfort and safe care.
Use an evidenced-based approach to measurement
When the COVID-19 crisis has passed, you will need to provide evidence and demonstrate how you have handled tracking of the virus within your population health management structure. Now more than ever, there is a need to automate the tracking of already-established measures in order to provide analytics and report using them.
Whether the standards exist in your bylaws, policies, or procedures— measure them and demonstrate that they were followed for audits, patient safety and satisfaction, risk and liability, and payer reimbursement within value-based care and value-based purchasing.
Evidence-based measures are important for internal customers, too! Provider retention and staff satisfaction are imperative and depend on the quality data you collect.
Example quality improvement measures
If your quality measures need improvement, consider new metrics that best reflect your organization’s overall goals and mission.
Select at least six measures from categories such as these for CMS and MIPS/APM tracking and select at least one outcomes measure.
- Preventative Care and Screening
- Resource Management
- Patient Safety
- Infection Control/Prevention
- Patient satisfaction and experience
- Specialty measures
- Communication and professionalism
- Advanced Care Plan
- Virtual Medicine
Clinical Information on COVID-19
The illness is characterized primarily by fever, cough, and bilateral infiltrates on chest imaging. The possibility of COVID-19 should be considered primarily in patients with fever and/or lower respiratory tract symptoms who reside in or have recently traveled to areas with community transmission (e.g., China, South Korea, Iran, Italy, Japan, Spain) or who have had close contact with a confirmed or suspected case of COVID-19.
Clinicians should also consider the possibility in patients with severe respiratory illness when no other cause has been identified. When COVID-19 is suspected, infection control measures should be implemented, and public health officials notified. Management of documented cases is supportive.
Additional resources on COVID-19
- World Health Organization
- Quality Improvement Organizations
- Centers for Disease Control (See "Coronaviruses", section on 'Coronavirus disease 2019 (COVID-19) outbreak in China')
symplr’s Quality Improvement specialists can assist your organization in using evidenced-based approaches for quality improvement and track workflows and measures to demonstrate outcomes and actions taken. Learn more today.