Medical process improvement takes years to accomplish. A new study reveals the pandemic overcame that entrenched model in some facilities, driving healthcare providers to better serve their patients.
A new study in JAMA Network Open explored how quickly process changes occurred in healthcare facilities as a result of the COVID-19 pandemic. Prior research on the time lag between evidence-based research and adoption of health interventions placed the average delay at about 17 years. While Root Cause Analysis (RCA) and other interventions may result in focused practice adjustments—it takes much longer to make wholesale practice changes that could benefit patients. Factors that contribute to the delay include communication challenges between and within hospitals and gaining buy-in from practice groups, specialty providers, and others.
Dr. Alan Kubey, with Jefferson Health and the Mayo Clinic was co-study lead on JAMA research. He said, “The translation of evidence to practice in medicine is notoriously slow. For example, despite the clear mortality benefit of giving beta blockers after a heart attack, it took decades from the publication of evidence to the majority of hospitals using it. Given the singular focus on COVID-19, we were interested to see how nimble hospitals were able to shift care based on rapidly changing, and sometimes conflicting, evidence.”
Study data was obtained through survey between December 2020 and February 2021 from participants in the Hospital Medicine Reengineering Network (HOMERuN). The network is a collaborative effort of researchers, hospitalists and others with a goal to develop and deliver rigorous, broad-based research to improve patient experience and treatment. Data was collected from 52 hospitals, most of which identified as teaching facilities.
The survey results provided an inside look at how clinical evidence was developed, shared, and put into practice. One example was the almost universal adoption of dexamethasone (a corticosteroid) within six to eight months after a randomized clinical trial demonstrated a survival benefit. The drug is used for COVID patients who are receiving respiratory support.
Most hospitals used multiple channels to share and obtain guidelines from other facilities. Dr. Amy Berger, with the University of California at San Francisco noted, “We were all learning in real-time and there was a resolve to collaborate. Hospitals were sharing protocols online, huge amounts of data were coming in almost daily in peer-reviewed journals and pre-print servers, and many doctors were also detailing their experiences on social media.”
The study, and the pandemic, demonstrate the remarkable agility and resolve of healthcare providers around the world to meet and ultimately respond to a deadly and novel viral challenge. While rapid acquisition and sharing of knowledge to improve patient care seems like basic common-sense, it took a pandemic to prove that hospitals and care-providers could collaborate with colleagues locally and across the world—to improve outcomes for seriously ill patients.
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