COVID-19 Collaborative Model for an Academic Hospital and Long-Term Care Facilities.
Laurie R Archbald-Pannone, Drew A Harris, Kimberly Albero and 3 others
PMID 32563752WHAT IT FOUND
A hospital-long-term care collaboration reached 35 of 77 contacted facilities with prevention calls, liaisons, telehealth and infection advice; 2 outbreak facilities used response rounds, with mortality reported at 12% and 19% versus a published 28%.
Key findings
01Project ECHO contacted 77 facilities and 35 facilities participated.
02The response arm was implemented in 2 facilities with outbreaks.
03The two outbreak facilities had mortality rates of 12% and 19%, which the authors compared with a published rate of 28%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper presents a practical approach and states that strong evidence does not yet exist regarding efficacy or effectiveness. It describes facilities that participated and does not compare them with facilities that did not participate. The response arm was implemented in only 2 facilities, so the mortality and transmission observations are very small. The mortality rates were compared with a published rate, not with a concurrent control group, so the program cannot be credited for the lower mortality. The program bundled many components, including telemedicine, nursing liaison, infection advice and social calls, so the contribution of any single component cannot be separated. The authors state successful implementation and outcomes cannot be assured and the model may need modification for others.
The easy way to misread this
Do not read the 12% and 19% mortality rates or the lack of sustained transmission as proof the program works. The paper is a descriptive implementation report with only 2 response facilities, many bundled components, and the authors state strong evidence does not yet exist regarding efficacy or effectiveness.