Department of Pediatrics, University of Chicago, Chicago, Illinois.
Department of Medicine, University of Chicago, Chicago, Illinois.
Infect Control Hosp Epidemiol. 2023 Feb;44(2):260-267. doi: 10.1017/ice.2022.64. Epub 2022 Mar 22.
The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems to meet new demands for rapid information dissemination, resource allocation, and data reporting. To help address these challenges, our institution leveraged electronic health record (EHR)-integrated clinical pathways (E-ICPs), which are easily understood care algorithms accessible at the point of care.
To describe our institution's creation of E-ICPs to address the COVID-19 pandemic, and to assess the use and impact of these tools.
Urban academic medical center with adult and pediatric hospitals, emergency departments, and ambulatory practices.
Using the E-ICP processes and infrastructure established at our institution as a foundation, we developed a suite of COVID-19-specific E-ICPs along with a process for frequent reassessment and updating. We examined the development and use of our COVID-19-specific pathways for a 6-month period (March 1-September 1, 2020), and we have described their impact using case studies.
In total, 45 COVID-19-specific pathways were developed, pertaining to triage, diagnosis, and management of COVID-19 in diverse patient settings. Orders available in E-ICPs included those for isolation precautions, testing, treatments, admissions, and transfers. Pathways were accessed 86,400 times, with 99,081 individual orders were placed. Case studies demonstrate the impact of COVID-19 E-ICPs on stewardship of resources, testing optimization, and data reporting.
E-ICPs provide a flexible and unified mechanism to meet the evolving demands of the COVID-19 pandemic, and they continue to be a critical tool leveraged by clinicians and hospital administrators alike for the management of COVID-19. Lessons learned may be generalizable to other urgent and nonurgent clinical conditions.
2019 年冠状病毒病（COVID-19）大流行要求医疗系统满足快速信息传播、资源分配和数据报告的新需求。为了帮助应对这些挑战，我们的机构利用了电子健康记录（EHR）集成的临床路径（E-ICPs），这些路径是在护理点可以轻松理解的护理算法。
描述我们机构创建 E-ICPs 以应对 COVID-19 大流行的情况，并评估这些工具的使用和影响。
拥有成人和儿科医院、急诊部门和门诊实践的城市学术医疗中心。
利用我们机构建立的 E-ICP 流程和基础设施作为基础，我们开发了一套 COVID-19 特定的 E-ICPs，以及一个频繁重新评估和更新的流程。我们检查了 COVID-19 特定途径的开发和使用情况，为期 6 个月（2020 年 3 月 1 日至 9 月 1 日），并使用案例研究描述了它们的影响。
总共开发了 45 种 COVID-19 特定途径，涉及分诊、诊断和管理各种患者环境中的 COVID-19。E-ICPs 中提供的医嘱包括隔离预防措施、检测、治疗、入院和转院。途径被访问了 86400 次，共下达了 99081 个单独的医嘱。案例研究表明了 COVID-19 E-ICPs 对资源管理、检测优化和数据报告的影响。
E-ICPs 提供了一种灵活和统一的机制，可以满足 COVID-19 大流行不断变化的需求，并且它们仍然是临床医生和医院管理人员管理 COVID-19 的关键工具。吸取的经验教训可能适用于其他紧急和非紧急临床情况。
