北卡罗来纳州西部初级医疗实践的新冠疫情需求评估与支持
COVID-19 Needs Assessment and Support for Primary Care Practices in Western North Carolina.
作者信息
Denslow Sheri, Fromewick Jill, Scott Kacey, Bossingham Jesse, Cass Brian, Hodge Bryan, Richman Erica L, Garrity Tammy, Mottus Kathleen, Halladay Jacqueline R
机构信息
UNC Health Sciences at MAHEC, Asheville, NC.
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
出版信息
HCA Healthc J Med. 2020;1:395-404. doi: 10.36518/2689-0216.1157.
BACKGROUND
It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC).
METHODS
A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their COVID-19 testing and telehealth offerings, PPE adequacy, and capacity to continue serving patients. The survey's emergency alert feature linked practices to immediate support. Descriptive data were generated to identify regional needs.
RESULTS
Out of 110 practices, 48 (43.6%) offered COVID-19 testing, with testing more common in rural counties (56.3% vs 33.9%). Telehealth services, including phone-only visits, were offered by almost all practices (91.8%). PPE needs included N-95 respirators (49.1%), face shields (45.5%), and staff gowns (38.2%). Rural practices were more likely to report the need for PPE. Assistance was requested for staff member childcare (34.5%) and providing or billing for telehealth (31.8%). The most urgent practice requests were related to finances, PPE, and telehealth. MAHEC's Practice Support team linked practices to virtual coaching, tip sheets, case-based video didactics and communication forums, and newsletters.
CONCLUSION
During a pandemic, it is crucial to ensure that PCPs can continue to serve their patients. A rapid needs assessment of PCPs can allow for immediate and ongoing support that matches regional and practice-specific needs. Rural practices may require more assistance than their urban counterparts. Our rapid survey process jumpstarted a statewide system for enhanced communications with PCPs to better prepare for future emergencies.
背景
在大流行期间，确保基层医疗服务提供者（PCP）拥有充足的个人防护装备（PPE）、物资、培训、人员配备和应急计划至关重要，尤其是在农村地区。2020年3月，在新冠疫情爆发初期，山区健康教育中心（MAHEC）与北卡罗来纳大学教堂山分校的塞西尔·G·谢普斯卫生服务研究中心合作，迅速对北卡罗来纳州西部（WNC）的基层医疗服务提供者进行了需求评估。
方法
一组20名志愿者对WNC 16个县地区的基层医疗服务提供者进行了电话调查。询问了医疗机构关于其新冠病毒检测和远程医疗服务、个人防护装备的充足性以及继续为患者服务的能力。该调查的紧急警报功能将医疗机构与即时支持联系起来。生成描述性数据以确定地区需求。
结果
在110家医疗机构中，48家（43.6%）提供新冠病毒检测，农村县的检测更为普遍（56.3%对33.9%）。几乎所有医疗机构（91.8%）都提供远程医疗服务，包括仅通过电话就诊。个人防护装备需求包括N95口罩（49.1%）、面罩（45.5%）和工作服（38.2%）。农村医疗机构更有可能报告对个人防护装备的需求。有人请求提供员工子女照料方面的帮助（34.5%）以及远程医疗的提供或计费方面的帮助（31.8%）。最紧迫的医疗机构需求与财务、个人防护装备和远程医疗有关。MAHEC的实践支持团队将医疗机构与虚拟指导、提示单、基于案例的视频教学和交流论坛以及时事通讯联系起来。
结论
在大流行期间，确保基层医疗服务提供者能够继续为患者服务至关重要。对基层医疗服务提供者进行快速需求评估可以提供符合地区和特定实践需求的即时和持续支持。农村医疗机构可能比城市医疗机构需要更多帮助。我们的快速调查过程启动了一个全州范围的系统，以加强与基层医疗服务提供者的沟通，为未来的紧急情况做好更好的准备。
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