PMC:7536903 / 3173-6790 JSONTXT

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    LitCovid-PD-FMA-UBERON

    {"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T3","span":{"begin":3005,"end":3009},"obj":"Body_part"}],"attributes":[{"id":"A3","pred":"fma_id","subj":"T3","obj":"http://purl.org/sig/ont/fma/fma9712"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}

    LitCovid-PD-UBERON

    {"project":"LitCovid-PD-UBERON","denotations":[{"id":"T1","span":{"begin":3005,"end":3009},"obj":"Body_part"}],"attributes":[{"id":"A1","pred":"uberon_id","subj":"T1","obj":"http://purl.obolibrary.org/obo/UBERON_0002398"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}

    LitCovid-PD-MONDO

    {"project":"LitCovid-PD-MONDO","denotations":[{"id":"T17","span":{"begin":29,"end":37},"obj":"Disease"},{"id":"T18","span":{"begin":223,"end":231},"obj":"Disease"},{"id":"T19","span":{"begin":309,"end":313},"obj":"Disease"},{"id":"T20","span":{"begin":742,"end":750},"obj":"Disease"},{"id":"T21","span":{"begin":1003,"end":1011},"obj":"Disease"},{"id":"T22","span":{"begin":1114,"end":1123},"obj":"Disease"},{"id":"T23","span":{"begin":2247,"end":2251},"obj":"Disease"},{"id":"T24","span":{"begin":3548,"end":3556},"obj":"Disease"}],"attributes":[{"id":"A17","pred":"mondo_id","subj":"T17","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A18","pred":"mondo_id","subj":"T18","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A19","pred":"mondo_id","subj":"T19","obj":"http://purl.obolibrary.org/obo/MONDO_0005091"},{"id":"A20","pred":"mondo_id","subj":"T20","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A21","pred":"mondo_id","subj":"T21","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A22","pred":"mondo_id","subj":"T22","obj":"http://purl.obolibrary.org/obo/MONDO_0005550"},{"id":"A23","pred":"mondo_id","subj":"T23","obj":"http://purl.obolibrary.org/obo/MONDO_0005091"},{"id":"A24","pred":"mondo_id","subj":"T24","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}

    LitCovid-PD-CLO

    {"project":"LitCovid-PD-CLO","denotations":[{"id":"T7","span":{"begin":595,"end":596},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T8","span":{"begin":1102,"end":1103},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T9","span":{"begin":2015,"end":2017},"obj":"http://purl.obolibrary.org/obo/CLO_0053733"},{"id":"T10","span":{"begin":2330,"end":2337},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T11","span":{"begin":2470,"end":2480},"obj":"http://purl.obolibrary.org/obo/CLO_0002807"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}

    LitCovid-PubTator

    {"project":"LitCovid-PubTator","denotations":[{"id":"80","span":{"begin":17,"end":21},"obj":"Disease"},{"id":"81","span":{"begin":29,"end":37},"obj":"Disease"},{"id":"86","span":{"begin":74,"end":81},"obj":"Species"},{"id":"87","span":{"begin":116,"end":124},"obj":"Species"},{"id":"88","span":{"begin":111,"end":115},"obj":"Disease"},{"id":"89","span":{"begin":162,"end":166},"obj":"Disease"},{"id":"92","span":{"begin":232,"end":240},"obj":"Species"},{"id":"93","span":{"begin":223,"end":231},"obj":"Disease"},{"id":"96","span":{"begin":309,"end":319},"obj":"Species"},{"id":"97","span":{"begin":342,"end":350},"obj":"Species"},{"id":"99","span":{"begin":388,"end":405},"obj":"Disease"},{"id":"101","span":{"begin":547,"end":551},"obj":"Disease"},{"id":"104","span":{"begin":721,"end":725},"obj":"Disease"},{"id":"105","span":{"begin":742,"end":750},"obj":"Disease"},{"id":"107","span":{"begin":846,"end":853},"obj":"Species"},{"id":"109","span":{"begin":1003,"end":1011},"obj":"Disease"},{"id":"111","span":{"begin":1023,"end":1027},"obj":"Disease"},{"id":"114","span":{"begin":1059,"end":1063},"obj":"Disease"},{"id":"115","span":{"begin":1114,"end":1123},"obj":"Disease"},{"id":"117","span":{"begin":1502,"end":1510},"obj":"Species"},{"id":"119","span":{"begin":1577,"end":1584},"obj":"Species"},{"id":"122","span":{"begin":1665,"end":1673},"obj":"Species"},{"id":"123","span":{"begin":1623,"end":1627},"obj":"Disease"},{"id":"126","span":{"begin":1860,"end":1868},"obj":"Species"},{"id":"127","span":{"begin":1825,"end":1829},"obj":"Disease"},{"id":"129","span":{"begin":2177,"end":2185},"obj":"Species"},{"id":"131","span":{"begin":2895,"end":2903},"obj":"Species"},{"id":"133","span":{"begin":2933,"end":2937},"obj":"Disease"},{"id":"135","span":{"begin":3128,"end":3132},"obj":"Disease"},{"id":"137","span":{"begin":3341,"end":3349},"obj":"Species"},{"id":"144","span":{"begin":3359,"end":3367},"obj":"Species"},{"id":"145","span":{"begin":3450,"end":3458},"obj":"Species"},{"id":"146","span":{"begin":3534,"end":3542},"obj":"Species"},{"id":"147","span":{"begin":3579,"end":3584},"obj":"Species"},{"id":"148","span":{"begin":3478,"end":3482},"obj":"Disease"},{"id":"149","span":{"begin":3548,"end":3556},"obj":"Disease"}],"attributes":[{"id":"A81","pred":"tao:has_database_id","subj":"81","obj":"MESH:C000657245"},{"id":"A86","pred":"tao:has_database_id","subj":"86","obj":"Tax:9606"},{"id":"A87","pred":"tao:has_database_id","subj":"87","obj":"Tax:9606"},{"id":"A92","pred":"tao:has_database_id","subj":"92","obj":"Tax:9606"},{"id":"A93","pred":"tao:has_database_id","subj":"93","obj":"MESH:C000657245"},{"id":"A96","pred":"tao:has_database_id","subj":"96","obj":"Tax:2697049"},{"id":"A97","pred":"tao:has_database_id","subj":"97","obj":"Tax:9606"},{"id":"A105","pred":"tao:has_database_id","subj":"105","obj":"MESH:C000657245"},{"id":"A107","pred":"tao:has_database_id","subj":"107","obj":"Tax:9606"},{"id":"A109","pred":"tao:has_database_id","subj":"109","obj":"MESH:C000657245"},{"id":"A115","pred":"tao:has_database_id","subj":"115","obj":"MESH:D007239"},{"id":"A117","pred":"tao:has_database_id","subj":"117","obj":"Tax:9606"},{"id":"A119","pred":"tao:has_database_id","subj":"119","obj":"Tax:9606"},{"id":"A122","pred":"tao:has_database_id","subj":"122","obj":"Tax:9606"},{"id":"A126","pred":"tao:has_database_id","subj":"126","obj":"Tax:9606"},{"id":"A129","pred":"tao:has_database_id","subj":"129","obj":"Tax:9606"},{"id":"A131","pred":"tao:has_database_id","subj":"131","obj":"Tax:9606"},{"id":"A137","pred":"tao:has_database_id","subj":"137","obj":"Tax:9606"},{"id":"A144","pred":"tao:has_database_id","subj":"144","obj":"Tax:9606"},{"id":"A145","pred":"tao:has_database_id","subj":"145","obj":"Tax:9606"},{"id":"A146","pred":"tao:has_database_id","subj":"146","obj":"Tax:9606"},{"id":"A147","pred":"tao:has_database_id","subj":"147","obj":"Tax:9606"},{"id":"A149","pred":"tao:has_database_id","subj":"149","obj":"MESH:C000657245"}],"namespaces":[{"prefix":"Tax","uri":"https://www.ncbi.nlm.nih.gov/taxonomy/"},{"prefix":"MESH","uri":"https://id.nlm.nih.gov/mesh/"},{"prefix":"Gene","uri":"https://www.ncbi.nlm.nih.gov/gene/"},{"prefix":"CVCL","uri":"https://web.expasy.org/cellosaurus/CVCL_"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}

    LitCovid-sentences

    {"project":"LitCovid-sentences","denotations":[{"id":"T27","span":{"begin":0,"end":46},"obj":"Sentence"},{"id":"T28","span":{"begin":47,"end":176},"obj":"Sentence"},{"id":"T29","span":{"begin":177,"end":241},"obj":"Sentence"},{"id":"T30","span":{"begin":242,"end":284},"obj":"Sentence"},{"id":"T31","span":{"begin":285,"end":351},"obj":"Sentence"},{"id":"T32","span":{"begin":353,"end":405},"obj":"Sentence"},{"id":"T33","span":{"begin":406,"end":594},"obj":"Sentence"},{"id":"T34","span":{"begin":595,"end":663},"obj":"Sentence"},{"id":"T35","span":{"begin":664,"end":760},"obj":"Sentence"},{"id":"T36","span":{"begin":762,"end":779},"obj":"Sentence"},{"id":"T37","span":{"begin":780,"end":883},"obj":"Sentence"},{"id":"T38","span":{"begin":884,"end":1012},"obj":"Sentence"},{"id":"T39","span":{"begin":1014,"end":1058},"obj":"Sentence"},{"id":"T40","span":{"begin":1059,"end":1235},"obj":"Sentence"},{"id":"T41","span":{"begin":1236,"end":1405},"obj":"Sentence"},{"id":"T42","span":{"begin":1406,"end":1566},"obj":"Sentence"},{"id":"T43","span":{"begin":1568,"end":1593},"obj":"Sentence"},{"id":"T44","span":{"begin":1594,"end":1728},"obj":"Sentence"},{"id":"T45","span":{"begin":1729,"end":1928},"obj":"Sentence"},{"id":"T46","span":{"begin":1929,"end":2194},"obj":"Sentence"},{"id":"T47","span":{"begin":2196,"end":2257},"obj":"Sentence"},{"id":"T48","span":{"begin":2258,"end":2346},"obj":"Sentence"},{"id":"T49","span":{"begin":2347,"end":2418},"obj":"Sentence"},{"id":"T50","span":{"begin":2419,"end":2562},"obj":"Sentence"},{"id":"T51","span":{"begin":2563,"end":2712},"obj":"Sentence"},{"id":"T52","span":{"begin":2713,"end":2825},"obj":"Sentence"},{"id":"T53","span":{"begin":2827,"end":2841},"obj":"Sentence"},{"id":"T54","span":{"begin":2842,"end":2932},"obj":"Sentence"},{"id":"T55","span":{"begin":2933,"end":3063},"obj":"Sentence"},{"id":"T56","span":{"begin":3064,"end":3176},"obj":"Sentence"},{"id":"T57","span":{"begin":3177,"end":3358},"obj":"Sentence"},{"id":"T58","span":{"begin":3359,"end":3557},"obj":"Sentence"},{"id":"T59","span":{"begin":3558,"end":3617},"obj":"Sentence"}],"namespaces":[{"prefix":"_base","uri":"http://pubannotation.org/ontology/tao.owl#"}],"text":"Overall goals of HITH during COVID‐19 pandemic\nTo provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.\nTo plan for new clinical pathways to care for COVID‐19 patients.\nTo minimise the impact of staff shortages.\nTo minimise the risk of SARS‐CoV‐2 exposure to staff and patients.\n\nIssues to consider in planning for HITH preparedness\nIt is recommended that all home care services consider what is achievable within current capacity, and the responses to increased demand for HITH services with potentially decreased staff. A checklist of issues to consider can support this process (Fig. 1).\nFigure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.\n\nManaging staffing\nWorkforce planning: resources required for projected increases in patient numbers, and impact of leave.\nWorkforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.\n\nManaging HITH equipment use and availability\nHITH equipment use: minimising the risk as a source of infection through determining what needs to be in the home, cleaning requirements and lifespan of PPE stored in hot cars.\nEquipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.\nTelehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.\n\nManaging patient workload\nMeasures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.\nManaging interventions: minimising simple referrals, frequency of interventions and duration on HITH; 10 education and support of patients remotely in their own care; deferral of elective referrals.\nManaging need for in‐home visits: replacement of some in‐home visits with telehealth; 11 use of home observation kits (thermometer, oximeter) with remote monitoring; decreased driving distance, and if too far, engaging local services or rehousing patients locally.\n\nMinimising risk of exposure to and transmission of SARS‐CoV‐2\nStaff should follow current health department guidelines for screening, testing and PPE.\nRisk factor screening script use: at referral and prior to every visit.\nEducation and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.\nLimiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.\nDecreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.\n\nCommunications\nCommunication is critical in ensuring that staff and patients feel informed and supported.\nHITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.\nHospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.\nGeneral practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.\nPatients: to ensure they feel safe receiving home care; development of information for all patients receiving care via HITH during the pandemic and additional information for patients with COVID‐19. 12 This may include child‐orientated language or pictures."}