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LitCovid-sentences  

PMC:7536903 JSONTXT 15 Projects

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Id Subject Object Predicate Lexical cue
T1 0-153 Sentence denotes Planning and clinical role of acute medical home care services for COVID‐19: consensus position statement by the Hospital‐in‐the‐Home Society Australasia
T2 154-190 Sentence denotes Hospital‐in‐the‐Home during COVID‐19
T3 191-204 Sentence denotes Bryant et al.
T4 206-214 Sentence denotes Abstract
T5 215-223 Sentence denotes Abstract
T6 224-406 Sentence denotes During a pandemic when hospitals are stretched and patients need isolation, the role of hospital‐in‐the‐home (HITH) providing acute medical care at home has never been more relevant.
T7 407-512 Sentence denotes We aimed to define and address the challenges to acute home care services posed by the COVID‐19 pandemic.
T8 513-643 Sentence denotes Planning for service operation involves staffing, equipment availability and cleaning, upskilling in telehealth and communication.
T9 644-781 Sentence denotes Planning for clinical care involves maximising cohorts of patients without COVID‐19 and new clinical pathways for patients with COVID‐19.
T10 782-927 Sentence denotes The risk of SARS‐CoV‐2 transmission, specific COVID‐19 clinical pathways and the well‐being of patients and staff should be addressed in advance.
T11 929-1126 Sentence denotes Hospital‐in‐the‐home (HITH) provision of acute medical care at home is increasingly advocated as safe, effective, psychologically beneficial and reducing financial burden on hospitals and patients.
T12 1127-1285 Sentence denotes 1 , 2 , 3 During a pandemic where hospitals are at capacity and patients need to be isolated, the role of ambulatory services has never been more relevant.
T13 1286-1287 Sentence denotes 4
T14 1289-1325 Sentence denotes The role of acute home care services
T15 1326-1569 Sentence denotes The role of HITH is to provide hospital‐level patient‐centred care that can safely and effectively be delivered at home to keep patients out of hospital, 5 for example, outpatient parenteral antibiotic therapy, chemotherapy and physiotherapy.
T16 1570-1941 Sentence denotes The COVID‐19 pandemic does not change this, but the role of HITH may be impacted through: (i) increased referrals of patients without COVID‐19 to maximise hospital inpatient capacity; and (ii) new referrals of patients suspected or confirmed to have COVID‐19 with clinical features on the less severe end of the spectrum but requiring some element of hospital‐level care.
T17 1943-1984 Sentence denotes Challenges posed by the COVID‐19 pandemic
T18 1985-2060 Sentence denotes There are several challenges unique to HITH posed by the COVID‐19 pandemic.
T19 2061-2196 Sentence denotes First, there are duelling priorities of proactively trying to increase patient referrals while managing patient load to allow for that.
T20 2197-2349 Sentence denotes 6 , 7 Second, new referrals for COVID‐19 add to this increased workload and create the risk of transmission of SARS‐CoV‐2 to staff and other patients.
T21 2350-2503 Sentence denotes 8 Third, staff may become unwell, need quarantine or to provide care for their own families, reducing the available workforce with a specific skill set.
T22 2504-2639 Sentence denotes Finally, there are unique challenges with managing personal protective equipment (PPE) and cleaning items taken into the home and cars.
T23 2640-2773 Sentence denotes This is a consensus statement by the HITH Society Australasia on the planning and clinical role of HITH during the COVID‐19 pandemic.
T24 2774-2947 Sentence denotes The HITH Society Australasia represents doctors, nurses, allied health and other healthcare workers who provide HITH care in Australia and New Zealand, Asia and the Pacific.
T25 2948-3072 Sentence denotes 9 As the peak HITH body in the region for 20 years, it is well placed to consider planning for the impact on HITH services.
T26 3073-3171 Sentence denotes The content should be used in conjunction with health department and infection control guidelines.
T27 3173-3219 Sentence denotes Overall goals of HITH during COVID‐19 pandemic
T28 3220-3349 Sentence denotes To provide safe, effective patient‐centred care at home for all HITH patients, while managing increased demand for HITH services.
T29 3350-3414 Sentence denotes To plan for new clinical pathways to care for COVID‐19 patients.
T30 3415-3457 Sentence denotes To minimise the impact of staff shortages.
T31 3458-3524 Sentence denotes To minimise the risk of SARS‐CoV‐2 exposure to staff and patients.
T32 3526-3578 Sentence denotes Issues to consider in planning for HITH preparedness
T33 3579-3767 Sentence denotes It 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.
T34 3768-3836 Sentence denotes A checklist of issues to consider can support this process (Fig. 1).
T35 3837-3933 Sentence denotes Figure 1 Checklist for optimising hospital‐in‐the‐home (HITH) service during COVID‐19 pandemic.
T36 3935-3952 Sentence denotes Managing staffing
T37 3953-4056 Sentence denotes Workforce planning: resources required for projected increases in patient numbers, and impact of leave.
T38 4057-4185 Sentence denotes Workforce flexibility: changing shift times, teleconferencing from home, especially for those with increased risk from COVID‐19.
T39 4187-4231 Sentence denotes Managing HITH equipment use and availability
T40 4232-4408 Sentence denotes HITH 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.
T41 4409-4578 Sentence denotes Equipment stock availability and cars: ensuring sufficient stock or supply chain of usual and additional (PPE, flocked swabs) equipment for the duration of the pandemic.
T42 4579-4739 Sentence denotes Telehealth equipment: ensuring good connection; access to videoconferencing is not universal in patients' homes, and may need to be replaced by telephone calls.
T43 4741-4766 Sentence denotes Managing patient workload
T44 4767-4901 Sentence denotes Measures to decrease current HITH workload will maximise the number of patients that can be transferred home to free up hospital beds.
T45 4902-5101 Sentence denotes Managing 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.
T46 5102-5367 Sentence denotes Managing 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.
T47 5369-5430 Sentence denotes Minimising risk of exposure to and transmission of SARS‐CoV‐2
T48 5431-5519 Sentence denotes Staff should follow current health department guidelines for screening, testing and PPE.
T49 5520-5591 Sentence denotes Risk factor screening script use: at referral and prior to every visit.
T50 5592-5735 Sentence denotes Education and training staff for PPE use: guidance on donning, doffing and waste disposal, because every visit is in an unfamiliar environment.
T51 5736-5885 Sentence denotes Limiting exposure during visits: family members should be limited in number, physically distanced and if unwell, not in the room with visiting staff.
T52 5886-5998 Sentence denotes Decreasing risk for staff at increased risk (co‐morbidities, increased age): telehealth and non‐clinical duties.
T53 6000-6014 Sentence denotes Communications
T54 6015-6105 Sentence denotes Communication is critical in ensuring that staff and patients feel informed and supported.
T55 6106-6236 Sentence denotes HITH staff: to provide updates and support, emphasise the importance of hand hygiene and other measures and provide moral support.
T56 6237-6349 Sentence denotes Hospital staff: to remind referrers of the role and capacity of HITH in ongoing institutional pandemic planning.
T57 6350-6531 Sentence denotes General practitioners, community physicians and other healthcare workers: to ensure care is co‐ordinated with other healthcare workers providing supportive care to patients at home.
T58 6532-6730 Sentence denotes Patients: 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.
T59 6731-6790 Sentence denotes 12 This may include child‐orientated language or pictures.
T60 6792-6813 Sentence denotes Supporting each other
T61 6814-7072 Sentence denotes We support our own HITH team and our colleagues by treating everyone with respect and kindness, inclusion, regular communication, understanding of natural anxiety, reassurance and advocacy for infection protection for them in their role as front‐line carers.
T62 7074-7108 Sentence denotes Clinical role of HITH for COVID‐19
T63 7109-7278 Sentence denotes The clinical role of HITH will depend on the pathways that already exist and what capacity the HITH service has to expand or modify services and to develop new pathways.
T64 7280-7351 Sentence denotes Provision of safe effective HITH care to meet increased hospital demand
T65 7352-7418 Sentence denotes During a pandemic, the first priority is to optimise current care.
T66 7419-7511 Sentence denotes However, there may be opportunities to think about the role of HITH for more patient groups.
T67 7512-7688 Sentence denotes Maximise referral of usual HITH patients: transferring all cohorts that the institutional HITH usually takes; using communication, education and advertising signage about HITH.
T68 7689-7885 Sentence denotes Modify usual care to include additional HITH patients: extension of limits of current patient groups: acuity/severity, referral timing and intervention frequency, without decreasing level of care.
T69 7886-7988 Sentence denotes Opportunities to develop new HITH pathways: development for new patient cohorts and new interventions.
T70 7989-8077 Sentence denotes HITH societies are well positioned to establish sharing of information across hospitals.
T71 8079-8125 Sentence denotes Referral of new patients to HITH with COVID‐19
T72 8126-8226 Sentence denotes The role of HITH for patients with suspected or confirmed COVID‐19 is untested and likely to evolve.
T73 8227-8420 Sentence denotes Current case definition criteria should be used: patients with mild disease can go home without HITH, patients with severe disease need hospital admission, and the role of HITH lies in between.
T74 8421-8536 Sentence denotes HITH may also be a source of reassurance for people who are safe to go home but feel frightened by their diagnosis.
T75 8537-8635 Sentence denotes Referral processes: who will review, relay results and give isolation advice, in and out of hours.
T76 8636-8977 Sentence denotes Clinical criteria appropriate for HITH suggested for COVID‐19: these should be based on usual institutional HITH criteria:Requirement for ongoing assessment and/or management for moderate illness, for example, respiratory effort but not needing oxygen, decreased fluid intake, moderate secondary bacterial pneumonia requiring IV antibiotics.
T77 8978-9110 Sentence denotes COVID‐specific modifications may be considered, for example, tolerance of fevers and/or mild hypoxia in otherwise suitable patients.
T78 9111-9275 Sentence denotes Monitoring those at higher risk of deterioration: those with respiratory/cardiac/oncological co‐morbidities, neonates and elderly should be considered individually.
T79 9276-9411 Sentence denotes Duration of HITH admission: symptoms should be clearly improving before discharge; deterioration may occur beyond day 5 of the illness.
T80 9412-9627 Sentence denotes Additional interventions that may increase use of HITH: depending on HITH capability: equipment kits for patient self‐observation, nasogastric/intravenous hydration, oxygen using concentrators and remote monitoring.
T81 9629-9673 Sentence denotes Mode of HITH care for patients with COVID‐19
T82 9674-9767 Sentence denotes Mode of care depends on patient medical needs and risk of transmission of COVID‐19 infection.
T83 9768-9915 Sentence denotes Telehealth for assessment/review: if no clinical intervention required; also semi‐urgent review of new symptoms or potential need to escalate care.
T84 9916-10095 Sentence denotes In‐person assessment: if intervention, for example, intravenous antibiotics required, or clinical examination for deterioration alerted by telehealth or patient/family phone call.
T85 10096-10214 Sentence denotes Responsive mobile unit: consideration for ability to respond to need for an in‐person visit after a telehealth review.
T86 10216-10291 Sentence denotes Transfer from HITH back to hospital of deteriorating patients with COVID‐19
T87 10292-10451 Sentence denotes Use of standard procedure for escalation of care for deteriorating patients: contact numbers and signs to watch out for on information provided to the patient.
T88 10452-10624 Sentence denotes Consideration of specific criteria in COVID‐19 patients: worsening respiratory status, for example, oxygen saturations <92%; poor urinary output or other clinical concerns.
T89 10625-10760 Sentence denotes Transfer back to hospital: clear process for both in hours and after hours, including where and by which team patient will be reviewed.
T90 10762-10772 Sentence denotes Conclusion
T91 10773-10971 Sentence denotes As the pandemic progresses, HITH activities will need to be updated, to align with recommendations from health departments and infection control, and in response to experience of COVID‐19 infection.
T92 10972-11207 Sentence denotes This is the current consensus position of a large group of healthcare workers experienced in HITH care, with the aim of facilitating preparedness for institutions to provide acute home care in the early stages of the COVID‐19 pandemic.
T93 11209-11225 Sentence denotes Acknowledgements
T94 11226-11228 Sentence denotes P.
T95 11229-11231 Sentence denotes A.
T96 11232-11328 Sentence denotes Bryant is the recipient of the Dr Nicholas Collins Fellowship from the HITH Society Australasia.
T97 11329-11331 Sentence denotes P.
T98 11332-11334 Sentence denotes A.
T99 11335-11348 Sentence denotes Bryant and A.
T100 11349-11351 Sentence denotes C.
T101 11352-11389 Sentence denotes Bowen hold NHMRC Investigator Grants.
T102 11390-11551 Sentence denotes As this position paper is based on HITH‐COVID‐19 Guidelines of the HITH Society Australasia, we would like to acknowledge their role in reviewing the guidelines.