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Australian Children’s Hospital: SARS-CoV-2 Testing

Posted in COVID-19, tagged , , , , on May 20, 2020| Leave a Comment »

 

SARS-CoV-2 Testing and Outcomes in the First 30 Days After the First Case of COVID-19 at an Australian Children’s Hospital

Reporter: Gail S. Thornton, M.A.

2020

Objective: International studies describing COVID-19 in children have shown low proportions of paediatric cases and generally a mild clinical course. We aimed to present early data on children tested for SARS-CoV-2 at a large Australian tertiary children’s hospital according to the state health department guidelines, which varied over time.

Methods: We conducted a retrospective cohort study at The Royal Children’s Hospital, Melbourne, Australia. It included all paediatric patients (aged 0-18 years) who presented to the Emergency Department (ED) or the Respiratory Infection Clinic (RIC) and were tested for SARS-CoV-2. The 30-day study period commenced after the first confirmed positive case was detected at the hospital on 21st March 2020, until 19th April 2020. We recorded epidemiological and clinical data.

Results: There were 433 patients in whom SARS-CoV-2 testing was performed in ED (331 (76%)) or RIC (102 (24%)). There were 4 (0.9%) who had positive SARS-CoV-2 detected, none of whom were admitted to hospital or developed severe disease. Of these SARS-CoV-2 positive patients, 1/4 (25%) had a comorbidity, which was asthma. Of the SARS-CoV-2 negative patients, 196/429 (46%) had comorbidities. Risk factors for COVID-19 were identified in 4/4 SARS-CoV-2 positive patients and 47/429 (11%) SARS-CoV-2 negative patients.

Conclusions: Our study identified a very low rate of SARS-CoV-2 positive cases in children presenting to a tertiary ED or RIC, none of whom were admitted to hospital. A high proportion of patients who were SARS-CoV-2 negative had comorbidities.

Keywords: Australia; COVID-19; SARS-CoV-2; children; novel coronavirus.

SOURCE:

https://pubmed.ncbi.nlm.nih.gov/32390285/

 

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Responses to the COVID-19 outbreak from Oncologists, Cancer Societies and the NCI: Important information for cancer patients

Posted in Cancer - General, Cancer and Current Therapeutics, Cancer Prevention: Research & Programs, Cancer Screening, Cancer-Immune Interactions, COVID-19, Immunotherapy, Infectious Disease & New Antibiotic Targets, interventional oncology, Lung and pulmonology, Neutropenia, Neutrophilia, Patient Experience, Patient Experience: Personal Memories of Invasive Medical Intervantion, Patient Outlook, Population Health Management, Nutrition and Phytochemistry, Pulmonary diseases, Pulmonary pathology, SARS-CoV-2, Support Staff, Virology - Vector-borne DIsease, Virus Infective Acute Respiratory Syndrome: SARS-CoV, Voices of Patients and Healthcare Providers, Women Health, tagged , , , , , , , , , , , , , , , , on March 19, 2020| Leave a Comment »

Responses to the #COVID-19 outbreak from Oncologists, Cancer Societies and the NCI: Important information for cancer patients

Curator: Stephen J. Williams, Ph.D.

UPDATED 3/20/2020

Among the people who are identified at risk of coronovirus 2019 infection and complications of the virus include cancer patients undergoing chemotherapy, who in general, can be immunosuppressed, especially while patients are undergoing their treatment.  This has created anxiety among many cancer patients as well as their care givers and prompted many oncologist professional groups, cancer societies, and cancer centers to formulate some sort of guidelines for both the cancer patients and the oncology professional with respect to limiting the risk of infection to coronavirus (COVID19). 

 

This information will be periodically updated and we are working to get a Live Twitter Feed to bring oncologist and cancer patient advocacy groups together so up to date information can be communicated rapidly.  Please see this page regularly for updates as new information is curated.

IN ADDITION, I will curate a listing of drugs with adverse events of immunosuppression for people who might wonder if the medications they are taking are raising their risk of infections.

Please also see @pharma_BI for updates as well.

Please also see our Coronavirus Portal at https://pharmaceuticalintelligence.com/coronavirus-portal/

For ease of reading information for patients are BOLDED and in RED

ASCO’s Response to COVID-19

From the Cancer Letter: The following is a guest editorial by American Society of Clinical Oncology (ASCO) Executive Vice President and Chief Medical Officer Richard L. Schilsky MD, FACP, FSCT, FASCO. This story is part of The Cancer Letter’s ongoing coverage of COVID-19’s impact on oncology. A full list of our coverage, as well as the latest meeting cancellations, is available here.

 

The worldwide spread of the coronavirus (COVID-19) presents unprecedented challenges to the cancer care delivery system.

Our patients are already dealing with a life-threatening illness and are particularly vulnerable to this viral infection, which can be even more deadly for them. Further, as restrictions in daily movement and social distancing take hold, vulnerable patients may be disconnected from friends, family or other support they need as they manage their cancer.

As providers, we rely on evidence and experience when treating patients but now we face uncertainty. There are limited data to guide us in the specific management of cancer patients confronting COVID-19 and, at present, we have no population-level guidance regarding acceptable or appropriate adjustments of treatment and practice operations that both ensure the best outcome for our patients and protect the safety of our colleagues and staff.

As normal life is dramatically changed, we are all feeling anxious about the extreme economic challenges we face, but these issues are perhaps even more difficult for our patients, many of whom are now facing interruption

As we confront this extraordinary situation, the health and safety of members, staff, and individuals with cancer—in fact, the entire cancer community—is ASCO’s highest priority.

ASCO has been actively monitoring and responding to the pandemic to ensure that accurate information is readily available to clinicians and their patients. Recognizing that this is a rapidly evolving situation and that limited oncology-specific, evidence-based information is available, we are committed to sharing what is known and acknowledging what is unknown so that the most informed decisions can be made.

To help guide oncology professionals as they deal with the impact of coronavirus on both their patients and staff, ASCO has collated questions from its members, posted responses at asco.org and assembled a compendium of additional resources we hope will be helpful as the virus spreads and the disease unfolds. We continue to receive additional questions regarding clinical care and we are updating our FAQs on a regular basis.

We hope this information is helpful even when it merely confirms that there are no certain answers to many questions. Our answers are based on the best available information we identify in the literature, guidance from public health authorities, and input received from oncology and infectious disease experts.

For patients, we have posted a blog by Dr. Merry Jennifer Markham, chair of ASCO’s Cancer Communications Committee. This can be found on Cancer.Net, ASCO’s patient information website, and it provides practical guidance to help patients reduce their risk of exposure, better understand COVID-19 symptoms, and locate additional information.

This blog is available both in English and Spanish. Additional blog posts addressing patient questions will be posted as new questions are received and new information becomes available.

Find below a Tweet from Dr.Markham which includes links to her article on COVID-19 for cancer patients

https://twitter.com/DrMarkham/status/1237797251038220289?s=20

NCCN’s Response to COVID-19 and COVID-19 Resources

JNCCN: How to Manage Cancer Care during COVID-19 Pandemic

Experts from the Seattle Cancer Care Alliance (SCCA)—a Member Institution of the National Comprehensive Cancer Network® (NCCN®)—are sharing insights and advice on how to continue providing optimal cancer care during the novel coronavirus (COVID-19) pandemic. SCCA includes the Fred Hutchinson Cancer Research Center and the University of Washington, which are located in the epicenter of the COVID-19 outbreak in the United States. The peer-reviewed article sharing best practices is available for free online-ahead-of-print via open access at JNCCN.org.

Coronavirus disease 2019 (COVID-19) Resources for the Cancer Care Community

NCCN recognizes the rapidly changing medical information relating to COVID-19 in the oncology ecosystem, but understands that a forum for sharing best practices and specific institutional responses may be helpful to others.  Therefore, we are expeditiously providing documents and recommendations developed by NCCN Member Institutions or Guideline Panels as resources for oncology care providers. These resources have not been developed or reviewed by the standard NCCN processes, and are provided for information purposes only. We will post more resources as they become available so check back for additional updates.

Documents

Links

National Cancer Institute Response to COVID-19

More information at https://www.cancer.gov/contact/emergency-preparedness/coronavirus

What people with cancer should know: https://www.cancer.gov/coronavirus

Get the latest public health information from CDC: https://www.coronavirus.gov

Get the latest research information from NIH: https://www.nih.gov/coronavirus

 

Coronavirus: What People with Cancer Should Know

ON THIS PAGE

Both the resources at cancer.gov (NCI) as well as the resources from ASCO are updated as new information is evaluated and more guidelines are formulated by members of the oncologist and cancer care community and are excellent resources for those living with cancer, and also those who either care for cancer patients or their family and relatives.

Related Resources for Patients (please click on links)

 

 

 

Some resources and information for cancer patients from Twitter

Twitter feeds which may be useful sources of discussion and for cancer patients include:

 

@OncLive OncLive.com includes healthcare information for patients and includes videos and newsletters

 

 

@DrMarkham Dr. Markham is Chief of Heme-Onc & gyn med onc @UF | AD Med Affairs @UFHealthCancer and has collected very good information for patients concerning #Covid19 

 

 

@DrMaurieMarkman Dr. Maurie Markman is President of Medicine and Science (Cancer Centers of America, Philadelphia) @CancerCenter #TreatThePerson #Oncology #Genomics #PrecisionMedicine and hosts a great online live Tweet feed discussing current topics in cancer treatment and care for patients called #TreatThePerson Chat

UPDATED 3/20/2020 INFORMATION FROM NCI DESIGNATED CANCER CENTERS FOR PATIENTS/PROVIDERS

The following is a listing with links of NCI Designated Comprehensive Cancer Centers and some select designated Cancer Centers* which have information on infectious risk guidance for cancer patients as well as their physicians and caregivers.   There are 51 NCI Comprehensive Cancer Centers and as more cancer centers formulate guidance this list will be updated. 

 

Cancer Center State Link to COVID19 guidance
City of Hope CA Advice for cancer patients, survivors and caregivers
Jonsson Cancer Center at UCLA CA Cancer and COVID19
UCSF Hellen Diller Family Comprehensive Cancer CA COVID-19 Links for Patients and Providers
Lee Moffit FL Protecting against Coronavirus 19
University of Kansas Cancer Center* KS COVID19 Info for patients
Barbara & Karmanos Cancer Institute (Wayne State) MI COVID19 Resources
Rogel Cancer Center (Univ of Michigan) MI COVID19 Patient Specific Guidelines
Alvin J. Siteman Cancer Center (MO) Coronavirus
Fred & Pamela Buffet CC* NE Resources for Patients and Providers
Rutgers Cancer Institute of NJ NJ What patients should know about COVID19
Memorial Sloan Kettering NY What COVID19 means for cancer patients
Herbert Irving CC (Columbia University) NY Coronavirus Resource Center
MD Anderson Cancer  TX Planning for Patients, Providers
Hunstman Cancer Center UT COVID19 What you need to know
Fred Hutchinson WA COVID19 What patients need to know

 

 

Please also see related information on Coronavirus 2019 and Cancer and Immunotherapy at the following links on the Open Access Online Journal:

Volume Two: Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery 

at

https://pharmaceuticalintelligence.com/biomed-e-books/series-c-e-books-on-cancer-oncology/volume-two-immunotherapy-in-cancer-radiation-oncology/

AND

Coronavirus Portal

 

 

 

 

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Patients First

Posted in Hospital reputation, Patient Experience, Reputation of Interventionist, Support Staff, tagged , , , , , on November 15, 2015| Leave a Comment »

Patients First

Larry H. Bernstein, MD, FCAP, Curator

LPBI

 

Office of Patient Experience

http://my.clevelandclinic.org/patients-visitors/patient-experience

 

Cleveland Clinic defines our patient experience as putting “Patients First”.

http://my.clevelandclinic.org/ccf/media/Images/Patient%20Experience/carousel/patients_first.jpg

 

Putting patients first requires more than world-class clinical care – it requires care that addresses every aspect of a patient’s encounter with Cleveland Clinic, including the patient’s physical comfort, as well as their educational, emotional, and spiritual needs. Our team of professionals serves as an advisory resource for critical initiatives across the Cleveland Clinic health system. In addition, we provide resources and data analytics; identify, support, and publish sustainable best practices; and collaborate with a variety of departments to ensure the consistent delivery of patient-centered care.

Cleveland Clinic was the first major academic medical center to make patient experience a strategic goal, appoint a Chief Experience Officer, and one of the first to establish an Office of Patient Experience.

 

Patient Experience Measurement

http://my.clevelandclinic.org/ccf/media/Images/Patient%20Experience/launchpads/programs-lp.jpg

How We Measure Patient Experience

All acute care hospitals throughout the United States participate in a patient survey process designed and regulated by the Centers for Medicare and Medicaid Services (CMS). This HCAHPS survey (Hospital Consumer Assessment of Healthcare Providers and Systems) measures patients’ perspectives of their hospital care.

Public results are available at hospitalcompare.hhs.gov. Eligible adult patients are surveyed after hospital discharge and results displayed represent four consecutive calendar quarters.

Due to a time lag of the published HCAHPS survey results, we believe it is important for you to see our most recent feedback. View our HCAHPS scores from the last public reported period as well as our recent performance.

HCAHPS Education and Data Coordination

The Intelligence Team in the Office of Patient Experience plays a vital role in coordinating survey data transmission between the survey vendor and the Cleveland Clinic system. Real-time survey results, complete with benchmark comparisons and performance indicators, are maintained on an internal web-based dashboard program available to all staff in leadership and management roles. The team also provides survey education, particularly for the CMS-required inpatient HCAHPS survey process, and works together with leadership to uncover feedback trends and help prioritize experience improvement efforts.

 

Patient Experience: Empathy & Innovation Summit

Patient Experience: A Key Differentiator

Visit the Empathy +
Innovation Summit website

Patient experience has emerged as a dynamic issue for healthcare executives, physicians, nursing executives and industry leaders. No provider can afford to offer anything less than the best clinical, physical and emotional experience to patients and families. As patients become savvier, they judge healthcare providers not only on clinical outcomes, but also on their ability to be compassionate and deliver excellent, patient-centered care.

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Patient Satisfaction with Hospital Experience

Posted in Hospital reputation, Pain Alleviation, Patient Experience, Patient Outlook, Reputation of Interventionist, Support Staff, Surgical Procedure, tagged on November 15, 2015| Leave a Comment »

Patient Satisfaction with Hospital Experience

Curator: Larry H. Bernstein, MD, FCAP

 

 

Getting It Right: The Link Between the Patient Experience and Hospital Reputation

Katie Johnson, Ph.D., Director of Research and Analytics, National Research: 02/21/2014 –
See more at: http://www.nationalresearch.com/blog/33/#sthash.z8OlwguT.dpuf

 

When you get your daily vanilla latte, you know what to expect every single time—a great cup of Joe. And because of your positive morning (or afternoon) experience, you’ll keep going back. Does this same notion apply in healthcare? Absolutely.

But if you had a poor experience at your hospital, would you go back? Probably not.

It’s not rocket science that when you have a positive, favorable consumer experience with a product or service, you will keep going back for more—you may even adopt brand loyalty. However, as simple as this sounds, healthcare providers are not always “getting it right.”

According to a study by the National Research Corporation Market Insights Survey, the largest healthcare consumer survey in the U.S., eight percent of patients said their hospital experience was poor enough to not recommend the healthcare facility to family or friends. In addition, nine percent of patients rated their overall hospital care and services poorly.

When patients have a highly engaged, positive experience with their hospital, it’s a win-win situation. Hospital reputation is everything. And this rings true even more so today, since the patient experience is tied to hospital reimbursements. Below is a list of research-based evidence that explains why reputation matters:

    • Patient experience is important. It’s important because treating patients well is the right thing to do. It’s important because a positive patient experience is related to better health outcomes (including lower readmission rates). It’s important because Value Based Purchasing has tied Medicare reimbursement to HCAHPS scores. It’s also important, we have found, because of its impact on hospital reputation.

 

    • Hospital reputation is important. Why should hospitals care about their reputations? Hospital reputation plays a part in the selection process among would-be patients. Approximately nine in 10 people indicate that reputation is important when selecting a hospital. Further, once an individual selects and utilizes a hospital, he or she is more likely to utilize that same facility for future healthcare needs (pending a positive experience, of course).

 

    • Hospital reputation is related to patient experience. Our research has shown that hospitals providing positive patient experiences have better reputations. In other words, hospitals that are rated highly by their discharged patients are also rated highly by the general public (whether they’ve had a direct hospital experience or not).

 

    • We’ve found evidence to support an important chain of events. Patient experience drives reputation. Reputation drives utilization. Utilization drives future utilization.

 

    • Some aspects of reputation are more closely related to patient experience than others. The top five correlates, in descending order, are:
      • most personalized care
      • best accommodations
      • highest patient safety
      • best nurses
      • best overall quality

 

    • Today’s patient experience is related to tomorrow’s reputation. It takes time for reputations to form and change, and there is evidence of lag-time in the relationship between patient experience and hospital reputation. Correlations are strongest when patient experience is measured at the first time, and reputation is measured at the second time and six months later. This lag relationship indicates that the quality of the patient experience being administered in a hospital today is significantly related to the reputation of that hospital six months from now.

 

    • “Bad” hospital reputations are even more important. Facilities delivering poor patient experiences are four times more likely to have poor reputations than facilities delivering good patient experiences. Bad news travels fast and wide. In order to improve a poor reputation brought on by a poor patient experience, facilities would be wise to turn their attention inward and focus on improving the experiences they provide their patients.

 

  • We have a roadmap. The figure below is designed for healthcare leaders who would like to explore potential improvement strategies based on where their facilities are situated on the continuum of patient experience and reputation. While all strive to be in the top right category, scoring well on both patient experience and reputation, the reality is that the majority of facilities will find themselves located in one of the other three groups. Facilities in the top or bottom groups on the left side would do well to focus on the patient experience first and foremost. As we’ve learned, if the quality of patient experience is low, there is little that can be done effectively in terms of marketing and advertising. Facilities in the bottom right quadrant (high quality patient experience, but with reputations not reflective of that), should put resources into spreading the word and advertise the strength of their patient experience. It’s important that those in the community are made aware of the high-caliber care being delivered.

 

http://www.nationalresearch.com/uploads/Image/blog/BlogPic2-21-14.jpg

 

Research Brief: The Link Between the Patient Experience and Hospital Reputation

Hospitals and health systems across the United States are focusing increased effort on the delivery of superior patient experience, and with good reason. The provision of top-notch patient care translates to tangible benefits to both patients and their families, as well as to the healthcare facility itself.

In a research brief published by National Research Corporation in February 2014, The Link Between Patient Experience and Hospital Reputation, Dr. Katie Johnson presents findings showing how the patient experience is directly tied to a hospital or health system’s reputation. Research is derived from the National Research Market Insights Survey, the largest online healthcare consumer survey in the United States.

 

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