Building Back Better: Applying Lessons from the COVID-19 Pandemic to Expand Critical Information Access - PubMed (original) (raw)

Building Back Better: Applying Lessons from the COVID-19 Pandemic to Expand Critical Information Access

Hope E M Schwartz et al. J Emerg Med. 2021 Nov.

Abstract

Background: The Coronavirus disease 2019 (COVID-19) pandemic generated an unprecedented volume of evolving clinical guidelines that strained existing clinical information systems and necessitated rapid innovation in emergency departments (EDs).

Objectives: Our team aimed to harness new COVID-19-related reliance on digital clinical support tools to re-envision how all clinical guidelines are stored and accessed in our ED.

Methods: We used a design-thinking approach including empathizing, defining the problem, ideating, prototyping, and testing to develop a low-cost, homegrown clinical information hub: E*Drive. To measure impact, we compared web traffic on E*Drive to our legacy cloud-based folder system and conducted a survey of end-users using a validated health technology utilization instrument.

Results: Our final product, E*Drive, is a centralized clinical information hub storing everything from clinical guidelines to discharge resources. Clinical guidelines are standardized and housed within the high-traffic E*Drive platform to increase accessibility. Since launch, E*Drive has averaged 84 unique weekly users, compared with less than one weekly user on the legacy system. We surveyed 52 clinicians for a total response rate of 47%. Prior to the E*Drive rollout, 12.5% of ED clinicians felt confident accessing clinical information on the legacy system, whereas 76.6% of ED clinicians felt they could more easily access clinical information using E*Drive.

Conclusion: The COVID pandemic revealed vulnerabilities within our information dissemination system and presented an opportunity to improve clinical information delivery. Centralized web-based clinical information hubs designed around the clinician end-user experience can increase clinical guideline access in the ED.

Keywords: COVID-19; clinical guidelines; design; digital; information; innovation.

Copyright © 2021 Elsevier Inc. All rights reserved.

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Figures

Figure 1

Figure 1

Clinical guideline development: key stakeholders and change control process map.

Figure 2

Figure 2

E*Drive landing page (

https://edrive.ucsf.edu

).

Figure 3

Figure 3

Exemplar protocol pre and post standardization: cervical spine clearance. GCS = Glasgow Coma Scale score; CT = computed tomography; MRI = magnetic resonance imaging; ED = emergency department.

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