Utilization of a multidisciplinary treatment and follow-up program for COVID-19 patients in the outpatient setting
Creators: name: Johnson-Maxim, Alexis
Publisher: name: No Publisher Supplied
Year: 2024

description: BackgroundCoronavirus-19 (COVID-19) has resulted in physical, cognitive, and psychological impairments in millions of Americans since the start of the COVID-19 pandemic in 2020. The aim of this program was to implement an evidence-based protocol for clinical management of those diagnosed and recovering from COVID-19 in the outpatient setting. The use of a clinical pathway was implemented to improve provider comfort with managing patients with COVID-19 in the outpatient setting. Patients with COVID-19 may present with symptoms such as dyspnea, weakness, and palpitations in the post-acute phase. They are also at higher risk for complications such as thromboembolic disease, obstructive ventilatory defect, and stroke, among other ailments during this post-acute period as well. The clinical pathway provided support for decision making regarding complication surveillance using targeted follow ups, on-site testing, and specialty referral. The surveillance testing included pulmonary function testing, echocardiograms and venous dopplers of the lower extremities. PurposeThe purpose of this DNP project was to evaluate if the development and implementation of an outpatient treatment and follow-up program can improve provider and clinical staff confidence with providing care to COVID-19 patients in the outpatient setting.MethodologyThis quality improvement project was an exploratory pilot program that utilized the implementation of an evidence based clinical pathway for the clinical management of patients with COVID-19. Clinician feedback was obtained using an anonymous web-based feedback tool collected using a QR code in Qualtrics. The anonymous web-based feedback tool included 5 questions answered using with a 5 point Likert scale. An analysis of clinician and support staff feedback was completed to evaluate whether the clinical pathway made a clinically significant difference in improving clinician and support staff comfort with managing patients with COVID19. ResultsThe outcomes measured were provider comfort, provider perception of helpfulness, frequency, and ease of use of the clinical pathway. Testing data as a result of provider usage of the clinical pathway was also collected. The results revealed 75% of clinicians and clinical staff reported improvement in their comfort with managing patients with COVID-19 in the outpatient setting after utilizing the clinical pathway. In total, 36 patients were managed using the clinical pathway. The use of this program resulted in 38 follow up visits, 22 PFTs, 12 echocardiograms, 12 Electrocardiograms, 22 chest x-rays and 7 CT scans of the chest. The results indicate that a structured approach to clinical management of patients with COVID-19 is feasible for use throughout other locations within the organization. Implications for PracticeThe results of this quality improvement project indicated the use of a clinical pathway created a structured approach to clinical management of patients with COVID –19 in the outpatient setting. This structured approach helped to promote skill development in clinical staff and comfort in their daily practice when managing patients with COVID-19.