scholarly journals A Web-based, Mobile Responsive Application to Screen Healthcare Workers for COVID Symptoms: Descriptive Study

2020 ◽  
Author(s):  
Haipeng (Mark) Zhang ◽  
Dimitar Dimitrov ◽  
Lynn Simpson ◽  
Balaji Singh ◽  
Nina Plaks ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Healthcare Delivery ◽  
The United States ◽  
Time Of Day ◽  
Lessons Learned ◽  
The Self ◽  
Web Based ◽  
Symptom Screening ◽  
Self Service ◽  
Service Application

AbstractBackgroundThe COVID-19 pandemic has impacted over 1 million people across the globe, with over 330,000 cases in the United States. To help limit the spread in Massachusetts, the Department of Public Health required that all healthcare workers must be screened for symptoms daily – individuals with symptoms may not work. We rapidly created a digital COVID-19 symptom screening tool for a large, academic, integrated healthcare delivery system, Partners HealthCare, in Boston, Massachusetts.ObjectiveWe describe the design and development of the COVID-19 symptom screening application and report on aggregate usage data from the first week of use across the organization.MethodsUsing agile principles, we designed, tested and implemented a solution over the span of a week using progressively custom development approaches as the requirements and use case become more solidified. We developed the minimum viable product (MVP) of a mobile responsive, web-based self-service application using REDCap (Research Electronic Data Capture). For employees without access to a computer or mobile device to use the self-service application, we established a manual process where in-person, socially distanced screeners asked employees entering the site if they have symptoms and then manually recorded the responses in an Office 365 Form. A custom .NET Framework application was developed solution as COVID Pass was scaled. We collected log data from the .NET application, REDCap and Office 365 from the first week of full enterprise deployment (March 30, 2020 – April 5, 2020). Aggregate descriptive statistics including overall employee attestations by day and site, employee attestations by application method (COVID Pass automatic screening vs. manual screening), employee attestations by time of day, and percentage of employees reporting COVID-19 symptomsResultsWe rapidly created the MVP and gradually deployed it across the hospitals in our organization. By the end of the first week of enterprise deployment, the screening application was being used by over 25,000 employees each weekday. Over the first full week of deployment, 154,730 employee attestation logs were processed across the system. Over this 7-day period, 558 (0.36%) employees reported positive symptoms. In most clinical locations, the majority of employees (∼80-90%) used the self-service application, with a smaller percentage (∼10-20%) using manual attestation. Hospital staff continued to work around the clock, but as expected, staff attestations peaked during shift changes between 7-8am, 2-3pm, 4-6pm, and 11pm-midnight.ConclusionsUsing rapid, agile development, we quickly created and deployed a dedicated employee attestation application that gained widespread adoption and use within our health system. Further, we have identified over 500 symptomatic employees that otherwise would have possibly come to work, potentially putting others at risk. We share the story of our implementation, lessons learned, and source code (via GitHub) for other institutions who may want to implement similar solutions.

scholarly journals A Web-Based, Mobile-Responsive Application to Screen Health Care Workers for COVID-19 Symptoms: Rapid Design, Deployment, and Usage

10.2196/19533 ◽  
2020 ◽  
Vol 4 (10) ◽  
pp. e19533
Author(s):  
Haipeng Zhang ◽  
Dimitar Dimitrov ◽  
Lynn Simpson ◽  
Nina Plaks ◽  
Balaji Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
The United States ◽  
Time Of Day ◽  
The Self ◽  
Web Based ◽  
Symptom Screening ◽  
Care Workers ◽  
Self Service ◽  
Service Application

Background As of July 17, 2020, the COVID-19 pandemic has affected over 14 million people worldwide, with over 3.68 million cases in the United States. As the number of COVID-19 cases increased in Massachusetts, the Massachusetts Department of Public Health mandated that all health care workers be screened for symptoms daily prior to entering any hospital or health care facility. We rapidly created a digital COVID-19 symptom screening tool to enable this screening for a large, academic, integrated health care delivery system, Partners HealthCare, in Boston, Massachusetts. Objective The aim of this study is to describe the design and development of the COVID Pass COVID-19 symptom screening application and report aggregate usage data from the first three months of its use across the organization. Methods Using agile principles, we designed, tested, and implemented a solution over the span of one week using progressively customized development approaches as the requirements and use case become more solidified. We developed the minimum viable product (MVP) of a mobile-responsive, web-based, self-service application using research electronic data capture (REDCap). For employees without access to a computer or mobile device to use the self-service application, we established a manual process where in-person, socially distanced screeners asked employees entering the site if they have symptoms and then manually recorded the responses in an Office 365 Form. A custom .NET Framework application solution was developed as COVID Pass was scaled. We collected log data from the .NET application, REDCap, and Microsoft Office 365 from the first three months of enterprise deployment (March 30 to June 30, 2020). Aggregate descriptive statistics, including overall employee attestations by day and site, employee attestations by application method (COVID Pass automatic screening vs manual screening), employee attestations by time of day, and percentage of employees reporting COVID-19 symptoms, were obtained. Results We rapidly created the MVP and gradually deployed it across the hospitals in our organization. By the end of the first week, the screening application was being used by over 25,000 employees each weekday. After three months, 2,169,406 attestations were recorded with COVID Pass. Over this period, 1865/160,159 employees (1.2%) reported positive symptoms. 1,976,379 of the 2,169,406 attestations (91.1%) were generated from the self-service screening application. The remainder were generated either from manual attestation processes (174,865/2,169,406, 8.1%) or COVID Pass kiosks (25,133/2,169,406, 1.2%). Hospital staff continued to work 24 hours per day, with staff attestations peaking around shift changes between 7 and 8 AM, 2 and 3 PM, 4 and 6 PM, and 11 PM and midnight. Conclusions Using rapid, agile development, we quickly created and deployed a dedicated employee attestation application that gained widespread adoption and use within our health system. Further, we identified 1865 symptomatic employees who otherwise may have come to work, potentially putting others at risk. We share the story of our implementation, lessons learned, and source code (via GitHub) for other institutions who may want to implement similar solutions.

scholarly journals A Web-Based, Mobile-Responsive Application to Screen Health Care Workers for COVID-19 Symptoms: Rapid Design, Deployment, and Usage (Preprint)

2020 ◽  
Author(s):  
Haipeng Zhang ◽  
Dimitar Dimitrov ◽  
Lynn Simpson ◽  
Nina Plaks ◽  
Balaji Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
The United States ◽  
Time Of Day ◽  
The Self ◽  
Web Based ◽  
Symptom Screening ◽  
Care Workers ◽  
Self Service ◽  
Service Application

BACKGROUND As of July 17, 2020, the COVID-19 pandemic has affected over 14 million people worldwide, with over 3.68 million cases in the United States. As the number of COVID-19 cases increased in Massachusetts, the Massachusetts Department of Public Health mandated that all health care workers be screened for symptoms daily prior to entering any hospital or health care facility. We rapidly created a digital COVID-19 symptom screening tool to enable this screening for a large, academic, integrated health care delivery system, Partners HealthCare, in Boston, Massachusetts. OBJECTIVE The aim of this study is to describe the design and development of the COVID Pass COVID-19 symptom screening application and report aggregate usage data from the first three months of its use across the organization. METHODS Using agile principles, we designed, tested, and implemented a solution over the span of one week using progressively customized development approaches as the requirements and use case become more solidified. We developed the minimum viable product (MVP) of a mobile-responsive, web-based, self-service application using research electronic data capture (REDCap). For employees without access to a computer or mobile device to use the self-service application, we established a manual process where in-person, socially distanced screeners asked employees entering the site if they have symptoms and then manually recorded the responses in an Office 365 Form. A custom .NET Framework application solution was developed as COVID Pass was scaled. We collected log data from the .NET application, REDCap, and Microsoft Office 365 from the first three months of enterprise deployment (March 30 to June 30, 2020). Aggregate descriptive statistics, including overall employee attestations by day and site, employee attestations by application method (COVID Pass automatic screening vs manual screening), employee attestations by time of day, and percentage of employees reporting COVID-19 symptoms, were obtained. RESULTS We rapidly created the MVP and gradually deployed it across the hospitals in our organization. By the end of the first week, the screening application was being used by over 25,000 employees each weekday. After three months, 2,169,406 attestations were recorded with COVID Pass. Over this period, 1865/160,159 employees (1.2%) reported positive symptoms. 1,976,379 of the 2,169,406 attestations (91.1%) were generated from the self-service screening application. The remainder were generated either from manual attestation processes (174,865/2,169,406, 8.1%) or COVID Pass kiosks (25,133/2,169,406, 1.2%). Hospital staff continued to work 24 hours per day, with staff attestations peaking around shift changes between 7 and 8 AM, 2 and 3 PM, 4 and 6 PM, and 11 PM and midnight. CONCLUSIONS Using rapid, agile development, we quickly created and deployed a dedicated employee attestation application that gained widespread adoption and use within our health system. Further, we identified 1865 symptomatic employees who otherwise may have come to work, potentially putting others at risk. We share the story of our implementation, lessons learned, and source code (via GitHub) for other institutions who may want to implement similar solutions.

scholarly journals Recommendations From a Descriptive Evaluation to Improve Screening Procedures for Web-Based Studies With Couples: Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Jason W Mitchell ◽  
Tanaka M D Chavanduka ◽  
Stephen Sullivan ◽  
Rob Stephenson
Keyword(s):  
Research Study ◽  
The United States ◽  
Lessons Learned ◽  
Data Validation ◽  
Same Sex ◽  
Dyadic Relationship ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Web Based ◽  
Male Couples

BACKGROUND Although there are a number of advantages to using the internet to recruit and enroll participants into Web-based research studies, these advantages hinge on data validity. In response to this concern, researchers have provided recommendations for how best to screen for fraudulent survey entries and to handle potentially invalid responses. Yet, the majority of this previous work focuses on screening (ie, verification that individual met the inclusion criteria) and validating data from 1 individual, and not from 2 people who are in a dyadic relationship with one another (eg, same-sex male couple; mother and daughter). Although many of the same data validation and screening recommendations for Web-based studies with individual participants can be used with dyads, there are differences and challenges that need to be considered. OBJECTIVE This paper aimed to describe the methods used to verify and validate couples’ relationships and data from a Web-based research study, as well as the associated lessons learned for application toward future Web-based studies involving the screening and enrollment of couples with dyadic data collection. METHODS We conducted a descriptive evaluation of the procedures and associated benchmarks (ie, decision rules) used to verify couples’ relationships and validate whether data uniquely came from each partner of the couple. Data came from a large convenience sample of same-sex male couples in the United States, who were recruited through social media venues for a Web-based, mixed methods HIV prevention research study. RESULTS Among the 3815 individuals who initiated eligibility screening, 1536 paired individuals (ie, data from both partners of a dyad) were assessed for relationship verification; all passed this benchmark. For data validation, 450 paired individuals (225 dyads) were identified as fraudulent and failed this benchmark, resulting in a total sample size of 1086 paired participants representing 543 same-sex male couples who were enrolled. The lessons learned from the procedures used to screen couples for this Web-based research study have led us to identify and describe four areas that warrant careful attention: (1) creation of new and replacement of certain relationship verification items, (2) identification of resources needed relative to using a manual or electronic approach for screening, (3) examination of approaches to link and identify both partners of the couple, and (4) handling of <i>bots</i>. CONCLUSIONS The screening items and associated rules used to verify and validate couples’ relationships and data worked yet required extensive resources to implement. New or updating some items to verify a couple’s relationship may be beneficial for future studies. The procedures used to link and identify whether both partners were coupled also worked, yet they call into question whether new approaches are possible to help increase linkage, suggesting the need for further inquiry.

scholarly journals Recommendations From a Descriptive Evaluation to Improve Screening Procedures for Web-Based Studies With Couples: Cross-Sectional Study

10.2196/15079 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e15079
Author(s):  
Jason W Mitchell ◽  
Tanaka M D Chavanduka ◽  
Stephen Sullivan ◽  
Rob Stephenson
Keyword(s):  
Research Study ◽  
The United States ◽  
Lessons Learned ◽  
Data Validation ◽  
Same Sex ◽  
Dyadic Relationship ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Web Based ◽  
Male Couples

Background Although there are a number of advantages to using the internet to recruit and enroll participants into Web-based research studies, these advantages hinge on data validity. In response to this concern, researchers have provided recommendations for how best to screen for fraudulent survey entries and to handle potentially invalid responses. Yet, the majority of this previous work focuses on screening (ie, verification that individual met the inclusion criteria) and validating data from 1 individual, and not from 2 people who are in a dyadic relationship with one another (eg, same-sex male couple; mother and daughter). Although many of the same data validation and screening recommendations for Web-based studies with individual participants can be used with dyads, there are differences and challenges that need to be considered. Objective This paper aimed to describe the methods used to verify and validate couples’ relationships and data from a Web-based research study, as well as the associated lessons learned for application toward future Web-based studies involving the screening and enrollment of couples with dyadic data collection. Methods We conducted a descriptive evaluation of the procedures and associated benchmarks (ie, decision rules) used to verify couples’ relationships and validate whether data uniquely came from each partner of the couple. Data came from a large convenience sample of same-sex male couples in the United States, who were recruited through social media venues for a Web-based, mixed methods HIV prevention research study. Results Among the 3815 individuals who initiated eligibility screening, 1536 paired individuals (ie, data from both partners of a dyad) were assessed for relationship verification; all passed this benchmark. For data validation, 450 paired individuals (225 dyads) were identified as fraudulent and failed this benchmark, resulting in a total sample size of 1086 paired participants representing 543 same-sex male couples who were enrolled. The lessons learned from the procedures used to screen couples for this Web-based research study have led us to identify and describe four areas that warrant careful attention: (1) creation of new and replacement of certain relationship verification items, (2) identification of resources needed relative to using a manual or electronic approach for screening, (3) examination of approaches to link and identify both partners of the couple, and (4) handling of bots. Conclusions The screening items and associated rules used to verify and validate couples’ relationships and data worked yet required extensive resources to implement. New or updating some items to verify a couple’s relationship may be beneficial for future studies. The procedures used to link and identify whether both partners were coupled also worked, yet they call into question whether new approaches are possible to help increase linkage, suggesting the need for further inquiry.

scholarly journals Occupational Stress and Mental Health Among Healthcare Workers Serving Socially Vulnerable Populations During the COVID-19 Pandemic

2021 ◽  
Vol 9 ◽  
Author(s):  
V. Nelly Salgado de Snyder ◽  
Alice P. Villatoro ◽  
Marisol D. McDaniel ◽  
Ana Sofia Ocegueda ◽  
Deliana Garcia ◽  
...  
Keyword(s):  
Mental Health ◽  
Vulnerable Populations ◽  
Healthcare Workers ◽  
Well Being ◽  
Safety Net ◽  
The United States ◽  
Lessons Learned ◽  
Community Safety ◽  
Vulnerable Groups ◽  
Work Place

The purpose of this study was to analyze occupational and personal stressors, mental health indicators, perceived discrimination and help-seeking behaviors among healthcare workers and providers (HCWPs) serving socially vulnerable groups such as immigrants, refugees, farmworkers, homeless individuals, people living in poverty, and other disadvantaged populations in the United States (U.S.) during the COVID-19 pandemic. Using a cross-sectional descriptive approach, we gathered information between July and September 2020, from a sample of 407 affiliates of two national organizations of clinic-based HCWPs who worked at federally funded and community safety-net clinics. Informed consent was obtained from all participants who completed a self-administered online survey available in English and Spanish. Our results indicated that the HCWPs serving vulnerable groups in the midst of the pandemic experienced high levels of occupational and personal stressors as well as anxiety and depressive symptomology. Major occupational stressors were excessive workload, long working-hours, and institutional barriers to refer and follow-up on their clients' access to needed social services. High-rated personal stressors included sleep disorders, lack of and child-care, partner's loosing job, and other family related situations. Our findings suggest that HCWPs working with vulnerable populations need specialized interventions that bolster their mental health and well-being as the pandemic continues to unfold. We recommend implementing initiatives that encourage HCWPs' to be actively involved in clinic decisions regarding employee safety and protection as well as in management decisions to improve work place infrastructure and capacity to respond to the social needs of their clients. Lessons learned from the pandemic are useful tools in designing protocols for addressing the mental-health needs of HCWPs in health-care organizations that attend to socially underprivileged populations.

scholarly journals Beyond biopolitics: the importance of the later work of Foucault to understand care practices of healthcare workers caring for undocumented migrants

2021 ◽  
Author(s):  
Dirk Lafaut
Keyword(s):  
Role Models ◽  
Healthcare Workers ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
The Self ◽  
Undocumented Migrants ◽  
Care Of The Self ◽  
Healthcare Ethics ◽  
Care Practices

Abstract BackgroundUndocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely obedient instruments of humanitarian government or gatekeeping.MethodsBased on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers.ResultsHealthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants.ConclusionsThe findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics.Trial RegistrationMedical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279

scholarly journals Covid-19 pandemic: chronicle of responses and experiences of the infection prevention and control committee at a tertiary hospital in southwest Nigeria

2021 ◽  
Vol 21 (3) ◽  
pp. 1093-1099
Author(s):  
Akinwumi Ayodeji Akinbodewa ◽  
Michael Simidele Odimayo ◽  
Olorunfemi Akinbode Ogundele ◽  
Tosin Oluwapelumi Ogunleye ◽  
Olanrewaju Olayinka Johnson ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Virus Disease ◽  
Healthcare Delivery ◽  
Healthcare Management ◽  
Lessons Learned ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
And Control

Since the advent of 2019-Corona virus Disease (COVID-19) in Nigeria in February 2020, the number of confirmed cases has risen astronomically to over 61,307 cases within 8 months with more than 812 healthcare workers infected and some recorded deaths within their ranks. Infection prevention and control is a key component in ensuring safety of healthcare workers in the hospital as health- care-associated infection is one of the most common complications of healthcare management. Unbridled transmission of infection can lead to shortage of healthcare personnel, reduced system efficiency, increased morbidity and mortality among patients and in some instances, total collapse of healthcare delivery services. The Infection Prevention and Control Committee is a recognised group by the Centre for Disease Control and Prevention with their core programmes including drawing up activities, procedures and policies designed to achieve above-stated objectives before, during and after any disease outbreak, especially emerging and re-emerging ones such as the 2019 Coronavirus Disease. In this report, we highlight the roles played by the Infection Prevention and Control Committee of the University of Medical Sciences Teaching Hospital to prevent the spread of COVID-19 within and outside the hospital community and the lessons learned to date. Keywords: COVID-19; infection prevention; infection control; Nigeria.

scholarly journals Avatar Web-Based Self-Report Survey System Technology for Public Health Research: Technical Outcome Results and Lessons Learned

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Craig Savel ◽  
Stan Mierzwa ◽  
Pamina M Gorbach ◽  
Samir Souidi ◽  
Michelle Lally ◽  
...  
Keyword(s):  
Public Health ◽  
Health Research ◽  
The United States ◽  
Public Health Research ◽  
Lessons Learned ◽  
Self Report ◽  
Web Based ◽  
Survey System ◽  
Report Data ◽  
Self Report Data

This paper reports on a specific Web-based self-report data collection system that was developed for a public health research study in the United States. Our focus is on technical outcome results and lessons learned that may be useful to other projects requiring such a solution. The system was accessible from any device that had a browser that can support HTML5. Report findings include: which hardware devices, Web browsers, and operating systems were used, the rate of survey completion, and key considerations for employing Web-based surveys in a clinical trial setting. 

scholarly journals Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole Y. Penwill ◽  
Nadia Roessler De Angulo ◽  
Priya R. Pathak ◽  
Clairissa Ja ◽  
Martha J. Elster ◽  
...  
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Well Being ◽  
The United States ◽  
Lessons Learned ◽  
Pediatric Care ◽  
Hospitalized Children ◽  
Hospital Policies ◽  
Hospital Leaders

Abstract Background The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. The objectives of this study were to identify major changes in healthcare delivery for hospitalized children during the COVID-19 pandemic, identify lessons learned from these changes, and compare and contrast the experiences of children’s and community hospitals. Methods We purposefully sampled participants from both community and children’s hospitals serving pediatric patients in the six U.S. states with the highest COVID-19 hospitalization rates at the onset of the pandemic. We recruited 2–3 participants from each hospital (mix of administrators, front-line physicians, nurses, and parents/caregivers) for semi-structured interviews. We analyzed interview data using constant comparative methods to identify major themes. Results We interviewed 30 participants from 12 hospitals. Participants described how leaders rapidly developed new hospital policies (e.g., directing use of personal protective equipment) and how this was facilitated by reviewing internal and external data frequently and engaging all relevant stakeholders. Hospital leaders optimized communication through regular, transparent, multi-modal, and bi-directional communication. Clinicians increased use of videoconference and telehealth to facilitate physical distancing, but these technologies may have disadvantaged non-English speakers. Due to declining volumes of hospitalized children and surges of adult patients, clinicians newly provided care for hospitalized adults. This was facilitated by developing care teams supported by adult hospitalists, multidisciplinary support via videoconference, and educational resources. Participants described how the pandemic negatively impacted clinicians’ mental health, and they stressed the importance of mental health resources and wellness activities/spaces. Conclusions We identified several major changes in inpatient pediatric care delivery during the COVID-19 pandemic, including the adoption of new hospital policies, video communication, staffing models, education strategies, and staff mental health supports. We outline important lessons learned, including strategies for successfully developing new policies, effectively communicating with staff, and supporting clinicians’ expanding scope of practice. Potentially important focus areas in pandemic recovery include assessing and supporting clinicians’ mental health and well-being, re-evaluating trainees’ skills/competencies, and adapting educational strategies as needed. These findings can help guide hospital leaders in supporting pandemic recovery and addressing future crises.

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