Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

• Published in: BMJ open Vol. 13; no. 5; p. e067986
• Main Authors: Choo, Esther K, Strehlow, Matthew, Del Rios, Marina, Oral, Evrim, Pobee, Ruth, Nugent, Andrew, Lim, Stephen, Hext, Christian, Newhall, Sarah, Ko, Diana, Chari, Srihari V, Wilson, Amy, Baugh, Joshua J, Callaway, David, Delgado, Mucio Kit, Glick, Zoe, Graulty, Christian J, Hall, Nicholas, Jemal, Abdusebur, KC, Madhav, Mahadevan, Aditya, Mehta, Milap, Meltzer, Andrew C, Pozhidayeva, Dar'ya, Resnick-Ault, Daniel, Schulz, Christian, Shen, Sam, Southerland, Lauren, Du Pont, Daniel, McCarthy, Danielle M
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 08.05.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: COVID-19; COVID-19 - epidemiology; COVID-19 diagnostic tests; Data collection; Emergency medical care; Emergency preparedness; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; Health Services Research; Hospitals; Humans; Observational studies; Organisation of health services; Pandemics; Patient safety; Protocols & guidelines; PUBLIC HEALTH; SARS-CoV-2; Social networks; Teaching hospitals; Telemedicine; Workforce; United States > US; COVID-19; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PUBLIC HEALTH; Protocols & guidelines; Organisation of health services
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-067986

ObjectivesThe COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic.Design, setting and participantsThis was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021.Outcomes and analysisWe identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts.ResultsWe found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity.ConclusionsHospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.