Innovation: Response To The Pandemic: Housing For Health In The Va Tent Community
Tiffany Owens, Daniel Ewing, Melissa Devera, Sandesh Shrestha, Peter Capone- Newton, Kristin Kopelson, Lisa Altman, Lillian Gelberg
In response to the COVID-19 pandemic, an innovative approach to providing integrated primary care services was initiated in the Veterans Administration Greater Los Angeles Healthcare System (Figure 1). The Care, Treatment and Rehabilitation Services, a unique street medicine program, was placed within an encampment that is supported by the West Los Angeles VA health care services including onsite provision of 24/7 security, stability of tent sites, 3 meals a day, unlimited water, hygiene stations, face masks, showers and housing placement services. 29 Oct, 2021. Non-refereed, under review. Permanent URL: https://hdl.handle.net/2027.42/170780
Innovation: Community Collaboration to Implement a Vaccination Clinic in Rural Areas
Roger Garvin, Ryan Norton, Joe Skariah, Sonja Likumahuwa-Ackman, Jennifer DeVoe, Stein Berger, Megan McGhean, Suzanne Sullivan, Deborah Cohen, Brian Garvey
Oregon Health & Science University
Primary care has delivered more vaccinations to people in the US than any other healthcare organization or entity. Patients seek vaccine advice from their primary care clinician, and this is no different for the COVID-19 vaccine. While mass COVID-19 vaccination sites are a critical piece of the greater public health strategy to immunize our communities, reaching older, underserved, and vaccine adverse communities will require engaging primary care and leveraging the trusting relationships practices establish with communities. Oregon Health & Science University Family Medicine Health Center, Scappoose, OR, collaborated with our rural county health department to establish a mass vaccination site at our clinic building. Based on our experience, we also developed a toolkit for decision-makers and implementers of vaccine clinics, designed to be a “vaccination clinic in a box,” that could be replicated in, and tailored to, many types of settings. 31 March, 2021. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/167008
Primary Care's Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs
John Westfall, Elizabeth Wilkinson, Anuradha Jetty, Stephen Petterson, Yalda Jabbarpour
Robert Graham Center for Policy Studies in Family Medicine and Primary Care
COVID-19 pandemic recovery will require a broad and coordinated effort for infection testing, immunity determination, and vaccination. With the advent of several COVID-19 vaccines, the dissemination and delivery of COVID-19 immunization across the nation is of concern. A study of the delivery of vaccinations, using 2017 Medicare Part B Fee-For-Service data and the 2013-2017 Medical Expenditure Panel Survey at the service, physician, and visit level show that Primary Care Physicians have played a crucial role in delivery of vaccinations to the U.S. population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States. 29 January, 2021. In-press, accepted 1/28/2021; Published 3/11/2021. URL: https://www.annfammed.org/content/early/2021/03/10/afm.2679
THE NATION THAT OPENED BARS AND CLOSED SCHOOLS
Thomas Bodenheimer
For the elderly, optimal health in the COVID-19 era is well-established: stay at home and strictly follow prevention guidelines. For children, achieving optimal health poses a serious dilemma. Staying at home and not physically attending school reduces the risk of encountering the virus but creates major problems in child health and development. How has our nation navigated this dilemma? 24 July 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/156050
Food Bag Program to Address the Immediate Food Needs of Patients During the COVID-19 Crisis
Katherine Jahnes, Kathleen Hopkins, Emily Foote, Diana Fleisher, Kelly M. Doran
In this report we describe creation of a novel emergency department (ED) food bag program in New York City. The food bag program was designed to help meet immediate food needs of patients being discharged from the ED. Each bag contained shelf-stable food as well as a handout describing other community food resources. The program leveraged community-hospital partnerships, was met with enthusiasm from patients and staff alike, and would be highly replicable to other settings. 6 July 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/156010
Community Health Centers Poised to Weather Uncertainty from the COVID-19 Pandemic: Lessons from the Past, Reflections on Federal Program Durability
Evan V. Goldstein
Like most sectors of the U.S. health care system, federally-funded community health centers (CHCs) face new challenges imposed by the COVID-19 pandemic. However, important lessons from the past and recent history serve to remind us that COVID-19 will not deliver a fatal blow to the federal CHC program – and most CHCs and their clinicians will weather this new storm of uncertainty while continuing to provide invaluable services to persons who need them most. 22 May, 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155401
Why a shortage of ventilators should not be the take-away from COVID-19: The case for primary care
Deborah Edberg, Santina Wheat
The current COVID-19 crisis has rightly highlighted severe shortages in ICU personnel, ventilators and other ICU equipment. It is critical to remember, however, that aside from this particular crisis, our healthcare needs were not revolving around this specific type of care. During and after the current pandemic, it is crucial we continue to emphasize the role and importance of primary care in improving the health care system and the overall health of the people of the United States. 15 May 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155364
The Five Phases of Pandemic Care for Primary Care
Alex H Krist, Jennifer E. DeVoe, Anthony Cheng, Thomas Ehrlich
During a pandemic, many more patients are likely to have symptoms and many more of those symptomatic patients will seek care. Nearly all will need primary care, and primary care will need to be there to help them. The authors provide a framework in five waves of needed primary care to address the current COVID-19 pandemic. Accepted 5/11/2020, Published, 7/13/2020. URL: https://www.annfammed.org/content/18/4/349
Responding to Community Questions During a Pandemic: Development of a COVID-19 Inquiry Group
Sean Robinson, Heather Angier, Kam Pierce, Anthony Cheng, Brett Lewis, Kanwarabijit Thind, Eva Davis, Asma Lotfi, Frances Biagioli
Oregon Health & Science University Department of Family Medicine formed the COVID-19 Inquiry Group to rapidly identify, evaluate, synthesize, and disseminate existing evidence to answer COVID-19-related questions for their community. After answers to questions from the community are finalized, team administrators submit answers for authorization by an institutional oversight committee. At the end of each day, a report of approved answers is disseminated widely. 28 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154809
Development and Implementation of a COVID-19 Respiratory Diagnostic Center
Amir Barzin, David Alain Wohl, Timothy P. Daaleman
In response to the COVID-19 pandemic, respiratory diagnostic centers (RDCs) have emerged as a health service model that offers symptom screening and provides diagnostic testing for patients. Primary care and outpatient medical directors as well as hospital leadership at the University of North Carolina Health Care System (UNCHCS) worked collaboratively to design and implement the UNC RDC. In this Innovation, the authors describe how these groups developed a “drive-through” model that allowed assessment in personal vehicles. Important lessons are discussed. 10 April 2020. Accepted 17 April 2020. Accepted 4/17/2020; Published 9/14/2020. URL: https://www.annfammed.org/content/18/5/464
Reflecting on COVID-19 in 55 Words
Maureen Grissom, Rolando Gomez, Abigail Hamilton, Shan Malik, Cristina Marti-Amarista, Howard Stephen Reinheimer
In an effort to address the anxiety that the coronavirus may cause for some, our Family Medicine Residency Program held a writing workshop using the 55-Word Story format, with writings specific to the theme of COVID-19. The exercise gave residents time and space to reflect on their own experiences and emotions, generated a great degree support and discussion and provided them a window into what some of their fellow residents were experiencing. 13 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154739
Implementation of Primary Care Pandemic Plan: Respiratory Clinic Model
Kathryn Harmes, Grace Jenq, Taylor Standiford, Melissa Pynnonen
In this article, the authors provide a detailed description of the implementation of phases 2 and 3 of the Primary Care Pandemic Plan as described by Krist et al, delivering care to sick and well patients, as well as ensuring staff safety, through establishing a geographically separated respiratory clinic. 13 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154742
Practicing Full-Spectrum Family Medicine During the COVID-19 Pandemic
Mary Ann Dakkak
The author, a board certified family medicine physician with a fellowship in surgical and high-risk obstetrics, is working to create a COVID-19 team staffed by family medicine practitioners that will encompass prenatal, antenatal and postpartum women to streamline their care. She relates her experiences adapting to this new reality. 8 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/15471
The COVID-19 Pandemic: The Urgency of Discussing Goals of Care in Patients with Advanced Illness
Amy Case
As the COVID-19 pandemic unfolds in real time before us, the author has witnessed an increase in the emphasis physicians are placing on timely advance care planning and goals of care discussions, especially for patients with advanced cancer, frailty, or advanced illness. This paper describes the need for goals of care discussions at this critical time, as well as potential barriers to doing so, and lists several excellent resources to help clinicians discuss important topics with COVID-19 patients. 31 March 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154604