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  1. Article ; Online: Respiratory support for patients with COVID-19: A national survey of respiratory departments in England.

    Bartlett-Pestell, Sam / Navaratnam, Annakan V / Adelaja, Ini / Allen, Martin

    The clinical respiratory journal

    2022  Volume 16, Issue 10, Page(s) 685–689

    Abstract: Objective: We developed a national survey to assess the changes implemented by respiratory departments across England in response to the first wave of the COVID-19 pandemic.: Methods: An online survey was sent to the respiratory clinical leads in 132 ...

    Abstract Objective: We developed a national survey to assess the changes implemented by respiratory departments across England in response to the first wave of the COVID-19 pandemic.
    Methods: An online survey was sent to the respiratory clinical leads in 132 NHS trusts in England. The survey was open between 10 August 2020 and 25 September 2020.
    Results: Fifty-three responses (42%) are included in our results. The total number of non-critical care led Level 2 beds (requiring care for single organ failure-capable of managing continuous positive airways pressure, CPAP) increased by 159% at peak COVID activity from levels prior to COVID-19. CPAP was used solely in side-rooms in 9% of sites, and 57% and 31% of sites used CPAP in closed bays and closed wards, respectively. Fifteen sites (28%) reported shortages of non-vented non-invasive ventilation (NIV) masks and 12 sites (23%) CPAP machines. There was regional variation.
    Conclusions: The number of beds capable of managing patients requiring CPAP increased significantly. We found deviations from previous standards of care, which likely reflects the pressure faced by hospitals in managing patients with COVID-19. The regional variation in equipment shortages suggests moving resources between regions may have been beneficial.
    MeSH term(s) COVID-19/epidemiology ; Continuous Positive Airway Pressure ; Humans ; Noninvasive Ventilation ; Pandemics ; Respiration, Artificial
    Language English
    Publishing date 2022-09-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2442214-9
    ISSN 1752-699X ; 1752-6981
    ISSN (online) 1752-699X
    ISSN 1752-6981
    DOI 10.1111/crj.13535
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  2. Article ; Online: Utilising the dental workforce in England, United Kingdom, to optimise the response to COVID-19.

    Wilson, Gavin J / Wordley, Valerie / Grocock, Ryan / Shah, Sagar / Devalia, Urshla / Iricijan, Julija / Sayma, Meelad / Adelaja, Ini / MacLachlan, Greta / Ormond, Martyn / Hurley, Sara

    Health policy (Amsterdam, Netherlands)

    2023  Volume 131, Page(s) 104760

    Abstract: COVID-19 presents a unique and significant challenge to healthcare systems across the globe. Dental workforce redeployment, in England, during the response to Coronavirus (COVID-19), is the first reported national effort to redeploy a professional body ... ...

    Abstract COVID-19 presents a unique and significant challenge to healthcare systems across the globe. Dental workforce redeployment, in England, during the response to Coronavirus (COVID-19), is the first reported national effort to redeploy a professional body into new clinical environments. The policy decision to facilitate redeployment of the dental workforce, in March 2020, by the Office of the Chief Dental Officer (OCDO), increased flexibility within workforce systems and allowed increasing demand on healthcare services to be managed safely and effectively. This paper outlines how this policy change was achieved via a multi-professional approach, mapping competencies of the dental workforce to high-priority areas of healthcare need. The dental workforce has a varied and often specialised skill set, offering expertise in infection prevention and control, airway management and often, behaviour management. These skills can be an important contribution to tackling a pandemic where expertise in these areas is vital. This increase in workforce supply allows healthcare systems to improve their surge response capabilities. Additionally, redeployment presents an opportunity to create greater and sustained collaboration between the medical and dental professions, leading to greater understanding of the contribution of oral health to wider medical wellbeing.
    MeSH term(s) Humans ; COVID-19 ; United Kingdom ; England ; Delivery of Health Care ; Workforce
    Language English
    Publishing date 2023-03-16
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 605805-x
    ISSN 1872-6054 ; 0168-8510
    ISSN (online) 1872-6054
    ISSN 0168-8510
    DOI 10.1016/j.healthpol.2023.104760
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 2250: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article: A comprehensive hospital agile preparedness (CHAPs) tool for pandemic preparedness, based on the COVID-19 experience.

    Adelaja, Ini / Sayma, Meelad / Walton, Henry / McLachlan, Greta / de Boisanger, James / Bartlett-Pestell, Sam / Roche, Emma / Gandhi, Vanita / Wilson, Gavin J / Brookes, Zara / Yeen Fung, Chee / Macfarlane, Heather / Navaratnam, Annakan / James, Christopher / Scolding, Peter / Sara, Hurley

    Future healthcare journal

    2020  Volume 7, Issue 2, Page(s) 165–168

    Abstract: COVID-19 presents an unprecedented challenge to hospitals and the systems in which they operate. The primary exponential surge of COVID-19 cases is arguably the most devastating event a hospital will face. In some countries, these surges during the ... ...

    Abstract COVID-19 presents an unprecedented challenge to hospitals and the systems in which they operate. The primary exponential surge of COVID-19 cases is arguably the most devastating event a hospital will face. In some countries, these surges during the initial outbreak of the disease have resulted in hospitals suffering from significant resource strain, leading to excess patient mortality and negatively impacting staff wellbeing. As experience builds in managing these surges, it has become evident that agile, tailored planning tools are required. The comprehensive hospital agile preparedness (CHAPs) tool provides clinical planners with six key domains to consider that frequently create resource strain during COVID-19; it also allows local planners to identify issues unique to their hospital, system or region. Although this tool has been developed from COVID-19 experiences, it has potential to be modified for a variety of pandemic scenarios according to transmission modes, rates and critical care resource requirements.
    Keywords covid19
    Language English
    Publishing date 2020-06-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 3016427-8
    ISSN 2514-6653 ; 2514-6645
    ISSN (online) 2514-6653
    ISSN 2514-6645
    DOI 10.7861/fhj.2020-0030
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  4. Article ; Online: Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England

    William K. Gray / Annakan V Navaratnam / Jamie Day / Pratusha Babu / Shona Mackinnon / Ini Adelaja / Sam Bartlett-Pestell / Chris Moulton / Cliff Mann / Anna Batchelor / Michael Swart / Chris Snowden / Philip Dyer / Michael Jones / Martin Allen / Adrian Hopper / Gerry Rayman / Partha Kar / Andrew Wheeler /
    Sue Eve-Jones / Kevin J Fong / John T Machin / Julia Wendon / Tim W.R. Briggs

    EClinicalMedicine, Vol 35, Iss , Pp 100859- (2021)

    A national observational study for the Getting It Right First Time Programme

    2021  

    Abstract: Background: A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of ... ...

    Abstract Background: A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March–July 2020. Methods: This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates. Findings: There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates. Interpretation: There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges.
    Keywords COVID-19 ; Coronavirus ; Mortality ; Unwarranted variation ; Variability ; Medicine (General) ; R5-920
    Subject code 360 ; 310
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme.

    Gray, William K / Navaratnam, Annakan V / Day, Jamie / Babu, Pratusha / Mackinnon, Shona / Adelaja, Ini / Bartlett-Pestell, Sam / Moulton, Chris / Mann, Cliff / Batchelor, Anna / Swart, Michael / Snowden, Chris / Dyer, Philip / Jones, Michael / Allen, Martin / Hopper, Adrian / Rayman, Gerry / Kar, Partha / Wheeler, Andrew /
    Eve-Jones, Sue / Fong, Kevin J / Machin, John T / Wendon, Julia / Briggs, Tim W R

    EClinicalMedicine

    2021  Volume 35, Page(s) 100859

    Abstract: Background: A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of ... ...

    Abstract Background: A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March-July 2020.
    Methods: This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates.
    Findings: There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates.
    Interpretation: There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges.
    Language English
    Publishing date 2021-04-26
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2021.100859
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