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IPRO Responds to public health emergencies

Team of mixed-races team of professional males and females doctors in hospital. Indoor. International group of medics in medical masks. Multi ethnic physicians in gowns and uniforms in clinic.

When COVID-19 struck, IPRO took on a critical role in educating providers to help protect their patients and healthcare workers.

IPRO’s multi-pronged and ongoing approach includes:

  • Assisting nursing homes
  • Working with community coalitions
  • Contributing to research published in national peer-reviewed journals
  • Addressing vaccination rates
  • Hospital quality improvement
  • Protecting the end-stage renal disease population
  • Deploying emergency responders

For additional information, contact Edison Machado, Jr., MD, MBA, Sr. Vice President, Chief Strategy Officer at emachado@ipro.org.

IPRO’s Quality Innovation Network-Quality Improvement Organization (QIN-QIO) infection control team is the hub of the organization’s COVID-19 response for nursing homes and community coalitions. Specific activities include:

  • Providing tiered infection control and technical assistance, including site visits to assist with infection control quality improvement plans, at hot spot nursing homes with spikes in COVID-19 infections

  • Providing education resources and technical assistance tools on topics including:
    • Personal protective equipment donning and doffing
    • Hand hygiene
    • Using disinfectants
    • Proper handling of shared equipment
    • Environmental cleaning
    • Community dining
  • Creating a scenario-based learning module to guide nursing homes in creating a dedicated COVID-19 unit
  • Establishing an Immunization Workgroup to spearhead IPRO’s vaccination initiatives, including:
    • Development of vaccination metrics
    • Identification of best practices
    • Development of interventions to increase vaccination rates
  • Identification of best practices from IPRO’s 12-state QIN-QIO region to contribute to Centers for Medicare & Medicaid Services’ (CMS’) National Best Practices and State Actions Toolkit

National Nursing Home COVID-19 Action Network

As part of the Agency for Healthcare Research and Quality (AHRQ) Extension for Community Healthcare Outcomes (ECHO) National Nursing Home COVID-19 Action Network, IPRO provides technical assistance, training and mentorship to support nursing home staff in implementing evidence-based infection prevention and safety practices. Activities include:

  • Developing a rapid response framework to disseminate urgent assistance, resources and information to nursing homes experiencing outbreaks or other emergencies
  • Providing access to experts and clinical specialists
  • Creating a virtual community of practice that fosters peer support
  • Sharing best practices, lessons learned, challenges and innovative solutions

IPRO collaborated in a study undertaken by researchers at the University at SUNY Albany School of Public Health, the New York State Department of Health (NYSDOH), and SUNY Downstate Health Sciences University, that examined mortality among hospitalized COVID-19 patients treated at 25 New York metropolitan area hospitals. IPRO designed and developed the study data collection process, which included creating a data collection tool and conducting data abstraction of hundreds of medical records over a three-week period. The study, co-authored by IPRO staff, was published in the Journal of the American Medical Association (JAMA), and showed that hospitalized COVID-19 patients receiving hydroxychloroquine and/or azithromycin fared no better than patients receiving neither drug.

IPRO continues its work with the NYS DOH on additional COVID-19-related projects including:

  • Conducting a study to examine the disparities in COVID-19- related deaths in safety net hospitals
  • Reviewing pediatric medical records to assess the connection between COVID-19 and the emerging multisystem inflammatory syndrome in children (MIS-C)
  • Conducting a study to determine correlations between HIV and COVID-19 cases, which will build upon the observational study published in JAMA
Using real-time vaccination data available through the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) system and the CDC Tracker, the IPRO QIN-QIO provides targeted technical assistance to nursing homes and community coalitions to improve COVID-19 vaccination rates by:
  • Disseminating accurate and up-to-date information on accessing COVID-19 vaccines to nursing homes, hospitals, home health agencies, community-based organizations, and outpatient providers
  • Offering educational webinars to community providers and patients/residents
  • Educating residents and staff on the benefits of COVID-19 vaccination using multi-modal strategies, including huddles which promote peer-to-peer interaction and access to subject matter experts
  • Assisting nursing home leadership teams in developing plans to address COVID-19 vaccination hesitancy and to increase rates among residents and staff

IPRO, as a Hospital Quality Improvement Contractor (HQIC), works with approximately 270 hospitals across a 12-state region to enhance emergency preparedness plans and systems, improve infection prevention, and control and increase COVID-19 vaccine confidence and uptake by:

  • Providing interactive educational webinars
  • Offering customized one-to-one technical assistance
  • Facilitating affinity groups
  • Communicating relevant and timely COVID-19 information to hospital leadership and infection preventionists/infection prevention teams
  • Collecting and trending COVID-19-related metrics

IPRO’s ESRD Network Program provides educational and technical assistance to support dialysis facilities and patients.

Supporting Individuals with ESRD Includes:

  • Facilitating patient support groups and an educational series for patients focusing on pandemic anxiety and fears, including vaccine hesitancy
  • Ensuring access to transplant medications as needed
  • Reporting mental health-related grievances and access to care issues to CMS

Supporting Dialysis Facilities and Staff Includes:

  • Collaborating with federal, state, and local emergency coalitions
  • Delivering targeted technical assistance to facilities with increasing rates of COVID-19
  • Providing COVID-19 screening and management education
  • Assisting facilities in reporting vaccine administration
  • Distributing and encouraging the use of hand hygiene, hand sanitizer, and physical environment audits
  • Training staff on how to report COVID-19 measures in the NHSN system
  • Coordinating COVID-19 prevention and management activities between dialysis facilities and federal and state emergency agencies
  • Fostering communication between ESRD providers and nursing homes
  • Serving as the liaison between dialysis facilities and state and federal regulatory agencies to advocate for the prioritization of vaccinating individuals who have ESRD
  • Disseminating up-to-date guidelines on telehealth and telemedicine for dialysis provider and patient use

IPRO tactically placed emergency responder staff into New York State’s response framework. IPRO staff served in various roles at New York City’s Jacob Javits Center alternate care site to:

  • Assist with the collection of clinical samples
  • Staff COVID-19 hotlines
  • Monitor the daily status of long-term care facilities
  • Provide patients with COVID-19 test results

The COVID-19 Dashboard  was used to manage response operations.

Expertise

Across nearly 100 state and federal programs in 32 states, IPRO makes creative use of clinical expertise, emerging technology, and data solutions to make the healthcare system work better.

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