As early experiences from the frontlines of the Covid-19 pandemic are shared within the medical community, internists are faced with the prospect of practicing outside of their usual practice environment with a knowledge base that is associated with reporting an emerging pathogen in its earliest stages. In this episode of Core IM, the team will discuss practical experiential knowledge garnered from frontline care of patients suffering from Covid-19 infection in Practical Tips on COVID Floors.
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Welcome to Core IM, a virtual medical community! Core IM strives to empower its colleagues of all levels and backgrounds with clinically applicable information as well as inspire curiosity and critical thinking. Core IM promotes its mission through podcasts and other multimodal dialogues. ACP has teamed up with Core IM to offer continuing medical education, available exclusively to ACP members by completing the CME/MOC quiz.
Tips and questions to think through given every hospital will be different
Tip #1: Have a consistent daily entrance and exit strategy that works for you and the resources at your hospital
Tip #2: Prepping a morning routine to set yourself up for the day
- What is your strategy for modifying team structure and delegation for patient care in this unusual time?
- What does pre-rounding and rounding look like on a Covid-19 team?
Tip # 3: Strategize conserving PPE and other protective equipment utilization
- Where do you store your PPE when not participating in patient care?
- How do you prevent unnecessary PPE usage?
Tip #4: Brush up on next steps with respiratory decompensation
- How does management of respiratory decompensation change where RT resources are limited?
- What is a general approach for escalating respiratory support for a Covid-19 patient?
Tip #5: Develop a list of key things to check-in about for your known patients with COVID
- What is the general illness script for a hospitalized patient with Covid-19?
Tip #6: Try to set yourself up for success early with goals of care discussion and expectations
- How do you proactively manage expectations and address goals of care?
- What is your system for making sure that family is updated and connected to their loved one?
Tip #7: Maximize documentation efficiency and clarity for COVID patients
- What is your strategy to ensure succinct and timely documentation?
- What specific information is important to consider including in signout?
Tip #8: Optimize EMR orders to minimize risk of exposure for self and colleagues
- What strategies have you employed to minimize unnecessary exposure for our colleagues in nursing, respiratory therapy and pharmacy?
Tip #9: Prepare patients for successful discharge, prioritizing population-level safety with self-isolation, SAR safety thresholds and return precautions
- What criteria must be met for a patient to go home at your hospital or subacute rehabilitation stay?
- How do you counsel your patients on self-quarantine and return precautions after hospital stay?
Tip #10: Prioritize self-care and acknowledge moral distress and grief in COVID patient care
- How do you practice self-care in the era of Covid-19?
- What do you do to maintain personal connection with patients where physical contact is so limited?
Shreya Trivedi, MD - Host, CME Questions
Sheetal Desai, MD - Expert Guest
Eric LaMotte, MD - Expert Guest
Timothy Rowe, MD - Host, Show notes
Emily Fisher, MD,
Rebecca MacAlllister, MD
Those named above unless otherwise indicated have no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.
Release Date: April 13, 2020
Expiration Date: April 13, 2023
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Physicians and the Core IM. The American College of Physicians is accredited by the ACCME to provide continuing medical education for physicians.
The American College of Physicians designates each enduring material (podcast) for 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABIM Maintenance of Certification (MOC) Points
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.5 medical knowledge MOC Point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
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After listening to the podcast, complete a brief multiple-choice question quiz. To claim CME credit and MOC points you must achieve a minimum passing score of 66%. You may take the quiz multiple times to achieve a passing score.