| Title: |
Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance during the COVID-19 Pandemic∗ |
| Authors: |
Anesi, G.L.; Andrews, A.; Bai, (Julia), H.; Bhatraju, P.K.; Brett-Major, D.M.; Broadhurst, M.J.; Campbell, E.S.; Cobb, J.P.; Gonzalez, M.; Homami, S.; Hypes, C.D.; Irwin, A.; Kratochvil, C.J.; Krolikowski, K.; Kumar, V.K.; Landsittel, D.P.; Lee, R.A.; Liebler, J.M.; Lutrick, K.; Marts, L.T.; Mosier, J.M.; Mukherjee, V.; Postelnicu, R.; Rodina, V.; Segal, L.N.; Sevransky, J.E.; Spainhour, C.; Srivastava, A.; Uyeki, T.M.; Wurfel, M.M.; Wyles, D.; Evans, L. |
| Contributors: |
Department of Emergency Medicine, College of Medicine, University of Arizona |
| Source: |
Critical Care Medicine |
| Publisher Information: |
Lippincott Williams and Wilkins |
| Publication Year: |
2023 |
| Collection: |
The University of Arizona: UA Campus Repository |
| Subject Terms: |
capacity strain; COVID-19; hospital stress; severe acute respiratory infection; severe acute respiratory syndrome coronavirus 2 |
| Description: |
OBJECTIVES: The COVID-19 pandemic threatened standard hospital operations. We sought to understand how this stress was perceived and manifested within individual hospitals and in relation to local viral activity. DESIGN: Prospective weekly hospital stress survey, November 2020-June 2022. SETTING: Society of Critical Care Medicine's Discovery Severe Acute Respiratory Infection-Preparedness multicenter cohort study. SUBJECTS: Thirteen hospitals across seven U.S. health systems. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed 839 hospital-weeks of data over 85 pandemic weeks and five viral surges. Perceived overall hospital, ICU, and emergency department (ED) stress due to severe acute respiratory infection patients during the pandemic were reported by a mean of 43% (sd, 36%), 32% (30%), and 14% (22%) of hospitals per week, respectively, and perceived care deviations in a mean of 36% (33%). Overall hospital stress was highly correlated with ICU stress (ρ = 0.82; p < 0.0001) but only moderately correlated with ED stress (ρ = 0.52; p < 0.0001). A county increase in 10 severe acute respiratory syndrome coronavirus 2 cases per 100,000 residents was associated with an increase in the odds of overall hospital, ICU, and ED stress by 9% (95% CI, 5-12%), 7% (3-10%), and 4% (2-6%), respectively. During the Delta variant surge, overall hospital stress persisted for a median of 11.5 weeks (interquartile range, 9-14 wk) after local case peak. ICU stress had a similar pattern of resolution (median 11 wk [6-14 wk] after local case peak; p = 0.59) while the resolution of ED stress (median 6 wk [5-6 wk] after local case peak; p = 0.003) was earlier. There was a similar but attenuated pattern during the Omicron BA.1 subvariant surge. CONCLUSIONS: During the COVID-19 pandemic, perceived care deviations were common and potentially avoidable patient harm was rare. Perceived hospital stress persisted for weeks after surges peaked. © 2023 Lippincott Williams and Wilkins. All rights reserved. ; Open access article ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://hdl.handle.net/10150/674627; Critical Care Medicine |
| DOI: |
10.1097/CCM.0000000000005802 |
| Availability: |
http://hdl.handle.net/10150/674627; https://doi.org/10.1097/CCM.0000000000005802 |
| Rights: |
© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND). ; https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.A687C1CA |
| Database: |
BASE |