The Case for Quality – COVID-19 and Order Set Development

As we pass the one-year mark of the start of the COVID-19 pandemic, we have the opportunity to reflect and learn from the lessons of the last year.  While much was, and still is, unknown about COVID-19, information collected from locations that cared for high volumes of patients during the pandemic suggests that certain strategies appear to be more effective when providing critical care for patients with COVID-19.  At Island Health, we felt it was important to implement the most evidence-based COVID-19 treatment strategies and as a result, identified an organization-wide clinical order set to promote standardized care for patients with COVID-19 across all our facilities. Additional new Clinical Decision Support tools have also been developed to support clinicians.

Increased VTE prevalence has been reported in patients with COVID-19, but the recommended best approach for VTE prophylaxis is still being determined. Island Health pharmacists and physicians leveraged early guidelines on VTE prophylaxis from the BC CDC and created the Island Health SBAR for VTE Prophylaxis in Patients with COVID-19, a unique aspect of the Island Health inpatient COVID-19 clinical order sets . This provides a summary of the literature on COVID-19 VTE prophylaxis along with practical recommendations such as drug, dose and frequency.  The SBAR is being regularly reviewed and revised to reflect new evidence and recommendations.

Clinical groups and the informatics industry have acknowledged Island Health for this work provincially and nationally.  Island Health was recognized by Zynx, one of the industry market leaders in clinical decision support tools working with EHR vendors, who celebrated the rapid development of COVID-19 order sets: Medical Staff create COVID-19 order set – 10 days, start to finish!

By utilizing the web-based remote consensus building component within the Knowledge Analyzer solution, Island Health was able to swiftly build and deploy vital COVID-19 order sets to its physician teams among their 37 inpatient facilities. The solution was developed in conjunction with Zynx Health’s partner hospitals and features a flexible platform known as Consensus Builder.