PRP059: COVID-19 & primary healthcare: a living scan of evolving challenges and innovations
Mélanie Smithman, MSc; Simon Décary, PhD, PT; Ysendre Cozic-Fournier, MSc; Marie-Eve Poitras, PhD, MSc, RN; Nancy Côté; Yves Couturier, PhD; Amira Benzina
Context: The COVID-19 pandemic poses substantial challenges to primary healthcare. Emerging challenges have led to many local primary healthcare innovations. These warrant dissemination to help inform quality improvement efforts in primary healthcare both amidst and in the wake of the pandemic. Objective: To monitor and share evolving challenges and innovations in primary healthcare, in the context of COVID-19. Design: Réseau-1 – a primary healthcare innovation network – and partners undertook a living scan. Data collection: online survey with open-ended questions, sent via mailing lists and Twitter. Survey will evolve and relaunch monthly to capture emerging data. Analysis: Ongoing thematic analysis (conducted by researchers, providers, patient) to rapidly disseminate summaries to providers, policymakers, and researchers. Setting: Primary healthcare, Quebec, Canada. Population: providers, patients, policymakers, community workers, and researchers. Outcomes: Evolving innovations and challenges. Preliminary Results: In the first weeks, we received 70 responses from diverse settings and stakeholders. Innovations (>40) included: remote service delivery (e.g., telemedicine, teledentistry, telepharmacy, online support groups, online prenatal education); evidence dissemination (e.g., infection control training videos, clinical wikis, research groups as rapid decision-making consultants); workforce reallocation (e.g., regional google sheet to identify available health workers and reallocation needs; dedicated regional clinic for all flu-like symptoms; COVID-19 designated psychiatrist supporting providers); tool development (e.g., primary care triage algorithm updated daily, discussion guides for levels of care). Unmet challenges included: mental health surveillance (e.g. self-assessment tool); developing remote care alternatives (e.g. chronic illness, dental care); governance & regulations for telehealth innovations; coordinated, pragmatic and easy to find official information & guidelines (e.g., provincial, public health, regional). Vulnerable populations being neglected included those living alone, experiencing homelessness, living with chronic disease or mental illness, single & future parents, those with low social support or low income. Conclusion: Primary healthcare is rapidly evolving. Capturing innovations and challenges through a living scan may help inform quality improvement efforts in primary healthcare to adapt to the context of COVID-19.