Use of the Donabedian Model as a Framework for COVID-19 Response at a Hospital in Suburban Westchester County, New York: A Facility-Level Case Report

J Emerg Nurs. 2021 Mar;47(2):239-255. doi: 10.1016/j.jen.2020.10.008. Epub 2020 Dec 11.

Abstract

The purpose of this facility-level case report was to describe our facility's leadership process of applying the Donabedian model to structure an early response to the coronavirus disease pandemic relative to emergency care. Using the Donabedian model as a guide, both structure and process changes were implemented to maintain high-quality clinical outcomes as well as ED staff safety and engagement. Rapid changes to the model of care, both architecturally and through the expansion of universal precautions through personal protective equipment, created the foundation for what was to follow. Clinical, service quality, and staff safety outcomes were evaluated to demonstrate that the collaborative changes that follow a known process improvement model can be used to address the coronavirus disease pandemic. Further study is needed to compare the outcomes of this facility-level case study with those of others to evaluate the success of the measures outlined.

Keywords: COVID-19; Donabedian Model; Emergency Department; Hospitals; Pandemics.

MeSH terms

  • COVID-19 / nursing
  • COVID-19 / prevention & control
  • COVID-19 / therapy*
  • Emergency Nursing / methods*
  • Emergency Service, Hospital*
  • Hospitals
  • Humans
  • Leadership
  • New York
  • Outcome and Process Assessment, Health Care / methods*
  • Pandemics
  • Personal Protective Equipment
  • SARS-CoV-2
  • Suburban Population