Emory-produced COVID-19 Community & Healthcare Facility Checklists for low resource settings now available

August 2020

detail from the COVID-19 Community & Healthcare Facility Checklists manual.

A partnership of Emory School of Medicine residents and medical students in association with the leadership of the multidisciplinary Emory Global Perioperative Health Group (EGPHG) has produced an impressively thorough and extensive COVID-19 Community & Healthcare Facility Checklists manual.

The electronic document is intended to serve as a needs assessment and organizational tool for low resource communities and healthcare facilities, and is formatted as a series of pertinent questions paired with concise answers and relevant linked resources. The project team hopes the manual will assist individuals and organizations from a variety of backgrounds in preparing for, preventing, and managing COVID-19.

The document is supported by the Global Alliance for Surgical, Obstetric, Trauma and Anesthesia Care (G4 Alliance), a multinational partnership dedicated to providing access to safe surgical care for patients in need. Additionally, many of the resources, guidelines, and infographics featured in the manual were sourced from such well-respected healthcare and public health organizations as the Centers for Disease Control and the World Health Organization.

The checklist is available for free download, and includes an introductory video that will help orient readers and increase usability. While the manual's core audience was originally defined as low and middle income environments and healthcare facilities, its detailed and comprehensive framework is suitable for use by any entity. Once needs are clarified through the checklist, users can focus on the corresponding answers and resources provided in the manual to strengthen their individual healthcare or community-based protocols.

"When we started this project in March 2020, a roadmap outlining how best to respond to the COVID-19 pandemic did not exist," says current PGY-3 surgery resident Erica Ludi, MD, who initiated the project when she was still an Emory global surgery fellow. "As we were putting the manual together, we discovered that other COVID-19 response documents were simply providing questions or an overview of topics to approach without supplying answers and/or resources to implement changes. Our document does both."

Dr. Ludi was joined in the creation and compilation of the manual by medical students Abigail Hatcher, MS, Ben Magod, Alexandra Medline, MPH, and Danielle Mustin, ME. As the compendium took shape, it was reviewed and vetted by the leadership of the EGPHG: Steven Roser, DMD, MD, Theresa Gillespie, PhD, MA, FAAN, Jahnavi Srinivasan, MD, Barbara Pettitt, MD, Joe Sharma, MD, and Johanna Hinman, MPH, MCHES. Dr. Roser founded the EGPHG, which aims to coordinate Emory's efforts to address gaps in perioperative care and emergency services in low resource environments, with an emphasis on training, education, and research.

The COVID Checklists team plans to share the manual with a wide variety of institutions and organizations through email, online services, and social media platforms. Target users include local and national contacts in school districts and healthcare facilities, as well as the global partners of the EGPHG, including G4 Alliance members, international nursing organizations, and other affiliated partners in Latin America and Africa. "Our greatest efforts will focus on providing this resource to countries with active or projected worsening of COVID-19 outbreaks," says Dr. Ludi.

The development of the checklists was supported by an Emory SOM Dean's Imagine, Innovate, and Impact (I3) Nexus grant awarded in 2019 to Dr. Roser as PI and the remaining EGPHG leadership. In July 2020, an additional I3 grant was received, and will be applied to studying the influence of the manual on COVID-19 preparedness for communities and healthcare facilities, cataloging any direct actions implemented following the use of the checklist, and translating the document into other languages such as Spanish, French, Arabic, Hindi, and Mandarin to increase accessibility.

This process will include collecting feedback from the anticipated users of the document, who will ideally represent different backgrounds, cultures, and areas of divergent disease impact, so that the utility and generalizability of the document can be improved in future iterations. All revisions of the manual will be redistributed accordingly.

The original resident/medical student team will also participate in the Nexus-funded phase of refining the manual, joined by additional general surgery residents Alexandra Reitz, MD, MPH, former global surgery fellow now on oncology research sabbatical, and Constance Shreckengost, MD, PhD, current global surgery fellow.

"Intermediate and long-term impacts of this checklists include improved understanding of available, necessary, and effective resources in communities and growth in the quality of how we serve others," says Dr. Shreckengost, who will coordinate the translation of the manual. "There is and will continue to be a need for data that contributes to our understanding of the similarities and differences in COVID-19's evolving impact on various regions across the globe."