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The impact of nursing home inspections to ensure the quality and safety of the service environment is lacking. Weaknesses in the process became more explicit as poor long-term care infection control was determined to be a contributor to the early spread of COVID amongst nursing home residents. This announcement outlines a targeted inspection initiative to assess whether organizations previously sited have made progress toward improving workforce safety.

Safe patient care is reliant on a healthy healthcare workforce. This alert emphasizes organizational conditions and supporting the wellbeing of clinicians under the stress of providing care during the COVID-19 pandemic. 

The COVID-19 pandemic is a rapidly evolving situation that requires a system orientation to diagnosis, management and post-acute care to keep clinicians, patients, families and communities safe. This set of recommendations is anchored on a human factors approach to provide overarching direction to design systems and approaches to respond to the virus. The recommendations focus on team communication and organizational culture; the diagnostic process; patient and family engagement to reduce spread; hospital, pediatric, and maternity processes and treatments; triage decision ethics; discharge communications; home isolation; psychological safety of staff and patients, and; outcome measures. An appendix covers drug interactions and adverse effects for medications used to treat this patient population. The freely-available full text document will be updated appropriately as Italy continues to respond, learn and amend its approach during the outbreak.

Innovations must be incorporated into care processes with safety in mind. This announcement shares insights to mitigate strategies that may cause patient harm through alternative use of ventilators to support multiple patients with compromised respiratory function.

As COVID-19 spreads globally, there is growing interest in methods for rapid diagnosis and the risk of diagnostic error. Delayed diagnosis of COVID-19 may lead to worse patient outcomes and increased exposure of healthy individuals to the novel coronavirus. Two early studies suggested that chest CT may have a sensitivity as high as 97%. However, higher quality studies have shown that the sensitivity of chest CT is only 67-93% among patients with viral pneumonia and imaging features must be interpreted with caution when the prevalence of SARS-CoV-2 infection is low. Based on the risks of misdiagnosis and viral transmission, the American College of Radiology recommends that CT should not be used to screen for or as a first-line test to diagnose COVID-19. CT should be reserved for hospitalized, symptomatic patients with specific clinical indications.