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Background: Little is known about how to best evaluate, diagnose, and treat long COVID, which presents challenges for patients as they seek care., Objective: Understand experiences of patients as they navigate care for long COVID., Design: Qualitative study involving interviews with patients about topics related to seeking and receiving care for long COVID., Participants: Eligible patients were at least 18 years of age, spoke English, self-identified as functioning well prior to COVID infection, and reported long COVID symptoms continued to impact their lives at 3 months or more after a COVID infection., Approach: Patients were recruited from a post-COVID recovery clinic at an academic medical center from August to September 2022. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis., Key Results: Participants (n=21) reported experiences related to elements of care coordination: access to care, evaluation, treatment, and ongoing care concerns. Some patients noted access to care was facilitated by having providers that listened to and validated their symptoms; other patients reported feeling their access to care was hindered by providers who did not believe or understand their symptoms. Patients reported confusion around how to communicate their symptoms when being evaluated for long COVID, and they expressed frustration with receiving test results that were normal or diagnoses that were not directly attributed to long COVID. Patients acknowledged that clinicians are still learning how to treat long COVID, and they voiced appreciation for providers who are willing to try new treatment approaches. Patients expressed ongoing care concerns, including feeling there is nothing more that can be done, and questioned long-term impacts on their aging and life expectancy., Conclusions: Our findings shed light on challenges faced by patients with long COVID as they seek care. Healthcare systems and providers should consider these challenges when developing strategies to improve care coordination for patients with long COVID., (© 2024. The Author(s).)

Long COVID is a growing health concern with data continuing to emerge about the psychosocial consequences of this new chronic condition. We aimed to improve understanding of the experiences of patients with Long COVID, focusing on emotional impacts arising from experiences of loss and grief caused by persistent physical symptoms and changes in lifestyle and social support. Patients (n = 21) were recruited August to September 2022 from a post-COVID recovery clinic to participate in semistructured interviews. We found that Long COVID patients (1) reported experiencing loss across multiple domains including loss of physical health, mental health, social support and connections, roles in their families, and self-identities, and (2) described experiences of grief that mirrored the 5 stages of grief in the Kubler-Ross model: denial, anger, bargaining, depression, and for some, acceptance. Our findings highlight the importance of evaluating the experiences of loss and grief among Long COVID patients as well as support systems for this patient population. Providers may be encouraged to incorporate mental health and bereavement support resources to address critical needs of Long COVID patients. [ABSTRACT FROM AUTHOR]

Background: Little is known about how to best evaluate, diagnose, and treat long COVID, which presents challenges for patients as they seek care. Objective: Understand experiences of patients as they navigate care for long COVID. Design: Qualitative study involving interviews with patients about topics related to seeking and receiving care for long COVID. Participants: Eligible patients were at least 18 years of age, spoke English, self-identified as functioning well prior to COVID infection, and reported long COVID symptoms continued to impact their lives at 3 months or more after a COVID infection. Approach: Patients were recruited from a post-COVID recovery clinic at an academic medical center from August to September 2022. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Key Results: Participants (n=21) reported experiences related to elements of care coordination: access to care, evaluation, treatment, and ongoing care concerns. Some patients noted access to care was facilitated by having providers that listened to and validated their symptoms; other patients reported feeling their access to care was hindered by providers who did not believe or understand their symptoms. Patients reported confusion around how to communicate their symptoms when being evaluated for long COVID, and they expressed frustration with receiving test results that were normal or diagnoses that were not directly attributed to long COVID. Patients acknowledged that clinicians are still learning how to treat long COVID, and they voiced appreciation for providers who are willing to try new treatment approaches. Patients expressed ongoing care concerns, including feeling there is nothing more that can be done, and questioned long-term impacts on their aging and life expectancy. Conclusions: Our findings shed light on challenges faced by patients with long COVID as they seek care. Healthcare systems and providers should consider these challenges when developing strategies to improve care coordination for patients with long COVID. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections (HAIs) remain a significant patient safety problem that can lead to illness and death, despite the implementation of clinical bundles to prevent HAIs. Management practices can support HAI prevention, but their role in HAI performance monitoring and feedback is not well understood. To address this knowledge gap, we previously conducted semi-structured interviews with staff at 18 hospitals to examine the role of management practices around the prevention of central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Interview transcripts were analyzed to identify themes related to HAI performance monitoring and feedback. The current analysis focuses on 10 higher-performing hospitals that were successful in preventing CLABSIs and CAUTIs. These institutions had robust practices including timely event analysis, leadership engagement, and multidisciplinary participation in HAI reviews. Across these sites, we found common goals including investigating HAIs without blame and identifying opportunities for improvement. Management practices such as timely analysis of HAIs, collaboration between facility leadership and multidisciplinary team members, and a focus on identifying the failure of a procedure or protocol, rather than the failure of staff members, are all approaches that can support infection prevention efforts. These management practices may be especially important as hospitals attempt to address increases in CLABSI and CAUTI rates that may have occurred during the coronavirus pandemic. [ABSTRACT FROM AUTHOR]