P5 A multi-professional education and improvement process to guide clinical practice in the developing management of COVID-19: the trainee experience

Introduction and Objectives On March 1st 2020 the World Health Organisation dashboard had recorded 1 897 cases of COVID-19, rising to 75 008 by April 1st 2020 In this time, there were rapidly emerging changes in clinical knowledge and management, challenging the work of hospital teams caring for these patients This project specifically aimed to rapidly bring together cross-speciality medical trainees in teams to develop a distanced weekly education update to help manage this 'infodemic', including real-time audit and quality improvement projects, local case reports, and a virtual journal club Method Initial opportunities were created for trainees to join projects including: Rapid follow up of local admissions examining demographics and clinical outcomes;anti-microbial audit;bi-weekly oxygen usage audit, and thrombosis prophylaxis These were carried out in a quality improvement style with education and re-evaluation Cases and journal articles were selected for educational interest A weekly update was sent online to those working within the COVID-19 inpatient departments There was input from over 35 individuals Results The overall data collection ran for 7 weeks, from March 13th to May 1st, rapidly assessing 874 patient presentations and tracking the progress of 329 COVID-19 positive patients 42 patients were admitted to level 2 care, with positive outcomes similar to national data associating with shorter lengths of stay, female gender, younger age, and lower peak CRP An antimicrobial audit on 2 occasions found 100% adherence to local guidance Prevalence of antimicrobial use did not differ from a concurrent audit in non covid wards (31%) Oxygen usage work showed the majority of our patients had stepwise improvement in adherence to saturation targets by week 5, in keeping with NHS England guideline of 92-96% The thrombosis prophylaxis project found an improvement in adherence from 88% to 100% as evidence emerged of a possible increased risk of pulmonary vascular complications A total of 5 cases of complex COVID-19 were presented during this period Outcomes This cross-department education process allowed for multiple trainee-led projects and presentations to guide local education, and ensured that our clinical practices were reviewed and in line with evolving national guidance during a pandemic