'Just in time' rapid learning during COVID-19.

Abstract

The worldwide pandemic created an urgent need for rapid learning to influence clinical practice and develop our understanding of COVID-19. Large scale trials were ongoing, but there was a need for rapid dissemination and sharing of evolving experience in order to save lives. With specialist expertise in cardiorespiratory and critical care (including ECMO), the organisations now comprising the KHP Cardiovascular and Respiratory Partnership* were in a unique position to share these strengths by disseminating learning. To facilitate this, clinical teams needed a forum to connect, discuss ideas and experiences and convert these to practical application. Virtual platforms quickly enabled ‘just in time’ learning to be possible and allowed for the dissemination of learning across geographical and institutional boundaries. Two formats were used to deliver virtual education to share knowledge and expertise at pace, to as large an audience as possible. The first was a series of weekly virtual discussions (chaired by subject matter experts) covering one topic each week. This provided clinical insights from several London hospitals into the management of patients acutely unwell with COVID-19. Topics were chosen based on evolving clinical need and included oxygen therapy, steroids, remdesivir and anticoagulation. The second format were half or full day webinars with audience and expert panel Q&A, covering several topics under an umbrella theme. Themes included COVID-19 from Bench to Bedside; Primary Care Course in Respiratory Medicine; Cardiology goes viral; Critical Care Data conference; and Paediatric Respiratory: Innovations from the Pandemic. The common aim for these courses was to explore service delivery and transformation during and postpandemic. Rapid education for immediate application in clinical care through virtual platforms helps maximise economies of scale by extending education reach and access at local, national and international levels. Short-targeted weekly facilitated virtual discussions provided a meaningful platform for iterative changes to patient care through consensus based on experience across a range of hospitals. The weekly webinars allowed discussion from a wider range of stakeholders and helped inform decisions on what should be recommended patient care moving forward. Speakers expressed that they liked not having to create presentations, and participants noted that they enjoyed the opportunity to speak about lived experiences on the wards. ‘Just in time’ virtual sessions provided the opportunity for bench to bedside learning to be applied rapidly. By facilitating discussions with multiple hospitals simultaneously, patient care was enhanced through collective learning. While this was crucial during the pandemic, this format could also be utilised in nonpandemic settings to bridge the second translational gap.