Table 5.

Specific implementation plans and materials for COVID-19 pandemic response

Implementation Strategy	Implementation Plan
Educational outreach program	• Development of educational video to demonstrate procedure for placing a patient into the prone position
	• Creation of a single-page infographic outlining patient eligibility, contraindications, and procedures for prone positioning
	• Availability of all educational materials on health-system website for COVID-19 learning resources
Learning collaborative	• Monthly meetings of interprofessional ICU leaders through the health-system Critical Care Committee to share experiences with prone-positioning use, among other clinical issues specific to critical illness with COVID-19
	• Availability of clinical nurse specialists experienced in prone positioning for consultation across all health-system ICUs
Written clinical protocol	• Dissemination across all hospitals of written clinical protocol for prone positioning developed before the pandemic by one hospital’s medical ICU
Prone-positioning team	• Development of a template for a prone-positioning team, including staffing and roles, equipment needed, and consultation parameters
	• Implementation of teams in four of six hospitals
EHR-based alerting system	• Enhancement of previously developed EHR-based screening system to identify patients with ARDS who are potentially eligible for prone positioning
	• Developed alerting system to prompt bedside clinicians, nursing leaders, and staff of ICU telemedicine program when a patient meets eligibility criteria
	• Increased interaction between ICU telemedicine staff and bedside staff to support decision-making regarding prone positioning and support and supervise procedures for turning patients safely

Definition of abbreviations: ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus disease 2019; EHR = electronic health record; ICU = intensive care unit.