All Publications


  • Gearing Up for a Vaccine Requirement: A Mixed Methods Study of COVID-19 Vaccine Confidence Among Workers at an Academic Medical Center. Journal of healthcare management / American College of Healthcare Executives Mahoney, M., Winget, M., Brown-Johnson, C., de Borba, L., Veruttipong, D., Luu, J., Jones, D., Bohman, B., Vilendrer, S. 2022; 67 (3): 206-220

    Abstract

    Assessing barriers to vaccination among healthcare workers may be particularly important given their roles in their respective communities. We conducted a mixed methods study to explore healthcare worker perspectives on receiving COVID-19 vaccines at a large multisite academic medical center.A total of 5,917 employees completed the COVID-19 vaccine confidence survey (20% response rate). Most participants were vaccinated (93%). Compared to vaccinated participants, unvaccinated participants were younger (60% < 44 years), more likely to be from a non-Asian minority group (48%), and more likely to be nonclinical employees (57% vs. 46%). Among the unvaccinated respondents, 53% indicated they would be influenced by their healthcare provider, while 19% reported that nothing would influence them to get vaccinated. Key perceived barriers to vaccination from the qualitative analysis included the need for more long-term safety and efficacy data, a belief in the right to make an individual choice, mistrust, a desire for greater public health information, personal health concerns, circumstances such as prior COVID-19 infection, and access issues.Strategies endorsed by some participants to address their concerns about safety and access included a communication campaign, personalized medicine approaches (e.g., individual appointments to discuss how the vaccine might interact with personal health conditions), and days off to recover. Mistrust and a belief in the right to make an individual choice may be harder barriers to overcome; further dialogue is needed.These findings reflect potential strategies for vaccine requirements that healthcare organizations can implement to enhance vaccine confidence. In addition, organizations can ask respected health professionals to serve as spokespeople, which may help shift the perspectives of unvaccinated healthcare workers.

    View details for DOI 10.1097/JHM-D-21-00226

    View details for PubMedID 35576446

  • Patient Perspectives of Inpatient Telemedicine During COVID-19: A Qualitative Assessment. JMIR formative research Vilendrer, S., Sackeyfio, S., Akinbami, E., Ghosh, R., Luu, J. H., Pathak, D., Shimada, M., Williamson, E. E., Shieh, L. 2022

    Abstract

    Telemedicine has been adopted in the inpatient setting to facilitate clinical interactions between on-site clinicians and isolated hospitalized patients. Such remote interactions have the potential to reduce pathogen exposure and use of personal protective equipment but may also pose new safety concerns given prior evidence that isolated patients can receive suboptimal care. Formal evaluations into the use and practical acceptance of inpatient telemedicine amongst hospitalized patients are lacking.We aimed to evaluate the experience of patients hospitalized for COVID-19 with inpatient telemedicine introduced as an infection control measure during the pandemic.We conducted a qualitative evaluation in a COVID-19 designated non-intensive care hospital unit at a large academic health center (Stanford Health Care) October 2020 through January 2021. Semi-structured qualitative interviews focused on patient experience, impact on quality of care, communication, and mental health. Purposive sampling were used to recruit participants represent-ing diversity across varying demographics until thematic saturation was reached. Interview transcripts were qualitatively analyzed using an inductive-deductive approach.Interviews with 20 hospitalized patients suggested non-emergency clinical care and bridging to in-person care comprised the majority of inpatient telemedicine use. Nurses were reported to enter the room and call on the tablet far more frequently than physicians, who typically entered the room at least daily. Patients reported broad acceptance of the technology, citing improved convenience and reduced anxiety but preferred in-person care where possible. Quality of care was believed to be similar to in-person care with the exception of a few patients who wanted more frequent in-person examinations. Ongoing challenges included low volume, shifting tablet location, and inconsistent verbal introductions from the clinical team.Patient experiences with in-patient telemedicine were largely favorable. Although most patients ex-pressed a preference for in-person care, telemedicine was acceptable given the circumstances asso-ciated with COVID-19. Technical and care team use improvements may enhance acceptability. Fur-ther evaluation is needed to understand the impact of inpatient telemedicine and the optimal balance between in-person and virtual care in the hospital setting.

    View details for DOI 10.2196/32933

    View details for PubMedID 35147510