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HealthJune 30, 2022

Fast access to clinical information helps Beirut teaching hospital deliver patient care in a crisis

Frontline caregivers across the world were challenged by the unprecedented demands of Covid-19. For clinicians at the American University of Beirut Medical Center (AUBMC), multiple catastrophic events forced them to find new, efficient ways to practice evidence-based medicine and deliver the best patient care, often under crisis circumstances.

Dr. Firas Kreidieh, a Clinical Fellow in Hematology and Oncology at AUBMC, and Dr. Ali Taher, AUBMC’s Vice Dean and a Professor of Medicine at the Division of Hematology and Oncology, both acknowledge that they couldn’t have anticipated how their team would be tested in the year 2020. The clinicians faced healthcare challenges stemming from a devastating explosion and a severe economic downturn, while still managing the unrelenting tide of the pandemic.

With compounding crises, the medical team needed the latest evidence and best practices, but they also needed access to information and recommendations as quickly as possible.

UpToDate® clinical decision support solution played a large role in helping teams practice evidence-based medicine efficiently and deliver quality patient care under both normal and crisis situations, Dr. Kreidieh says. Dr. Taher agrees, noting, “UpToDate has revolutionized our workflow on the wards and enhanced our ability to further promote quality patient care, particularly during the Covid pandemic and the blast crisis.”

Quality patient care during the Covid-19 pandemic

“When it came to the Covid-19 pandemic, the major issue was needing to be updated about the latest evidence or the latest news,” explains Dr. Kreidieh. “For example, a resident or intern who was on night duty and had lots of critical patients on the Covid unit to take care of, they could access UpToDate to get a fast, current, concise answer to a question rather than having to search for the data and to go to the articles not really knowing which article to look for. I strongly believe that UpToDate has enhanced our efficiency on the wards. Efficiency is an asset to promoting quality patient care, particularly in situations where time saves lives.”

The constantly evolving nature of evidence surrounding Covid-19 made it particularly important to stay apprised of changing information and best practices for both experienced clinicians and for medical residents and interns at the teaching hospital. “There’s so much to know in medicine, and you may not realize [what you don’t know] until somebody tells you or until you learn about it,” Dr. Kreidieh says.

Speed to answers in a crisis

While in the midst of the pandemic, the AUBMC team suddenly experienced a massive influx of trauma patients when the Beirut port exploded on August 4, 2020, injuring more than 6,000 people.

“I was in the infusion unit and felt the ground move, so I thought it was an earthquake,” Dr. Kreidieh recalls. “Then there was a second very loud sound, and I heard a patient who was receiving infusion say, ‘This is a bomb!’ There was so much smoke that I thought something happened within the AUBMC campus.”

“Residents used UpToDate on the day of the August 4 blast to get quick answers for acute management, such as tetanus administration,” says Dr. Taher. Many patients had to be entered into the hospital EMR system with numbers because they had no identification and needed antibiotics and other emergency treatment immediately.

While Dr. Kreidieh and his team functioned more in a support capacity than direct care in the immediate aftermath of the explosion, he was impressed and inspired to see his hospital pull together. “It was really an inspirational scene seeing all the medical teams, including surgery, oncology, internal medicine — all departments were really one hand. And I will never forget that night. They all helped each other, each through his or her own skills, each through what he or she can actually help with.”

Efficient patient care can affect economic outcomes

Dr. Kreidieh says the economic downturn in Lebanon has impacted the way he and his team at AUBMC approach patient care. “There are many drugs that are excellent, and supported by clinical trials and data, that help improve survival and progression through survival,” he says. “However, these drugs are very expensive and not all of them are covered by the Ministry of Public Health in Lebanon. Hence, many patients have to justify to their insurance companies the reason behind the use of a particular drug or pay for them out of their own pocket, which is very difficult for patients with limited finances and financial hardships. Despite all the situations we’ve gone through here in Lebanon, thus far we’ve not faced a major issue in terms of accessibility to drugs.”

Whenever the medical center can demonstrate value and cost-effective care, it is especially appreciated in times when healthcare costs and efficiencies need to be managed.

“Thanks to UpToDate, our efficiency on the wards has increased markedly,” Dr. Kreidieh says. “When you actually have no time to search for answers to a certain question is when UpToDate really proves its value.”

To learn more about how AUBMC improved patient care in the middle of multiple crises, read the full customer story.

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