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Evidence about health-system arrangements

 

Evidence syntheses on this webpage are organized by:

  1. approach to COVID-19 vaccine roll-out
  2. approach to population-health management for COVID-19 and for those whose care is disrupted by COVID-19
  3. delivery arrangements (service planning for COVID-19 prevention, service planning for COVID-19 treatment, service planning for the ongoing management of other conditions, infrastructure planning and resource allocation, workforce planning and development, and service planning for ‘return to normal’)
  4. financial arrangements
  5. governance arrangements.

To complement the evidence about vaccine roll-out below, COVID-END prepares twice-a-month updates to a living evidence profile covering all vaccine roll-out elements, including supply, allocation, communication, administration, and surveillance.

We continue to add evidence syntheses to this webpage as we harvest and process weekly updates from ‘high-yield, high quality’ sources of evidence syntheses and as we add new sources. More details are available about the context for the inventory, our approach to developing and maintain it, and tips for using it. Similar webpages are available for evidence about public-health measures, the clinical management of COVID-19 and related conditions, and economic and social responses.

Broad and specific decisions Criteria for 'best evidence synthesis' Details to support relevance assessment Additional decision-relevant details Citation
Date of last search Quality (AMSTAR) rating Evidence-certainty (e.g., GRADE) assessment available Key findings
Living evidence synthesis Type of synthesis              Type of question
  Approach to COVID-19 vaccine roll-out
                 
    Securing and distributing a reliable supply of vaccines and ancillary supplies
               
    Allocating vaccines and ancillary supplies equitably
               
    Communicating vaccine-allocation plans and the safety and effectiveness of vaccines
               
    Administering vaccines in ways that optimize timely uptake
2020-11-01  8/11  No  Evidence suggests that refusal to get vaccinated against COVID-19 has increased over time, while being female, younger, of lower income or education level and belonging to an ethnic minority group are associated with less intention to be vaccinated [Review of studies of unknown quality]  No  Rapid review  Views and experiences  Robinson E, Jones A, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples. medRxiv. 2020. 
      N/A (Protocol)
n/a  No  [Protocol - results not yet available] A review exploring practices to design, implement and scale immunization information systems in low-and middle-income countries in response to a pandemic situation is currently being conducted No  Protocol  Other  Siribaddana P, Hewapathirana R, Sahay S. Best evidence practices in deploying electronic immunization information systems in low and middle income countries in response to COVID-19: a systematic review. PROSPERO. 2021;CRD42021229030. 
    Surveillance, monitoring and evaluation, and reporting
               
  Approach to population-health management for COVID-19 and for those whose care is disrupted by COVID-19

               
    Segmenting the population into groups with shared health and social needs                
    Re-designing care pathways and in-reach and out-reach services              
    Addressing barriers to implementation of pathways and services N/A (Protocol)
n/a No [Protocol - results not yet available] A review on the factors affecting compliance with infant feeding practices to prevent respiratory infections is currently being conducted Yes (row content last updated on 2020-12-07) Protocol  Views and Experiences  Bick D, Fisher J, Chang Y, Sutcliffe P, Hillman S, Chien L. Barriers and Facilitators to Optimizing Parents’, Carers’ and Healthcare Workers’ Infant Feeding Hygiene Practices to Prevent Transmission of Respiratory Infectious Diseases, Including COVID-19: a Living Systematic Review. PROSPERO 2020; CRD42020184750.
    Addressing cultural safety in the implementation of pathways and services 2020-05-20
7/10  No  Although very little evidence is available to understand the impact of COVID-19 on Indigenous communities, the importance of having culturally appropriate responses to address the impact of the pandemic on this population is increasingly clear Yes (row content last updated on 2021-04-12) Rapid review  Other  National Collaborating Centre for Methods and Tools. Rapid review: What is known about the impact of the COVID-19 pandemic on Indigenous communities in Canada? Hamilton: National Collaborating Centre for Methods and Tools.; 2020.
    Maintaining gains made in population-health management (e.g., population segmentation, virtual care) and spreading and scaling them                
Delivery arrangements                
  Service planning for COVID-19 prevention                
    Changing emergency-medical service procedures (ambulances, paramedics) 2020-04-06
9/10 Yes A systematic review of indirect evidence finds uncertainty as to whether chest compression in patients with COVID-19 is aerosol generating or leads to infection transmission in cardiac arrest No Full review Other Couper K, Taylor-Phillips S, Grove A, Freeman K, Osokogu O, Court R, et al. COVID-19 in Cardiac Arrest and Infection Risk to Rescuers: A Systematic Review. Resuscitation 2020;151: 59-66.
    Re-locating hospital-based ambulatory clinics, cancer treatments, etc.                
    Limiting access to health facilities                
    Changing hospital-discharge procedures                
    Changing long-term care procedures 2020-06-26
7/10  Yes  Outbreak investigations show that long-term care facilities are more vulnerable to the COVID-19 pandemic, in terms of disease spread and mortality rate
Yes (row content last updated on 2021-04-12) Full review  Other  Salcher-Konrad M, Jhass A, Naci H, Tan M, El-Tawil Y, Comas-Herrera A. COVID-19 Related Mortality and Spread of Disease in Long-Term Care: First Findings from a Living Systematic Review of Emerging Evidence. MedRxiv 2020. 
      2021-02-01 7/10  No  Community incidence is probably the strongest factor associated with outbreaks in long-term care facilities, and PPE use and cleaning and hygiene measures may be associated with reduced outbreak risk Yes (row content last updated on 2021-04-12) Rapid review  Other  National Collaborating Centre for Methods and Tools. Rapid review update 2: What risk factors are associated with COVID-19 outbreaks and mortality in long-term care facilities and what strategies mitigate risk? National Collaborating Centre for Methods and Tools. 2021;
      2020-07-27
9/11  No  While mass testing of residents and staff as well as guidance on infection prevention and control measures were frequently implemented in long term care facilities their effects are uncertain [Review mainly based on observational studies of low quality] No  Rapid review  Other  Frazer K, Mitchell L, Stokes D, Lacey E, Crowley E, Kelleher C. A rapid systematic review of measures to protect older people in long term care facilities from COVID-19. medRxiv. 2020. 
      2021-01-26
8/10  No  Although evidence shows that for-profit ownership in care homes for older people has not been consistently associated with COVID-19 outbreaks, some studies show that they accounted for a larger proportion of cumulative infections and deaths, which could be explained by less access to personal protection equipment in these facilities [Review of observational studies mainly of low quality]  Yes (row content last updated on 2021-04-12) Full review  Other  Bach-Mortensen AM, Verboom B, Esposti MD. Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities. medRxiv. 2021.  
    Changing home and community care procedures                
  Service planning for COVID-19 treatment                
    Scaling up/down testing capacity 2020-12-22
9/11  Yes  The effects of mass testing with contact tracing compared to test and trace for effective suppression of COVID-19 are uncertain  No  Rapid review  Benefits and harms  Mbwogge M. Mass testing with contact tracing compared to test and trace for effective suppression of covid-19 in the uk: A rapid review. medRxiv. 2021.  
    Scaling up/down emergency-room capacity                
    Scaling up/down ICU capacity 2020-05-01
8/11  No  Studies show mortality rates among ICU patients is correlated with invasive ventilation, renal failure and acute respiratory distress syndrome, although absolute values have been shown to vary between regions.  No Full review  Other  Chang R, Elhusseiny KM, Yeh Y, Sun W. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes - A systematic review and meta-analysis. medRxiv 2020.
      2020-05-01
9/11  No  A meta-analysis estimated that 62% of COVID-19 patients are required to remain in hospital after initial admission [Review of studies of variable quality and substantial heterogeneity]  No  Full review  Other  Jafari A, Falahatkar S, Yekta K, Mohammad H. COVID-19 clinical characteristics, complications and comorbidity: An updated systemic review and meta-analysis. The Lancet. 2020.  
    Scaling up/down post-ICU recovery capacity (e.g., hospital beds)                
    Scaling up/down palliative-care capacity N/A (Protocol)
n/a No  [Protocol - results not yet available] A review exploring best practices for supporting persons at end of life during COVID-19 is currently being conducted No  Protocol  Other  Dowsett L, Clement F, Farkas B, Li J. Best practices for supporting persons at end of life during COVID-19: Rapid review. PROSPERO. 2020; CRD42020210943.  
      N/A (Protocol)
n/a  No  [Protocol - results not yet available] A review synthesizing mobile applications for helping patients in end-of-life care is currently being conducted No  Protocol  Other  Longo M, Anomneze-Collins A, Mann M, Nelson A. In light of the COVID-19 pandemic, a realist synthesis of mobile application-enabled communication and care management for patients in end-of-life care. PROSPERO. 2021; CRD42021231535. 
    Scaling up/down COVID-19 sequelae-management capacity                
    Scaling up/down capacity to manage the pandemic-related impacts on health more generally (e.g., mental health and addictions)              
    Surge-management models 2020-07-09
4/10  No  Hospital surge capacity planning models differ in their planning horizon, age-stratification parameters, and patient care pathways No  Full review  Other  Klein MG, Cheng CJ, Lii E, Mao K, Mesbahi H, Zhu T, et al. COVID-19 models for hospital surge capacity planning: A systematic review. Disaster Medicine and Public Health Preparedness. 2020:1-17. 
    Triage protocols  2020-03-26
7/9  Yes  Key factors affecting adherence to infection prevention and control guidelines among healthcare workers include their design and content, how they are communicated, and whether there is adequate organizational support, training, and access to personal prot   No Rapid review  Other  Houghton C, Meskell P, Delaney H, et al. Barriers and Facilitators to Healthcare Workers' Adherence with Infection Prevention and Control (IPC) Guidelines for Respiratory Infectious Diseases: a Rapid Qualitative Evidence Synthesis. Cochrane Database Syst Rev 2020;4(4):CD013582. 
      2020-04-21
7/11  No  Initial results from attempts to develop a risk stratification and triage tool for patients with comorbid COVID-19 and cardiovascular disease indicate clinical history, physical examination, pulse oxymetry and other laboratory markers can help recognize high-risk patients in a timely manner, although validation of the tool in future studies is still needed No  Full review  Other  Momtazmanesh S, Shobeiri P, Hanaei S, Mahmoud-Elsayed H, Dalvi B, Malakan Rad E. Cardiovascular disease in COVID-19: a systematic review and meta-analysis of 10,898 patients and proposal of a triage risk stratification tool. Egypt Heart J. 2020;72(1):41. Published 2020 Jul 13. doi:10.1186/s43044-020-00075-z
    Infection prevention and control measures in health facilities  2020-04-02
5/9  No  The risk of contracting SARS-CoV-2 through surgical smoke cannot be excluded, so healthcare personnel need to adopt all required protective strategies, including preoperative testing
No Full review  Other  Pavan N, Crestani A, Abrate A, et al. Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era. Eur Urol Focus. 2020;S2405-4569(20)30156-5. 
      2020-06-08  8/10 No  No evidence was found on the effectiveness of cohorting COVID-19 positive residents to shared rooms in healthcare facilities No  Rapid review  Benefits and harms  Technical Advisory Committee, Health Agency of Canada. Rapid review: What is the effectiveness of cohorting virus-positive residents to shared rooms in care facilities? Hamilton, ON: National Collaborating Centre for Methods and Tools; 2020. 
      2020-04-06 8/11  No  Using preprocedural mouth rinse using tempered clorhexidine appears to be the preferred method to reduce the aerosol-related bacterial load in dental practice  No  Full review  Other  Koletsi D, Belibasakis GN, Eliades T. Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials [published online ahead of print, 2020 Jul 13]. J Dent Res. 2020;22034520943574. doi:10.1177/0022034520943574 
      2020-07-21
4/11  No  SARS-CoV-2 RNA is frequently found in the air near and around spaces used by COVID-19 patients in hospital settings such as bathrooms, but limited evidence has been found to determine the infectivity of this airborne viral material No  Full review  Other  Birgand G, Peiffer-Smadja N, Fournier S, Kerneis S, Lescure FX, Lucet JC. Airborne contamination of COVID-19 in hospitals: A scoping review of the current evidence. medRxiv. 2020 
      2020-05-27
6/10  No  The evidence available is insufficient to evaluate the effectiveness of aerosol boxes and barrier enclosures for airway management in COVID-19 patients No  Full review  Other  Sorbello M, Rosenblatt W, Hofmeyr R, Greif R, Urdaneta F. Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: A scoping review and narrative synthesis. British Journal of Anaesthesia. 2020. 
      2020-06-22
7/9  No  The limited number of low-quality studies available makes is difficult to determine which effective infection prevention and control practices can be used in inpatient psychiatric facilities  No  Rapid review  Other  National Collaborating Centre for Methods and Tools. What is known about best practices for infection prevention and control in inpatient psychiatric facilities? Hamilton, ON: National Collaborating Centre for Methods and Tools; 2020. 
    Death certification                
    Handling dead bodies                
  Service planning for the ongoing management of other conditions                
    Changing acute care surgery and trauma-care procedures  Not specified 4/9 No  Conservative treatment, use of disposable instruments and low CO2 insufflation pressuers are all recommended practices for reducing risk of COVID-19 infection among health workers when conducting urgent pediatric surgery for patients with COVID-19 No Full review Other Prato AP, Conforti A, Almstrom M, Van Gemert W, Scuderi MG, Khen-Dunlop N, et al. Management of COVID-19-positive pediatric patients undergoing minimially invasive surgical procedures: Systematic review and recommendations of the Board of the European Society of Pediatric Endoscopic Surgeons. Frontiers in Pediatrics. 2020;8:259.
    Changing cancer-treatment procedures 2020-06-20
5/10  No  A number of strategies to prevent the spread of COVID-19 among children with cancer have been implemented, but their effects are uncertain [Review mainly based on observational studies of low quality]  No  Rapid review  Other  Amicucci M, Mastronuzzi A, Ciaralli I, Piccioni F, Schiopu AC, Tiozzo E, Gawronski O, Biagioli V, Dall'Oglio I. The management of children with cancer during the COVID-19 pandemic: A rapid review. J Clin Med. 2020 Nov 21;9(11):3756. 
      N/A (protocol)
N/A
No [Protocol - results not yet available] A review evaluating patients, caregivers and healthcare professionals' experiences on cancer screening and care during the COVID-19 pandemic is currently being conducted
No Protocol  Views and experiences  Dhada S, Hadi MA, Cheema E, Stewart D, Paudyal V. Cancer screening and care during the COVID-19 pandemic: A systematic review of patients, caregivers and healthcare professionals' experiences. PROSPERO. 2020; CRD42020214906.  
      N/A (protocol)
N/A
No [Protocol - results not yet available] A review evaluating the impact of the COVID-19 pandemic on cancer control and care is currently being conducted
No  Protocol  Other  Ali R, Farah E, El-Zein M, Franco E. A systematic review highlighting the impact of the COVID-19 pandemic on cancer control and care. PROSPERO. 2020; CRD42020190522.  
    Changing reproductive care
N/A (Protocol)
n/a No  [Protocol - results not yet available] A review evaluating the impact of COVID-19 lockdowns on the incidence of premature birth and stillbirth is currently being conducted  No  Protocol  Other  Almonte M, Bennett P, Perry A, Piel F. Indirect impact of COVID-19 lockdowns on incidence of premature birth and stillbirth: a systematic review and meta-analysis. PROSPERO. 2020;CRD42020213509. 
      N/A (Protocol)
n/a No  [Protocol - results not yet available] A review evaluating the effect of the COVID-19 pandemic on maternal, fetal and neonatal outcomes is currently being conducted No  Protocol  Other  Yang J & Shah P. COVID-19 pandemic and population level pregnancy and neonatal outcomes: A systematic review. PROSPERO. 2021; CRD42021234036 
    Delaying return visits, elective procedures, etc. 2020-07-01  6/9  No  Surgical practice was affected by hospital lockdown, but no evidence was found on the impact of these surgical practice changes on patient outcomes [Review of studies conducted during COVID-19, Ebola, MERS and SARS outbreaks] Yes (row content last updated on 2021-04-12) Rapid review Other Lee Y, Kirubarajan A, Patro N, Sam Soon M, Doumouras AG, Hong D. Impact of hospital lockdown secondary to COVID-19 and past pandemics on surgical practice: A living rapid systematic review. American Journal of Surgery. 2020;S0002-9610(20)30742-X.
      2020-07-20
6/11  No  There have been steep declines in certain orthopedic services including elective surgeries and outpatient services due to the impact of COVID-19 pandemic, although this decline hasn't been seen for trauma surgeries [Review of studies of variable quality]  No  Full review  Other  Ow ZGW, Cheong CK, Chin YH, Chin BZ. A look at the global impact of SARS CoV-2 on orthopedic services. Journal of Clinical Orthopaedics and Trauma. 2020. 
  Infrastructure planning and resource allocation                
    Personal protective equipment under shortage conditions (including N95 respirators for health workers)  2020-06-04
7/11 No  Stockpiling, extending use, and UV decontamination are promising strategies to address mask shortage during pandemics, although their effects remain uncertain [Review of studies conducting during COVID-19, Ebola, H1N1 and SARS outbreaks]
No  Full review  Other Kirubarajan A, Khan S, Got T, Yau M, Bryan JM, Friedman SM. Mask shortage during epidemics and pandemics: A scoping review of interventions to overcome limited supply. BMJ Open. 2020;10(11):e040547. 
    For reusing or decontaminating PPE, see public-health measures                 
    Ventilators for sick COVID-19 patients 2020-05-01  6/9 No  A number of decision-support tools exist to inform the allocation of ICU beds and ventilators during public-health emergencies including COVID-19 No  Full review  Other  Cardona M, Dobler C, Koreshe E, Heyland DK, Nguyen R, Sim JPY, et al. Scoping review supporting decision-making on allocation of ICU beds and ventilators in pandemics. medRxiv. 2020. 
      N/A (protocol)
n/a  Yes  [Protocol - results not yet available] A review exploring the ethical implications of using severity scores for allocating ICU health resources is currently being conducted No  Protocol  Other  Santos R, Rego S, Brito L. Micro allocation of health resources and ethical implications: A systematic review. PROSPERO. 2020; CRD42020214029.  
    Medications and other technologies (under shortage conditions due to disrupted supply chains)                
    Remote monitoring 2020-05-31 4/9  No  Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telemonitoring during the post-acute phase of their illness
Yes (row content last updated on 2021-04-12) Full review  Other  de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. 
      2020-06-01
6/10  No  A number of COVID-19 mobile apps have shown benefits related to patient and provider information provision, and may help facilitate patient monitoring and follow-up [Review mainly based on observational studies of low quality] No  Full review  Other  Kondylakis H, Katehakis DG, Kouroubali A, Logothetidis F, Triantafyllidis A, Kalamaras I, et al. COVID-19 mobile apps: A systematic review of the literature. Journal of Medical Internet Research. 2020.  
    Virtual visits 2020-04-30
4/9  No  Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telerehabilitation during the post-acute phase of their illness
Yes (row content last updated on 2021-04-12) Full review  Other  de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. 
      2020-04-08
5/9  No  Studies from the pre-COVID era show that telehealth has been succesfully used to provide ongoing care for a number of urologic conditions, including prostate cancer and urinary infection No  Full review  Other  Novara G, Checcucci E, Crestani A, Abrate A, Esperto F, Pavan N, et al. Telehealth in urology: A systematic review of the literature. How much can telemedicine be useful during and after the COVID-19 pandemic? European Urology. 2020;S0302-2838(20)30454-1. 
      2020-04-05
4/9  No  The use of telemedicine might be feasible for use in neurosurgical patients, although some results from resource-constrained settings show promise [Review of studies conducted during the pre-COVID era and beyond] No  Full review  Other  Eichberg DG, Basil GW, Di L, Shah AH, Luther EM, Lu VM. Telemedicine in neurosurgery: Lessons learned from a systematic review of the literature for the COVID-19 era and beyond. Neurosurgery. 2020;nyaa306. 
      2020-05-01
6/9 No  Telemedicine for orthopaedics consultations can be safe, cost-effective, and be used to accurately diagnose patients, while having good acceptability among both patients and providers [Review based on studies of variable quality] No  Full review  Benefits and harms  Haider Z, Aweid B, Subramanian P, Iranpour F. Telemedicine in orthopaedics and its potential applications during COVID-19 and beyond: A systematic review. Journal of telemedicine and telecare. 2020;1357633X20938241. 
      2020-04-20
7/9  No  Virtual care interventions appear most effective as a supplement to or facilitator of in-person trauma-focused care for psychological therapies to reduce the psychological symptoms associated with domestic violence or sexual assault [Review based on studies of unknown quality] No  Rapid review  Benefits and harms  Montesanti S, Silverstone P, Wells L, Ghidei W. Examining the use of virtual care interventions to provide trauma-focused treatment to domestic violence and sexual assault populations. Edmonton, AB: Canadian Institutes of Health Research; 2020. 
  Workforce planning (including workforce shortages management) and development                
    Recruitment                
    Role extensions N/A (protocol)
n/a  No  [Protocol - results not yet available] A review evaluating the role of assistant in medicine for a workforce planning response to the COVID-19 pandemic is currently being conducted No  Protocol  Other  Davids J, Monrouxe L, Hockey P, OMara D, Khanna P, Klinner C, et al. Assistant in medicine as a workforce planning response to the COVID-19 pandemic in New South Wales: Protocol for a realist approach to evaluation. PROSPERO. 2020; CRD42020210585.  
    Training in new procedures 2020-03-19
8/10 No Disaster-training programs for medical students seems to improve their knowledge, skills and pandemic preparedness. No evidence on clinical performance was identified [Review of observational studies] No Full review Other Ashcroft J, Byrne MHV, Brennan PA, et al Preparing medical students for a pandemic: a systematic review of student disaster training programmes. Postgraduate Medical Journal Published Online First: 09 June 2020.
      2020-05-18
5/9  No  Online learning in medical education can be facilitated by using video conferencing synchronolousy, and giving instructors enough tools to adapt existing teaching strategies that enable the creation of a supportive learning environment No  Rapid review  Other  Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, et al. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63. Medical Teacher. 2020;1–14.  
      2020-05-02
5/9  No  A systematic review exploring management strategies and training for the medical-resident workforce during the COVID-19 pandemic found that residents need to be trained in infection prevention methods, and that training methods need to be adapted to alternative virtual teaching methods to maintain all pillars of residency education No  Full review  Other  Tolu LB, Feyissa GT, Ezeh A, Gudu W. Managing resident workforce and residency training during COVID-19 pandemic: Scoping review of adaptive approaches. Advances in Medical  Education and Practice. 2020;11:527-535. 
      2021-03-24 6/10  No  Training in infection prevention and control has consistently been associated with a decreased risk of coronavirus infection among healthcare workers [Review of studies conducted during COVID-19, MERS and SARS outbreaks] Yes (row content last updated on 2021-04-12) Rapid review  Other  Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Update alert 8: Epidemiology of and risk factors for coronavirus infection in health care workers. Ann Intern Med 2021; L21-0034.
      2020-12-01
7/10  No  Evidence shows that introduction to and sustained training in the basics of ICU monitoring, response to acute respiratory distress syndrome, prone and positioning, and donning and doffing PPE were important to healthcare professionals being redeployed to intensive care during the COVID-19 pandemic  [Review of studies of observational studies of unknown quality]  No  Full review  Other  San Juan NV, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Redeployment and training of healthcare professionals to intensive care during COVID-19: A systematic review. medRxiv. 2021.  
    Replacements when sick                
    Movement-control strategies 2020-12-01  7/10  No  Evidence shows that developing staff work groups based on skills rather than specialty,  maximizing the use of transferable skills, having a supportive environment, and developing flexible arrangements are key strategies to successful redeployment of staff to intensive care during the COVID-19 pandemic  [Review of studies of observational studies of unknown quality] No  Full review  Other  San Juan NV, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Redeployment and training of healthcare professionals to intensive care during COVID-19: A systematic review. medRxiv. 2021.  
    Supports to unpaid caregivers N/A (Protocol)  n/a  No  [Protocol - results not yet available] A review addressing technology-based health solutions for cancer caregivers is currently being conducted No Protocol  Other  Su Z, McDonnell D, Liang B, Kue J, Li X, Segalo S, et al. Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: A systematic review protocol. Research Square. 2020. 
    Volunteer engagement                
    Self-management supports                
  Service planning for ‘return to normal’                
    Sequencing of services re-starting, by sector, conditions, treatments (including diagnostics), and populations 2020-06-08  4/9  No  A review evaluating the evidence regarding the resumption of elective surgery only found modelling studies estimating the time needed to clear the backlog of deferred and cancelled procedures, and no assessments of the options available to efficiently resume these services were identified No  Rapid review  Other  Health, N., 2020. Resuming Elective Surgery. [ebook] NSW Government. Available at: <https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0003/594516/20200713-Evidence-Check-Resume_Elec-Surg.pdf> [Accessed 23 July 2020]. 
    Wait-lists management                
Financial arrangements                
  Financing health services                
  Funding organizations                
  Remunerating providers                
    New or adjusted fee codes for virtual care                
    Income replacement when virtual care is not possible (at the same scale)                
  Purchasing products and services                
    Bulk purchasing                
Governance arrangements (who can make what decisions)                
  Consumer and stakeholder involvement                
  Professional authority                
    Licensure changes to accommodate out-of-jurisdiction or retired health workers 2020-05-02
5/9  No  A systematic review exploring management strategies and training for the medical-resident workforce during the COVID-19 pandemic found that residency directors need to ease the impact of COVID-19 on the accreditation process by working with accreditation bodies and local clinical competency committees No  Full review  Other  Tolu LB, Feyissa GT, Ezeh A, Gudu W. Managing resident workforce and residency training during COVID-19 pandemic: Scoping review of adaptive approaches. Advances in Medical  Education and Practice. 2020;11:527-535. 
  Commercial authority                
    Technology approvals, public-private partnerships                
  Organizational authority                
    Limits of number of staff sent in                
    Ownership
2021-01-26  8/10  No  Although evidence shows that for-profit ownership in care homes for older people has not been consistently associated with COVID-19 outbreaks, some studies show that they accounted for a larger proportion of cumulative infections and deaths, which could be explained by less access to personal protection equipment in these facilities [Review of observational studies mainly of low quality] Yes (row content last updated on 2021-04-12) Full review  Other  Bach-Mortensen AM, Verboom B, Esposti MD. Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities. medRxiv. 2021. 
  Policy authority                
    Federal versus provincial                
    Adhering to the International Health Regulations                 

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