COVID-19 Project ECHO for Nursing Homes: A Patient-Centered, Randomized-Controlled Trial to Implement Infection Control and Quality-of-Life Best Practices

Background and+AP8679:AP8720 Significance: Nursing homes are ground zero for the COVID-19 pandemic. Pennsylvania nursing homes are particularly devastated, with more than 13,000 cases of COVID-19 and more than 2,800 deaths. Nursing homes are ill-equipped for the pandemic; though facilities are required to have infection control staff, only 3 percent have taken a basic infection control course. Significant research has focused on infection control in the acute care setting. However, little is known about the implementation of practices and effective interventions in long-term care facilities. We propose an intervention utilizing Project ECHO, an evidence-based telehealth model, to connect Penn State University experts with remote nursing home staff and administrators to proactively support evidence-based infection control guideline implementation. Project ECHO uses case-based, collaborative learning to support discussion of learners' challenges and barriers to guideline implementation. The model's explosive growth to 240 institutions nationally positions ECHO for outstanding responsiveness in a pandemic. Our study seeks to answer the critical research question of how evidence-based infection control guidelines can be implemented effectively in nursing homes. Study Aims: Our research and stakeholder team is expertly positioned to produce actionable findings to address our long-term objective of effectively addressing COVID-19 and other infectious outbreaks in nursing homes. Primary Aim: To compare the effectiveness of COVID-19 Project ECHO intervention (COVID-19 ECHO) with enhanced usual care in reducing the number of nursing home residents with COVID-19. Enhanced usual care will include a monthly newsletter communication about COVID-19 infection control guidelines. Secondary Aims: 1. To compare the effectiveness of COVID-19 ECHO versus enhanced usual care on other patient-centered outcomes, including quality of life (QOL), hospitalizations, and deaths. 2. To evaluate the impact of the COVID-19 ECHO on key implementation outcomes in nursing home settings using the RE-AIM framework.