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COVID-19 Healthcare System Operations Resources
Topic Collection
November 14, 2023

Topic Collection: COVID-19 Healthcare System Operations Resources

This Topic Collection focuses on adaptations to usual healthcare system operations and strategies to maintain provision of patient care during the COVID-19 pandemic.  

This Resource Collection was reviewed in Fall 2023. Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID-19 outbreak management.  

If you have COVID-19 best or promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area. Resources specific to healthcare system operations can be placed under the COVID-19 Healthcare System Operations Resources Topic.

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Administrative Preparedness

American Medical Association. (2023). COVID-19 CPT Vaccine and Immunization Codes. (Added 12/10/2020.)
The AMA has compiled CPT coding and guidance related to COVID-19, including immunizations; Category I pathology/laboratory; coding advice and testing guides; and other important tools and resources.
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American Society for Health Care Engineering. (2020). COVID-19 Resources for Health Care Facilities. (Added 4/29/2020.)
This page includes articles, tools, videos, and guidance to assist healthcare facilities in modifying and maintaining critical operations including air quality, safety and security, and infection prevention during the COVID-19 pandemic.
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American Society of Health-System Pharmacists. (2020). ASHP COVID-19 Pandemic Assessment Tool for Health-System Pharmacy Departments.
This tool allows departments of pharmacy to assess their readiness for COVID-19 by reviewing integration with institutional planning, departmental leadership, public and professional education and training, medications and supplies, staffing, and internal and external public affairs and communications.
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ASPR TRACIE. (2021). COVID-19: Concerns and Opportunities for Healthcare Leadership.
Healthcare leadership is essential in ensuring continuity of operations based on effective decision making. During the COVID-19 pandemic, leaders in healthcare innovated to address COVID-related challenges, safeguarding infrastructure, staff, and patients while maintaining their institutions’ mission and values. This ASPR TRACIE resource highlights some of the considerations and promising practices that healthcare executives may consider implementing in their systems during the pandemic and beyond.
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ASPR TRACIE. (2023). Health Care Facility Onboarding Checklist.
During a pandemic or other emergency, healthcare facilities face significant challenges to quickly onboard additional healthcare providers when hospital admissions and ICU occupancy increase rapidly. This onboarding checklist can ensure new employees are compliant with administrative requirements, familiar with the mission and culture of the hospital, and understand expectations.
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ASPR TRACIE. (2023). Healthcare Provider Shortages-Resources and Strategies for Meeting Demand.
Health care workforce planners can use the updated Health Care Provider Shortages document to help prevent staff shortages and meet the demand for additional staff during and after a disaster or public health emergency. Strategies for quantifying workforce needs and supporting, maximizing, and supplementing staff include lessons learned from the COVID-19 pandemic.
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Association of State and Territorial Health Officials. (2020). Administrative Preparedness: Strategies for Managing and Streamlining COVID-19 Response and Recovery.
This issue brief identifies strategies for state and territorial health agency leadership to consider in support of their COVID-19 response and recovery efforts.
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National Association of Community Health Centers. (2020). COVID-19: CHC Finance Toolkit.
This toolkit offers resources to assist community health centers manage their finances during the COVID-19 pandemic. Topics include proactive communication, cash flow planning, understanding relief options, tax provisions, cybersecurity considerations, and remote work best practices.
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National Association of Community Health Centers. (2021). Oversight of COVID-19 Funding Streams. (Added 1/12/2022)
This fact sheet for community health centers offers quick tips on the management of various COVID-19 funding streams, a Provider Relief Timeline, and links to additional financial information resources.
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U.S. Department of Health and Human Services. (2020). CARES Act Provider Relief: For Providers. (Added 8/25/2020.)
This page includes various resources to assist healthcare providers in understanding options available through the Provider Relief Fund under the CARES Act.
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Communications Tools and Strategies

Centers for Disease Control and Prevention. (2021). Communication Resources. U.S. Department of Health and Human Services.
The CDC's communication resources related to the COVID-19 pandemic are available on this updated page in digital audio and video format, as still photos and as text in multiple languages. Social media toolkits, one stop shop toolkits for various audiences, and public service announcements are also available from this page.
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Cleveland Clinic. (2020). Cleveland Clinic COVID-19 Response Digital Health Playbook.
This playbook describes the Cleveland Clinic's rapid implementation of telemedicine in response to the COVID-19 pandemic. It includes an ambulatory playbook to convert to telehealth, clinician training on virtual visits, patient facing materials, tips for showing empathy in virtual visits, and types of telehealth visits.
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COVID-19 Health Literacy Project. (2021). COVID-19 Health Literacy Project. (Added 1/11/2021.)
In collaboration with Harvard Health Publishing, this project creates and translates fact sheets about COVID-19 into more than 35 languages. Fact sheets are composed for a general adult audience, for pregnant people, and for children of different age brackets, with age-appropriate messages and illustrations.
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Endangered Languages Project. (2020). COVID-19 Information in Indigenous, Endangered, and Under-Resourced Languages *.
This is a resource hub for COVID-19 public health-related information in over 500 different languages.
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Patient Provider Communication Forum. (2020). Supporting Communication with Patients Who Have COVID-19. (Added 7/9/2020.)
This page hosts various free resources that healthcare providers can use to support communications with COVID-19 patients, particularly those who are unable to speak due to intubation or other interventions. Resources include pictograms and tools in various languages.
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Sandman, P. and Lanard, J. (2020). COVID-19: The CIDRAP Viewpoint - Part 2: Effective COVID-19 Crisis Communication. Center for Infectious Disease Research and Policy, University of Minnesota.
This report reviews established crisis communications principles in the context of the COVID-19 pandemic.
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Schwarze, M., Zelenski, A., Baggett, N., et al. (2020). Best Case/Worst Case: ICU, with Special Content for Patients with COVID-19. University of Wisconsin-Madison.
This framework is designed to help clinicians communicate with patients and their families to achieve treatment decisions that align with patient preferences. The toolkit contains step-by-step instructions for use, templates filled with hypothetical examples, a blank template, photos demonstrating use of the intervention, and an ICU pocket card.
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VitalTalk. (2020). COVID Ready Communication Playbook.
This playbook offers communications tips to help healthcare providers respond to questions from patients and their loved ones about COVID-19.
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Continuity of Operations (COOP)

* American Hospital Association and American Medical Association. (2020). Working from Home during COVID-19 Pandemic.
This document provides information to physicians on protecting their computers, mobile devices, home network, and medical devices from cyber threats while working from home.
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* Healthcare & Public Health Sector Coordinating Councils. (2020). Management Checklist for Teleworking Surge During the COVID-19 Response.
This checklist assists healthcare enterprise managers in implementing a telework strategy that enables an uninterrupted workflow, supports patient care and facility operations, and protects against cyberthreats.
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The COVID Staffing Project. (2020). COVIDStaffingProject *.
The COVID Staffing Project unites collaborators from Vanderbilt University Medical Center, Michigan Medicine, the Department of Learning Health Sciences, and the Center for Healthcare Engineering and Patient Safety, and the Procedural Learning and Safety Collaborative. The tools developed support hospitals in projecting frontline workforce needs, redeploying clinical teams, and protecting the health and well-being of providers.
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Cybersecurity

* American Hospital Association and American Medical Association. (2020). Working from Home during COVID-19 Pandemic.
This document provides information to physicians on protecting their computers, mobile devices, home network, and medical devices from cyber threats while working from home.
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Cybersecurity & Infrastructure Security Agency. (2020). Risk Management for Novel Coronavirus (COVID-19). U.S. Department of Homeland Security.
This guide identifies actions to address infrastructure protection, supply chain, and cybersecurity issues during the COVID-19 pandemic.
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Cybersecurity and Infrastructure Security Agency. (2020). COVID-19 Recovery CISA Tabletop Exercise Package (CTEP).
This package of materials assists stakeholders in assessing their recovery and business continuity plans related to organizational recovery from the COVID-19 pandemic.
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* Healthcare & Public Health Sector Coordinating Councils. (2020). Management Checklist for Teleworking Surge During the COVID-19 Response.
This checklist assists healthcare enterprise managers in implementing a telework strategy that enables an uninterrupted workflow, supports patient care and facility operations, and protects against cyberthreats.
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Healthcare & Public Health Sector Coordinating Councils. (2023). Health Industry Cybersecurity Tactical Crisis Response Guide (HIC-TCR).
This guide offers tactics for the healthcare system to address cyberthreats, focused on education and outreach, enhanced prevention techniques, enhanced detection and response, and taking care of the team.
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Ethics

Berlinger, N., Wynia, M., Powell, T., et al. (2020). Ethical Framework for Health Care Institutions and Guidelines for Institutional Ethics Services Responding to the Coronavirus Pandemic. The Hastings Center.
This document identifies ethical challenges associated with care of COVID-19 patients, specifies three ethical duties of health care leaders, provides examples of policies and processes for review, and offers guidelines for institutional ethics services.
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Incident Management

ASPR TRACIE. (2020). Hospital Incident Command and Scalability in a Pandemic: Notes from the Field.
Hospitals across the country have been managing COVID-19 patient surge for several months. To facilitate the response, many have activated hospital incident command, adjusting as necessary to match patient census. ASPR TRACIE met with subject matter experts to learn more about their experience with hospital incident command and scalability.
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ASPR TRACIE. (2021). The Effect of COVID-19 on the Healthcare Incident Command System.
This ASPR TRACIE tip sheet highlights several key observations about how healthcare incident command systems functioned during the COVID-19 pandemic and includes lessons learned collected from interviews, surveys, and literature reviews as of August 2021. While the intended audience of this document includes HCFs, EMs, executives, and leadership, additional stakeholders including regional HCFs, emergency response teams, HCC members, vendors, and staff involved in emergency response may also find this information useful.
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Lessons Learned

ASPR TRACIE. (2023). COVID-19 After Action Report Resources and Examples.
This ASPR TRACIE document includes sample considerations that healthcare entities can utilize when documenting their ongoing After Action Report (AAR) process for COVID-19 (gleaned from various sources). It also provides sample COVID-19 AARs that are currently available to the public.
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Balser, J., Ryu, J., Hood., M., et al. (2021). Care Systems COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. National Academy of Medicine.
This discussion paper reviews lessons learned from COVID-19 and suggests priorities for transforming the healthcare system, including addressing financial sustainability, supply chain resilience, workforce challenges, and coordination across sectors and systems.
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European Centre for Disease Prevention and Control. (2020). Strategic and Performance Analysis of ECDC Response to the COVID-19 Pandemic.
This report is an assessment of ECDC's response activities from the onset of the COVID-19 pandemic to September 2020 and includes improvement recommendations in the areas of public health emergency response, assets and capabilities, collaboration and coordination with stakeholders, and the mandate and scope of ECDC.
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Federal Emergency Management Agency. (2021). Coronavirus Disease (COVID-19) Initial Assessment Report. U.S. Department of Homeland Security.
This report assesses FEMA's response activities related to COVID-19 between January and September 2020. The page includes a link to download the full report, frequently asked questions, and findings and recommendations related to coordinating structures and policy, resources, preparedness and information analysis, organizational resilience, and supporting state, local, tribal and territorial partners.
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National Academy of Medicine. (2022). Emerging Stronger from COVID-19: Priorities for Health System Transformation.
This page includes links to several reports documenting lessons learned from COVID-19 that should inform priorities for health system transformation. Included are nine discussion papers and a special publication that collects the discussion papers in a single volume. Topics include: public health; care systems; health care payers; clinicians and professional societies; quality, safety, and standards organizations; biomedical research; patients, families, and communities; health product manufacturers and innovators; and digital health.
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Nuzzo, J. and Gostin, L. (2022). The First 2 Years of COVID-19: Lessons to Improve Preparedness for the Next Pandemic. (Added 1/12/2022) JAMA.
The authors of this article identify six lessons learned from COVID-19 to apply to future pandemic readiness efforts.
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Office of Inspector General. (2020). COVID-19 Portal. U.S. Department of Health and Human Services.
This webpage includes links to COVID-19 related reports, enforcement actions, policy statements, and other material issued by the U.S. Department of Health and Human Services Office of Inspector General.
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Pandemic Response Accountability Committee. (2021). Pandemic Oversight. (Added 10/7/2021) Council of the Inspectors General on Integrity and Efficiency.
This webpage highlights the activities of the independent committee created to support and coordinate oversight of federal COVID-19 relief spending. The page includes information on the laws that funded pandemic relief, data visualizations of how funds were spent, links to oversight reports, and fraud awareness.
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Pearson, C., Britt, H., and Schapiro, L. (2021). Adapting Health Care Delivery in Response to COVID-19: International Lessons for the United States. (Added 10/8/2021) The Commonwealth Fund.
The authors review the experiences of Australia, Finland, Germany, Singapore, and South Korea in response to the COVID-19 pandemic and offer recommendations for future effective responses to emergencies in the United States. Recommendations address staffing, access to care, decision-making, data sharing, and communication.
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The Independent Panel for Pandemic Preparedness and Response. (2021). COVID-19: Make it the Last Pandemic.
This report shares the Panel's perspective on the COVID-19 pandemic, identifies lessons learned, and offers recommendations to prevent future pandemics.
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U.S. Fire Administration. (2022). Pandemic Response Listening Session. U.S. Department of Homeland Security, Federal Emergency Management Agency.
This document summarizes a two-day listening session with emergency medical services, 911 dispatch, fire department, and other first responders about challenges experienced during the COVID-19 pandemic and potential solutions related to the workforce, logistics and supply chain, business operations and continuity, and agency funding, grants, and reimbursement.
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U.S. Government Accountability Office. (2022). Coronavirus Oversight.
This webpage provides links to all of the Government Accountability Office's reports related to the federal response to the COVID-19 pandemic. Also included is a downloadable spreadsheet of recommendations.
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Operational Modifications: COVID-19

Agency for Healthcare Research and Quality. (2020). COVID-19 Resources Developed by AHRQ's Evidence-based Practice Centers | Effective Health Care (EHC) Program. U.S. Department of Health and Human Services.
This resource page features COVID-19 guidance summary reports on operational and patient care topics of interest to frontline clinicians and leadership.
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American College of Emergency Physicians. (2021). ACEP COVID-19 Field Guide. (Added 4/15/2020.)
This frequently updated online guide compiles resources helpful to emergency physicians in the evaluation and treatment of COVID-19. Topics include personal safety, work safety, emergency medical services, triage, patient presentation, assessment, diagnosis, risk stratification, treatment, special populations, business, regulations and liability, personal well-being and resilience, and impact on education, licensure, and credentialing.
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American College of Physicians. (2023). Coronavirus Disease 2019 (COVID-19): Information for Internists.
This frequently updated web page collects resources to assist physicians in their response to COVID-19. It includes background information on coronaviruses; clinical response information (transmission, presentation, diagnosis, treatment, infection control); and links to additional resources, including clinical care resources, telehealth, patient education, coding, ethics, and physician well-being.
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American Society of Health-System Pharmacists. (2021). Summary of ASHP Virtual Roundtables on Business Recovery and COVID-19: Considerations for Pharmacy Leaders and Healthcare Executives. (Added 1/11/2021.)
This toolkit compiles ideas from a May 2020 virtual roundtable among pharmacy leaders. The discussion centered on business recovery issues related to the COVID-19 pandemic.
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ASHRAE. (2022). ASHRAE Epidemic Task Force Healthcare Buildings Guidance.
This updated, illustrated guidance for healthcare settings provides background information on the COVID-19 pandemic; identifies life safety and other goals; and categorizes information by suggested engineering approaches, specific "how-to" and unique areas, surge areas, facilities/maintenance, and medical gas/vacuum systems.
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ASPR TRACIE. (2020). COVID-19: Healthcare System Operations Strategies and Experiences.
Speakers from some of the hardest hit hospitals across the U.S. discuss their COVID-19 experiences in this webinar.
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ASPR TRACIE. (2020). Hospital Operations Toolkit for COVID-19.
This toolkit can help hospital emergency managers and planners manage large numbers of patients during the COVID-19 pandemic.
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Blum, J., Blackford, C., and Moody-Williams, J. (2022). Creating a Roadmap for the End of the COVID-19 Public Health Emergency. U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services.
The authors provide an overview of some of the regulatory changes implemented by CMS during the COVID-19 pandemic and describe a roadmap for the end of Medicare waivers and flexibilities when the emergency ends. Links are included to multiple fact sheets describing the current status of flexibilities by provider type.
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Lynch, J., Davitkov, P., Anderson, D., et al. (2020). Infectious Diseases Society of America Guidelines on Infection Prevention in Patients with Suspected or Known COVID-19. (Added 5/12/2020.)
These online guidelines systematically review the evidence related to eight COVID-19 infection prevention practices and grade recommendations as strong, conditional, or a knowledge gap. Related guidelines are available for treatment and management and diagnostics.
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Operational Modifications: Usual Care

American Academy of Pediatrics. (2022). Guidance on Providing Pediatric Well-Care During COVID-19.
This document provides guidance on the health care that should continue to be provided to children during the COVID-19 pandemic.
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American Medical Association. (2022). A physician guide to keeping your practice open during COVID-19. (Added 5/8/2020.)
This document outlines a list of steps physician practices should take before reopening during the COVID-19 pandemic. It also includes a pre-visit screening script template, frequently asked questions about privacy and confidentiality, and links other resources related to relaxation of stay at home restrictions.
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American Society for Health Care Engineering. (2020). COVID-19 Recovery. American Hospital Association.
This page offers detailed information for healthcare facilities to consider as they recover from COVID-19 and begin restoring usual care. It identifies specific facility management issues; pre-recovery planning activities; immediate, short-term, and long-term needs; and the new normal. It is accompanied by an Excel-based recovery checklist.
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ASPR TRACIE. (2020). Healthcare System Considerations for Resumption of Services during COVID-19 (Quick Sheet).
This resource highlights interrelated issues for the healthcare system to consider as they address their current status, restore services that have been curbed, maintain readiness for potential future waves of COVID-19 patients over the next two years, and adapt to improve their operations based on lessons learned.
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Geerts, J., Kinnair, D., Taheri, P., et al. (2021). Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement. JAMA Network Open. 4(7):e2120295.
The authors present a framework of 10 imperatives to guide health and public health leaders during recovery from the COVID-19 pandemic.
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