The All-Wales Secondary care COVID-19 hospital guideline (linked below) was created in early March as the COVID-19 pandemic gathered momentum. It was recognised that since this was a new disease, where evidence around the management of infected patients was scant, that we needed to create a guideline that was dynamic and responsive to emerging evidence. We therefore created a guideline with two key components:
- a fixed aspect which reflected the general flow through the hospital of COVID-19 patients from admission, to COVID ward or ITU, or to discharge
- the variable component encompassed management strategies at various stages of the pathway that were likely to change
There have been numerous changes at many of these points, including management of oxygenation failure on COVID wards, the categorisation of oxygenation failure and palliative care support. Underpinning this guideline has been a clear implementation strategy, with designated COVID coordinators in each hospital and a communication team that liaises with the coordinators to help implementation. By enforcing registration to access the guideline, we ensured that all registrants are notified to any updates within the guideline.