What the COVID-19 Pandemic Can Teach Us About Resource Stewardship and Quality in Health Care

Abrams, Elissa M.; Singer, Alexander G.; Shaker, Marcus; Greenhawt, Matthew

The Coronavirus disease 2019 (COVID-19) pandemic has forever changed how we view healthcare service delivery. While there are undoubtedly some unintended consequences that will result from current healthcare service reallocation, it provides a unique opportunity to consider how to deliver quality care currently, and after the pandemic. In the context of lessons learned, moving forward some of what was previously routine could remain reserved for more exceptional circumstances. In order to determine what is “routine”, what is “essential”, and what is “exceptional” it is necessary to view medical decisions within the paradigm of high-quality care. The Institute for Healthcare Improvement (IHI) definition of the dimensions of quality based on whether the care is safe, effective, patient-centred, timely, efficient and equitable. This type of stewardship has been applied to many interventions already deemed unnecessary by organizations such as the Choosing Wisely initiative, but the COVID-19 pandemic provides a lens from which to consider other aspects of care. The following will provide examples from Allergy/Immunology that outline how we can reconsider what quality means in the post-COVID health care system.