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

https://doi.org/10.1016/j.jaip.2020.11.033Get rights and content

The coronavirus disease 2019 pandemic has forever changed how we view health care service delivery. Although there are undoubtedly some unintended consequences that will result from current health care 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. 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 definition of the dimensions of quality is based on whether the care is safe, effective, patient-centered, 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 coronavirus disease 2019 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–coronavirus disease health care system.

Key words

COVID-19
Shared decision making
Resource stewardship

Abbreviations used

AIT
Allergen immunotherapy
COVID-19
Coronavirus disease 2019
EMS
Emergency Medical Services
SDM
Shared decision making

Cited by (0)

Conflicts of interest: E. M. Abrams is a collaborator with the Institute for Health Metrics and Evaluation; is on the National Advisory Board for Food Allergy Canada; and is on the National Food Allergy Action Plan Action Steering Team for Food Allergy Canada. A. G. Singer declares no relevant conflicts of interest. M. Shaker is a member of the Joint Taskforce on Allergy Practice Parameters; has a family member who is CEO of Altrix Medical; serves on the Editorial Board of the Journal of Allergy and Clinical Immunology: In Practice, the Journal of Food Allergy, and the Annals of Allergy, Asthma, and Immunology. M. Greenhawt has received past support from the Agency for Healthcare Research and Quality; is an Expert Panel and Coordinating Committee member of the National Institute of Allergy and Infectious Diseases-sponsored Guidelines for Peanut Allergy Prevention; has served as a consultant for the Canadian Transportation Agency, Thermo Fisher, Intrommune, and AimmuneTherapeutics; is a member of physician/medical advisory boards for Aimmune Therapeutics, DBV Technologies, Sanofi/Genzyme, Glaxo Smith Kline, Genentech, Nutricia, Pfizer, Novartis, Kaléo Pharmaceutical, Nestlé, Aquestive, Allergy Therapeutics, Allergenis, Aravax, Prota, and Monsanto; is a member of the Scientific Advisory Council for the National Peanut Board; has received honorarium for lectures from Thermo Fisher, Aimmune Therapeutics, DBV Technologies, Before Brands, multiple state allergy societies, the American College of Allergy, Asthma and Immunology, and the European Academy of Allergy and Clinical Immunology; is an associate editor for the Annals of Allergy, Asthma & Immunology; and is a member of the Joint Taskforce on Allergy Practice Parameters.

View Abstract