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Improving quality in adult long covid services: Findings from the LOCOMOTION quality improvement collaborative

Lookup NU author(s): Dr Jordan MullardORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). The protracted form of COVID-19 known as ‘long covid’ was first described in 2020. Its symptoms, course and prognosis vary widely; some patients have a multi-system, disabling and prolonged illness. In 2021, ring-fenced funding was provided to establish 90 long covid clinics in England; some clinics were also established in Scotland and Wales. The NIHR-funded LOCOMOTION project implemented a UK-wide quality improvement collaborative involving ten of these clinics, which ran from 2021 to 2023. At regular online meetings held approximately 8-weekly, participants prioritised topics, discussed research evidence and guidelines, and presented exemplar case histories and clinic audits. A patient advisory group also held a priority-setting exercise, participated in quality meetings and undertook a service evaluation audit. The goal of successive quality improvement cycles aimed at changing practice to align with evidence was sometimes hard to achieve because definitive evidence did not yet exist in this new condition; many patients had comorbidities; and clinics were practically constrained in various ways. Nevertheless, much progress was made and a series of ‘best practice’ guides was produced, covering general assessment and management; breathing difficulties; orthostatic tachycardia and other autonomic symptoms; fatigue and cognitive impairment; and vocational rehabilitation. This paper summarises key findings with the frontline clinician in mind.


Publication metadata

Author(s): Darbyshire J, Greenhalgh T, Bakerly ND, Balasundaram K, Baley S, Ball M, Bullock E, Cooper R, Davies H, De Kock JH, Echevarria C, Elkin S, Evans R, Falope Z, Flynn C, Fraser E, Halpin S, Jones S, Lardner R, Lee C, Lovett A, Masey V, Master H, Mir G, Mosley A, Mullard J, O'Connor RJ, Parkin A, Pick A, Scott J, Smith N, Tucker E, Williams P, Winch D, Wood C, Sivan M

Publication type: Article

Publication status: Published

Journal: Clinical Medicine

Year: 2024

Volume: 24

Issue: 5

Print publication date: 01/09/2024

Online publication date: 23/08/2024

Acceptance date: 15/08/2024

Date deposited: 30/09/2024

ISSN (print): 1470-2118

ISSN (electronic): 1473-4893

Publisher: Elsevier BV

URL: https://doi.org/10.1016/j.clinme.2024.100237

DOI: 10.1016/j.clinme.2024.100237

Data Access Statement: Data supporting this publication are owned by The University of Leeds, the project sponsor. Relevant data files can be made available on reasonable request where appropriate data sharing agreements can be put in place. For more details, please contact Thomas.Osbourne@leeds.ac.uk

PubMed id: 39181334


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Funding

Funder referenceFunder name
National Institute for Health and Care Research (NIHR) (long COVID grant, Ref: COV-LT2-0016)

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