Emergency Center Curbside Screening During the COVID-19 Pandemic: Retrospective Cohort Study.


Journal

JMIR public health and surveillance
ISSN: 2369-2960
Titre abrégé: JMIR Public Health Surveill
Pays: Canada
ID NLM: 101669345

Informations de publication

Date de publication:
21 07 2020
Historique:
received: 10 05 2020
accepted: 02 07 2020
revised: 02 06 2020
pubmed: 4 7 2020
medline: 31 7 2020
entrez: 4 7 2020
Statut: epublish

Résumé

Coronavirus disease (COVID-19) is a global pandemic that has placed a significant burden on health care systems in the United States. Michigan has been one of the top states affected by COVID-19. We describe the emergency center curbside testing procedure implemented at Beaumont Hospital, a large hospital in Royal Oak, MI, and aim to evaluate its safety and efficiency. Anticipating a surge in patients requiring testing, Beaumont Health implemented curbside testing, operated by a multidisciplinary team of health care workers, including physicians, advanced practice providers, residents, nurses, technicians, and registration staff. We report on the following outcomes over a period of 26 days (March 12, 2020, to April 6, 2020): time to medical decision, time spent documenting electronic medical records, overall screening time, and emergency center return evaluations. In total, 2782 patients received curbside services. A nasopharyngeal swab was performed on 1176 patients (41%), out of whom 348 (29.6%) tested positive. The median time for the entire process (from registration to discharge) was 28 minutes (IQR 17-44). The median time to final medical decision was 15 minutes (IQR 8-27). The median time from medical decision to discharge was 9 minutes (IQR 5-16). Only 257 patients (9.2%) returned to the emergency center for an evaluation within 7 or more days, of whom 64 were admitted to the hospital, 11 remained admitted, and 4 expired. Our curbside testing model encourages the incorporation of this model at other high-volume facilities during an infectious disease pandemic.

Sections du résumé

BACKGROUND
Coronavirus disease (COVID-19) is a global pandemic that has placed a significant burden on health care systems in the United States. Michigan has been one of the top states affected by COVID-19.
OBJECTIVE
We describe the emergency center curbside testing procedure implemented at Beaumont Hospital, a large hospital in Royal Oak, MI, and aim to evaluate its safety and efficiency.
METHODS
Anticipating a surge in patients requiring testing, Beaumont Health implemented curbside testing, operated by a multidisciplinary team of health care workers, including physicians, advanced practice providers, residents, nurses, technicians, and registration staff. We report on the following outcomes over a period of 26 days (March 12, 2020, to April 6, 2020): time to medical decision, time spent documenting electronic medical records, overall screening time, and emergency center return evaluations.
RESULTS
In total, 2782 patients received curbside services. A nasopharyngeal swab was performed on 1176 patients (41%), out of whom 348 (29.6%) tested positive. The median time for the entire process (from registration to discharge) was 28 minutes (IQR 17-44). The median time to final medical decision was 15 minutes (IQR 8-27). The median time from medical decision to discharge was 9 minutes (IQR 5-16). Only 257 patients (9.2%) returned to the emergency center for an evaluation within 7 or more days, of whom 64 were admitted to the hospital, 11 remained admitted, and 4 expired.
CONCLUSIONS
Our curbside testing model encourages the incorporation of this model at other high-volume facilities during an infectious disease pandemic.

Identifiants

pubmed: 32619184
pii: v6i3e20040
doi: 10.2196/20040
pmc: PMC7404008
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e20040

Informations de copyright

©Alexandra Halalau, Jeffrey Ditkoff, Jessica Hamilton, Aryana Sharrak, Aimen Vanood, Amr Abbas, James Ziadeh. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 21.07.2020.

Références

Emerg Infect Dis. 1999 Sep-Oct;5(5):659-71
pubmed: 10511522
J Autoimmun. 2020 May;109:102433
pubmed: 32113704
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
J Korean Med Sci. 2020 Mar 23;35(11):e123
pubmed: 32193904

Auteurs

Alexandra Halalau (A)

Beaumont Health, Royal Oak, MI, United States.

Jeffrey Ditkoff (J)

Beaumont Health, Royal Oak, MI, United States.

Jessica Hamilton (J)

Beaumont Health, Royal Oak, MI, United States.

Aryana Sharrak (A)

Oakland University William Beaumont School of Medicine, Rochester, MI, United States.

Aimen Vanood (A)

Oakland University William Beaumont School of Medicine, Rochester, MI, United States.

Amr Abbas (A)

Beaumont Health, Royal Oak, MI, United States.

James Ziadeh (J)

Beaumont Health, Royal Oak, MI, United States.

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