Organizing a COVID-19 triage unit: a Swiss perspective

Area of Science:

• Infectious Diseases
• Public Health
• Hospital Administration

Background:

• The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitated urgent healthcare system adaptations.
• Tertiary care hospitals required innovative strategies for managing the influx of patients with coronavirus disease 2019 (COVID-19).

Purpose of the Study:

• To describe the organizational process and outcomes of establishing a dedicated COVID-19 triage unit in a Swiss tertiary care hospital.
• To evaluate the initial performance and identify challenges associated with the new triage system.

Main Methods:

• A three-area triage unit (Pre-triage, Triage, Triage plus) was set up externally to the main hospital.
• Standardized protocols for patient screening, diagnostic testing (nasopharyngeal swabs), and disposition (discharge or admission) were implemented.
• Data on patient demographics and testing outcomes were collected during the initial operational period.

Main Results:

• A total of 1265 patients were screened between March 10 and April 12, 2020.
• 8.9% of screened patients (112/1265) tested positive for SARS-CoV-2.
• Positively tested patients were predominantly female (65%) and significantly younger than male patients (mean age 41.1 vs. 48.6 years, p < 0.001).

Conclusions:

• The established triage unit facilitated the organized management of potential COVID-19 cases.
• Key challenges included the sensitivity of diagnostic tests and limitations in staff and resources.
• The experience provides a model for other healthcare institutions developing similar COVID-19 triage systems.