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Emergency Center Curbside Screening During the COVID-19 Pandemic: Retrospective Cohort Study
Alexandra Halalau1, Jeffrey Ditkoff1, Jessica Hamilton1
1Beaumont Health, Royal Oak, MI, United States.
Insights
Beaumont Hospital implemented an emergency center curbside testing procedure for COVID-19, serving 2782 patients. This efficient model, with a median total process time of 28 minutes, can be adopted by other high-volume facilities.
Area of Science:
- Emergency Medicine
- Infectious Disease Management
- Public Health
Background:
- COVID-19 pandemic significantly impacted US healthcare systems, with Michigan being heavily affected.
- High patient volumes strained emergency departments during the pandemic.
Purpose of the Study:
- To describe and evaluate the safety and efficiency of an emergency center curbside testing procedure.
- To assess the feasibility of this model for other healthcare facilities.
Main Methods:
- A multidisciplinary team implemented a curbside testing procedure at Beaumont Hospital.
- Data collected over 26 days included patient throughput, testing times, and return visit rates.
Main Results:
- 2782 patients utilized curbside services; 41% received nasopharyngeal swabs, with a 29.6% positive test rate.
- Median total process time was 28 minutes; median time to medical decision was 15 minutes.
- Only 9.2% of patients returned for evaluation within 7 days, with low admission and mortality rates.
Conclusions:
- The curbside testing model proved safe and efficient for managing COVID-19 testing.
- This model is recommended for implementation at other high-volume healthcare facilities during pandemics.
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.
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