|
?:abstract
|
-
Study Objective: During the COVID-19 pandemic, the volume of patients presenting to the emergency departments (EDs) exceeded ED capacities Many health systems have implemented drive-through (DT) screening and testing for patients with COVID-19 symptoms for public health screening and to add to surge capacity The objective of this investigation was to describe both the testing and clinical outcomes of patients evaluated by a hospital system-based DT screening strategy early in the 2020 COVID-19 pandemic Methods: This is a retrospective, observational study of patients who were triaged to a DT COVID-19 screening area at one of eight hospitals in the health system between March 12 and April 15, 2020 Patients were evaluated by Advanced Practice Providers (APPs) through a car window, with vital signs, a focused clinical evaluation, and nasopharyngeal swabs for COVID-19 per clinical judgment Post-evaluation instructions for care were also provided An electronic medical record search was performed to identify patients’ returns to the EDs and their return disposition Outcomes were return visits, disposition on return, mortality, and results of COVID-19 testing for those tested Results: During the study period, we included 7061 patients from all hospitals (Range 12-2660/hospital) of which 58 0% were female, and 48 0% Caucasian The average age of subjects was 44 1 y/o (Range 0-97) Abnormal vital signs were identified in 1633(23 1%) patients on initial DT Of those 296(4 2%) had a fever >=100 4 F, 1355(19 2%) had tachycardia (HR>100 bpm), 174(2 5%) had hypoxia (SpO224) COVID-19 testing was performed for 1407(19 9%) patients during the initial DT screening of whom 381(27 1%) were positive for COVID-19-19 An in-system ED revisit occurred in 688(9 7%) patients with a median(IQR) time from initial DT evaluation of 4 3(2 2) days Returning patients were admitted 27 7% of the time (185/668) Revisit rates were slightly decreased when testing was done during the initial drive through (7 9% vs 9 9%, p=0 03) Of admitted patients, 9/668 died during hospitalization Conclusion: DT screening for COVID-19 appears to be an effective tool to provide screening and augment surge capacity during this pandemic Limitations of this work include an early pandemic study population with a high prevalence of disease, and a follow-up method that utilized a single health system which may have underestimated the rate of return visit However, we identified that a measurable proportion of patients required emergency evaluation, with complications including hospital admission and death We identify the need for DT screening programs to incorporate outcome measurements into their program
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}