Reduction in Hospital Transfers at a US COVID-19 Alternate Care Site: Maintaining Surge Capacity Support in Imperial County, California.

Autor:	Zhang FW; CAL-MAT, Rosemead, CA, USA., Meghoo CA; CAL-MAT, Daytona, FL, USA., Staats KL; Imperial County EMS, CA, USA.; Stanford University, Stanford, CA, USA., Hayes EP; Emergency Medicine, Vanderbilt Tullahoma-Harton Hospital, Tullahoma, TN, USA., Metzner M; Finance and Administration Section, CAL-MAT, CA, USA., Sobel J; Department of Emergency Medicine, University of California San Diego, CA, USA., Hultquist E; CAL-MAT, Pasadena, CA, USA., Noste EE; Department of Emergency Medicine, University of California San Diego, CA, USA., Wright CE; CAL-MAT, San Diego, CA, USA., Devereaux A; CAL-MAT, Coronado, CA, USA., Backer H; CAL-MAT, Rancho Cordova, CA, USA.
Jazyk:	angličtina
Zdroj:	Disaster medicine and public health preparedness [Disaster Med Public Health Prep] 2022 Jul 04; Vol. 17, pp. e231. Date of Electronic Publication: 2022 Jul 04.
DOI:	10.1017/dmp.2022.166
Abstrakt:	Objective: The transfer rate for patients from an Alternate Care Site (ACS) back to a hospital may serve as a metric of appropriate patient selection and the ability of an ACS to treat moderate to severely ill patients accepted from overwhelmed health-care systems. During the coronavirus infectious disease 2019 (COVID-19) pandemic, hospitals worldwide experienced acute surges of patients presenting with acute respiratory failure. Methods: An ACS in Imperial County, California was re-established in November 2020 to help decompress 2 local hospitals experiencing surges of COVID-19 cases. The patients treated often had multiple comorbid illnesses and required a median supplemental oxygen of 3 L/min (LPM) on admission. Numerous interventions were initiated during a 2-wk period to improve clinical care delivery. Results: The objectives of this retrospective observational study are to evaluate the impact of these clinical and staff interventions at an ACS on the transfer rate and to provide issues to consider for future ACS sites managing COVID-19 patients. Conclusions: The data suggest that continuous, real-time process-improvement interventions helped reduce the transfer rate back to hospitals from 36.7% to 14.5% and that an ACS is a viable option for managing symptomatic COVID-19 positive patients requiring hospital-level care when hospitals are overburdened.
Databáze:	MEDLINE
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