Title

Dedicated area within the emergency department versus an outside dedicated area for evaluation and management of suspected coronavirus disease 2019.

Authors

G. Garra, Zucker School of Medicine at Hofstra/NorthwellFollow
S. Gupta, Zucker School of Medicine at Hofstra/NorthwellFollow
S. Ferrante
W. Apterbach, Zucker School of Medicine at Hofstra/NorthwellFollow

Publication Date

2020

Journal Title

J Am Coll Emerg Physicians Open

Abstract

Background

The circumstances of the coronavirus disease 2019 pandemic necessitated an alternate operations strategy for efficient patient management. Alternate care sites were a viable option for managing emergency department (ED) surge in previous epidemics and disasters.

Objective

This study describes the development of an alternate care site and evaluates efficiency by comparing key performance indicators between an ad hoc nested respiratory evaluation unit (NRU) within the ED and an alternate care site outside the ED.

Methods

This was a cohort study of 2 care models in the same ED during 2 different time periods. As coronavirus disease 2019 surged in March 2020, potential treat-and-release patients with fever or respiratory symptoms were triaged to a dedicated ED area (NRU). As ED volume grew, these low-acuity patients were triaged to an ACS. We compared ED length of stay, elopement, and left without being evaluated rates and ED recidivism between the 2 care models: NRU patients presented to the ED from March 16, 2020, to March 31, 2020, and ACS patients presented from April 1, 2020, to April 15, 2020. Continuous variables were compared using independent t test or Mann-Whitney test. Categorical variables were compared using χ²test.

Results

There were 414 NRU patients and 146 alternate care site patients with no significant differences in sex or age. The mean ED length of stay was shorter for alternate care site patients: 155 versus 45 minutes (P < 0.01). Elopement and left without being evaluated rates were higher in the NRU. There was no significant difference in ED recidivism between groups: 10% versus 6% (P= 0.15).

Conclusions

An alternate care site provided an efficient resource for the evaluation of patients with fever or respiratory symptoms during the coronavirus disease 2019 pandemic.

Volume Number

1

Issue Number

6

Pages

1349 - 1353

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Emergency Medicine

Additional Departments

COVID-19 Publications

PMID

33392543

DOI

10.1002/emp2.12288