A Swift and Dynamic Strategy to Expand Emergency Department Capacity for COVID-19

Barten, Dennis G.; Kusters, Renske W J; Peters, Nathalie A L R

doi:10.1017/dmp.2020.430

Cited by 11 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the pandemic continued into May and beyond, LOS-A and LOS-D increased above the levels as expected from the pre-COVID-19 period, and this trend continued for the remainder of 2020 (Fig- across the United States in April and May 2020. [25][26][27] This has likely contributed to a nationwide reduction in inpatient bed availability, which numerous studies have shown to have the strongest correlation with ED LOS-A 23,24 ; the less inpatient bed availability, the longer the LOS-A.…”

Section: Discussionmentioning

confidence: 99%

“…23,24 Instead, we did attempt to address this by taking data from the US Department of Health and Human Services (HHS) and the COVID Tracking Project in order to explain the increase in LOS-A as a function of ED volume. [25][26][27] Another limitation is that we were unable to collect data regarding nurse staffing, specifically nursing hours worked as a function of time, number of furloughs, and number of nursing call-offs. Having such data may have been useful in determining if and how much nurse staffing had any correlation with LOS.…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Worsening of emergency department length of stay during the COVID‐19 pandemic

et al. 2021

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Worsening of emergency department length of stay during the COVID‐19 pandemic

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A certain degree of overcapacity may be pivotal for an effective response. As this pandemic is ongoing, surge capacity models that allow some flexibility may be the most useful [7,9,19]. Hospital capacity is dynamic and highly dependent on the occupancy of available resources [20].…”

Section: Plos Onementioning

confidence: 99%

“…The current COVID-19 pandemic was initially characterized by rapidly increasing patient hospital contacts. A swift overhaul of several aspects of ED preparations in Dutch hospitals was imperative [6,7]. Challenges mainly concerned surge capacity, frontline staff (staff at high risk of infection during initial contact with patients) protection and the segregation of suspect-COVID-19 patients [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Preparations of Dutch emergency departments for the COVID-19 pandemic: A questionnaire-based study

2021

Self Cite

View full text Add to dashboard Cite

Background The onset of the COVID-19 pandemic was characterized by rapid increases in Emergency department (ED) patient visits. EDs required an appropriate transformation. The main challenges were: adapting capacity to respond to surges in the number of patient visits, protection of high risk (frontline) staff and the segregation of suspect-COVID-19 patients. To date, only a few studies have assessed the nation-wide response of EDs to the COVID-19 pandemic. This study was designed to review the preparations of Dutch EDs during the initial phase of this public health crisis. Methods The study was designed as a nation-wide, cross-sectional, questionnaire-based study of Dutch hospital organizations having one or more EDs. One respondent completed the questionnaire for each hospital. The questionnaire was conducted between the first and the second COVID-19 wave in the Netherlands. It contained close-ended and open-ended questions on changes in ED infrastructure, ED workforce adaptions and the role of emergency physicians (EPs) in each hospital crisis management team. Results The questionnaire was completed by 58 respondents. This represented 80% of the total number of EDs. All respondents had made preparations in anticipation of a COVID-19 patient surge. Treatment capacity was expanded in 70% of EDs, with a median increase of 49% (IQR 33–73%). Suspect-COVID-19 was segregated from non-COVID-19 patients in 89% of EDs. Alternative locations (such as outpatient departments) were more often used to assess non-COVID-19 patients, than for suspect-COVID-19 patients. Staff was expanded in 82% of EDs. This largely concerned nursing staff. A formal role for Emergency Physicians (EPs) in the hospital’s crisis management team was reported by 94% of hospital organizations employing EPs. Conclusion All Dutch EDs responded to the COVID-19 pandemic in a very short time span despite much uncertainty. Preparations predominantly concerned expansion of treatment capacity and segregation of COVID-19 ED care. EPs played a prominent role, both in direct COVID-19 care and in the hospital crises management team. It is vital for EDs to adapt to community needs swiftly. The ability of EDs to respond to the pandemic varied considerably.

show abstract

“…The conjoined AMU-ED was segregated into a high-risk and a low-risk area: both medically unstable (for adequate resuscitation cubicles) and COVID-19 suspected patients were assigned to the ED (high-risk area) and isolated, whereas low-acuity, COVID-19 non-suspected patients were assigned to the AMU (low-risk area). This specific approach was comprehensively described in a previous publication [25].…”

Section: Study Design and Settingmentioning

confidence: 99%

Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

Hensgens

Rensen

Lekx

et al. 2021

IJERPH

Self Cite

View full text Add to dashboard Cite

Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to evaluate the performance of our pre-triage screening method and to analyse the characteristics of initially undetected COVID-19 patients. Methods. This was a retrospective, observational, single centre study. Patients ≥18 years visiting the AMU-ED between 17 March and 17 April 2020 were included. Primary outcome was the (correct) number of COVID-19 patients assigned to the AMU or ED. Results. In total, 1287 patients visited the AMU-ED: 525 (40.8%) AMU, 762 (59.2%) ED. Within the ED group, 304 (64.3%) of 473 tested patients were COVID-19 positive, compared to 13 (46.4%) of 28 tested patients in the AMU group. Our pre-triage screening accuracy was 63.7%. Of the 13 COVID-19 patients who were initially assigned to the AMU, all patients were ≥65 years of age and the majority presented with gastro-intestinal or non-specific symptoms. Conclusion. Older COVID-19 patients presenting with non-specific symptoms were more likely to remain undetected. ED screening protocols should therefore also include non-specific symptoms, particularly in older patients.

show abstract

A Swift and Dynamic Strategy to Expand Emergency Department Capacity for COVID-19

Cited by 11 publications

References 8 publications

Worsening of emergency department length of stay during the COVID‐19 pandemic

Worsening of emergency department length of stay during the COVID‐19 pandemic

Preparations of Dutch emergency departments for the COVID-19 pandemic: A questionnaire-based study

Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

Contact Info

Product

Resources

About