Coronavirus disease – 2019 assessment zone: A community hospital's rapid response to a novel infectious pandemic

Mohindra, Rohit; Atlin, Cori; Moran, Carla; Shook, Ann; Ennis, Andrea; Page, Jennifer L.; Vaglica, Marisa; Hannam, Paul

doi:10.1017/cem.2020.391

Cited by 3 publications

(3 citation statements)

References 1 publication

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“…For instance, Canadian hospitals have quickly restructured their emergency departments (ED) in order to facilitate an increase in health care delivery. A hospital in North York was able to completely reinvent its ED and continue operations within 33 hours [ 10 ]. Likewise, rural hospitals restructured patient flow protocols and built additional infrastructure for drastic patient increase that the smaller institutions were not equipped to accommodate in normal circumstances [ 11 ].…”

Section: Effective Measuresmentioning

confidence: 99%

COVID-19 in Canada: A self-assessment and review of preparedness and response

Prasad

Akande

et al. 2020

Journal of Global Health

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Section: Effective Measuresmentioning

confidence: 99%

COVID-19 in Canada: A self-assessment and review of preparedness and response

Prasad

Akande

et al. 2020

Journal of Global Health

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“…2,3 Based on challenging international experiences, many Canadian emergency departments (ED) sought to prepare for a high flux of patients with infectious symptoms. [4][5][6] However, as the pandemic unfolded, many EDs did not appear to experience surges, but rather decreases in volumes. In the prehospital realm, emergency medical system (EMS) activations for potential life-threatening presentations decreased in the US and Europe.…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on a Large, Canadian Community Emergency Department

Jung¹,

Lou²,

Rauchwerger³

et al. 2021

WJEM

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Introduction As the COVID-19 pandemic unfolded, emergency departments (EDs) across the world braced for surges in volume and demand. However, many EDs experienced decreased demand even for higher acuity illnesses. In this study we sought to examine the change in utilization at a large Canadian community ED, including changes in patient demographics and presentations, as well as structural and administrative changes made in response to the pandemic. Methods This retrospective observational study took place in Ontario, Canada, from March 17–June 30, 2020, during province-wide lockdowns in response to COVID-19. We used a control period of March 17–June 30 in 2018–2019. Differences between observed and expected values were calculated for total visits, Canadian Triage and Acuity Scale (CTAS) groups, and age groups using Fisher’s exact test. Length of stay (LOS), physician initial assessment time (PIA), and top primary and admission diagnoses were also examined. Results Patient visits fell to 66.3% of expected volume in the exposure period (20,901 vs 31,525, P<0.0001). CTAS-1 (highest acuity) patient volumes dropped to 86.8% of expected (P = 0.1964) while CTAS-5 (lowest acuity) patient volumes dropped to 32.4% of expected (P <0.0001). Youth (0–17), adult (18–64), and senior (65+) visits all decreased to 37.4%, 71.7%, and 72.9% of expected volumes, respectively (P <0.0001). Median PIA and median ED LOS both decreased (1.1 to 0.6 hours and 3.3 to 3.0 hours, respectively). The most common primary diagnosis in both periods was “other chest pain.” Viral syndromes were more prevalent in the exposure period. The top admission diagnoses were congestive heart failure in the control period (4.8%) and COVID-19 in the study period (3.5%). Conclusion ED utilization changed drastically during COVID-19. Our ED responded with wide stakeholder engagement, spatial reorganization, and human resources changes informed by real-time data. Our experiences can help prepare for potential subsequent “waves” of COVID-19 and future pandemics.

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“…1 Reports on how EDs anticipated to this public health emergency are limited. [2][3][4] In the Netherlands, the first case of COVID-19 was identified on February 27, 2020. As of August 27, there have been 68,114 confirmed cases of infection (of which 12,126 were hospitalized) and 6215 confirmed COVID-19-deaths.…”

mentioning

confidence: 99%

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

Barten

Kusters

Peters

2020

Disaster med. public health prep.

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Emergency departments (EDs) worldwide struggled to prepare for COVID-19 patient surge and to simultaneously preserve sufficient capacity for ‘regular’ emergency care. While many hospitals used costly shelter facilities, it was decided to merge the acute medical unit (AMU) and the ED. The conjoined AMU-ED was segregated into a high-risk and a low-risk area to maintain continuity of emergency care. This strategy allowed for a feasible, swift and dynamic expansion of ED capacity without the need for external tent facilities. This report details on the technical execution and discusses the pearls and potential pitfalls of this expansion strategy. Although ED preparedness for pandemics may be determined by local factors such as hospital size, ED census and primary healthcare efficacy, the conjoined AMU-ED strategy may be a potential model for other EDs.

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Coronavirus disease – 2019 assessment zone: A community hospital's rapid response to a novel infectious pandemic

Cited by 3 publications

References 1 publication

COVID-19 in Canada: A self-assessment and review of preparedness and response

COVID-19 in Canada: A self-assessment and review of preparedness and response

The Impact of COVID-19 on a Large, Canadian Community Emergency Department

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

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