Virginia Hospital’s COVID-19 Triage model can pay dividends even after the pandemic
Virginia Hospital’s COVID-19 Triage model can pay dividends even after the pandemic

Virginia Hospital’s COVID-19 Triage model can pay dividends even after the pandemic

Effective management of patient flow in the emergency department, staff, and discharged patients can be difficult in all conditions, but the pandemic presented its own set of challenges. Virginia-based Inova Fairfax Hospital developed an innovative approach to addressing these issues by implementing what it calls Provider-Only Patient (POP) protocols for patients suspected of having COVID-19, a recent NEJM Catalyst report.

The hospital developed a designated area in the ED where patients with low sharpness were seen and discharged directly by physicians or advanced practice providers. POP protocols were followed for patients aged 21-64 years who were suspected of having COVID-19 and who had a distress index score of 4 or 5 on a scale of 1 to 5, with 1 being the most urgent.

Patients who initially entered the ED were triaged by a nurse or physician to determine POP status. Those who showed signs of hemodynamic instability (eg hypo- or hypertension), had less than 96% oxygen saturation in the room air, were pregnant, had difficulty walking, or had inadequate social support were not included in the POP patient queue.

Inova studied the results of the program over a 46-day period between December 1, 2021 and January 15, 2022 and found some interesting results.

POP patients spent significantly less time in ED than non-POP patients, and none of the 640 POP patients returned to the hospital for hospitalization within 72 hours. The study authors also reported that the POP triage and delivery process saved nearly 1,900 hours of nursing and 705 hours of provider time during the 46-day study period.

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