Bell, Lucy Ck;
Norris-Grey, Caitlin;
Luintel, Akish;
Bidwell, Gabriella;
Lanham, David;
Marks, Michael;
Baruah, Tim;
... Logan, Sarah; + view all
(2021)
Implementation and evaluation of a COVID-19 rapid follow-up service for patients discharged from the emergency department.
Clinical Medicine
, 21
(1)
e57-e62.
10.7861/clinmed.2020-0816.
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Abstract
The COVID-19 pandemic has necessitated rapid adaptation of healthcare providers to new clinical and logistical challenges. Following identification of high levels of emergency department (ED) reattendance among patients with suspected COVID-19 at our centre, we piloted a rapid remote follow-up service for this patient group. We present our service framework and evaluation of our pilot cohort of 192 patients. We followed up patients by telephone within 36 hours of their ED attendance. Pulse oximetry was used for remote monitoring of a subset of patients. Patients required between one and six consecutive telephone assessments, dependent on illness severity, and 23 patients were recalled for in-person assessment. Approximately half of patients with confirmed or probable COVID-19 required onward referral for respiratory follow-up. This framework reduced unplanned ED reattendances in comparison with a retrospective comparator cohort (4.7% from 22.6%). We reproduced these findings in a validation cohort with a high prevalence of acute COVID-19, managed through the clinic in September-October 2020, where we identified an unplanned ED reattendance rate of 5.2%. We propose that rapid remote follow-up is a mechanism by which ambulatory patients can be clinically supported during the acute phase of illness, with benefits both to patient care and to health service resilience.
| Type: | Article |
|---|---|
| Title: | Implementation and evaluation of a COVID-19 rapid follow-up service for patients discharged from the emergency department |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.7861/clinmed.2020-0816 |
| Publisher version: | https://doi.org/10.7861/clinmed.2020-0816 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. |
| Keywords: | COVID-19, infectious diseases, ambulatory care, emergency medicine, service evaluation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10219823 |
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