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Reduction in Hospital Transfers at a US COVID-19 Alternate Care Site: Maintaining Surge Capacity Support in Imperial County, California

Published online by Cambridge University Press:  04 July 2022

Frank W. Zhang*
Affiliation:
CAL-MAT, Rosemead, CA, USA
Colin A. Meghoo
Affiliation:
CAL-MAT, Daytona, FL, USA
Katherine L. Staats
Affiliation:
Imperial County EMS, CA, USA Stanford University, Stanford, CA, USA
Elizabeth Perkins Hayes
Affiliation:
Emergency Medicine, Vanderbilt Tullahoma-Harton Hospital, Tullahoma, TN, USA
Mitch Metzner
Affiliation:
Finance and Administration Section, CAL-MAT, CA, USA
Julia Sobel
Affiliation:
Department of Emergency Medicine, University of California San Diego, CA, USA
Eric Hultquist
Affiliation:
CAL-MAT, Pasadena, CA, USA
Erin E. Noste
Affiliation:
Department of Emergency Medicine, University of California San Diego, CA, USA
Charles E. Wright
Affiliation:
CAL-MAT, San Diego, CA, USA
Asha Devereaux
Affiliation:
CAL-MAT, Coronado, CA, USA
Howard Backer
Affiliation:
CAL-MAT, Rancho Cordova, CA, USA
*
Corresponding author: Frank W. Zhang, E-mail: Fwzhang10@gmail.com

Abstract

Objective:

The transfer rate for patients from an Alternate Care Site (ACS) back to a hospital may serve as a metric of appropriate patient selection and the ability of an ACS to treat moderate to severely ill patients accepted from overwhelmed health-care systems. During the coronavirus infectious disease 2019 (COVID-19) pandemic, hospitals worldwide experienced acute surges of patients presenting with acute respiratory failure.

Methods:

An ACS in Imperial County, California was re-established in November 2020 to help decompress 2 local hospitals experiencing surges of COVID-19 cases. The patients treated often had multiple comorbid illnesses and required a median supplemental oxygen of 3 L/min (LPM) on admission. Numerous interventions were initiated during a 2-wk period to improve clinical care delivery.

Results:

The objectives of this retrospective observational study are to evaluate the impact of these clinical and staff interventions at an ACS on the transfer rate and to provide issues to consider for future ACS sites managing COVID-19 patients.

Conclusions:

The data suggest that continuous, real-time process-improvement interventions helped reduce the transfer rate back to hospitals from 36.7% to 14.5% and that an ACS is a viable option for managing symptomatic COVID-19 positive patients requiring hospital-level care when hospitals are overburdened.

Type
Original Research
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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