RT Journal Article
SR Electronic
T1 Implementation and evaluation of a COVID-19 rapid follow-up service for patients discharged from the emergency department
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e57
OP e62
DO 10.7861/clinmed.2020-0816
VO 21
IS 1
A1 Bell, Lucy CK
A1 Norris-Grey, Caitlin
A1 Luintel, Akish
A1 Bidwell, Gabriella
A1 Lanham, David
A1 Marks, Michael
A1 Baruah, Tim
A1 O'Shea, Luke
A1 Heightman, Melissa
A1 Logan, Sarah
YR 2021
UL http://www.rcpjournals.org/content/21/1/e57.abstract
AB 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.