Effective Triaging of Patients in Confronting Covid-19 Pandemic: Favorable Experience from Yarmouk Health Care Center, Kuwait
Keywords:
COVID-19 Pandemic, Patient Safety, Patient Satisfaction, Telemedicine, TriageAbstract
An efficient and functional triage system, is a successful strategy adopted at various health care facilities in combating against the COVID-19 pandemic. It helps to reduce exposure to the infection and ensures safety of health care workers, patients and visitors. The aim of the study was to observe the effectiveness of triage practice, at Yarmouk Primary Health Care Center, Kuwait. A descriptive cross-sectional study was conducted during February 2019, to December 2020 at the Yarmouk Primary Health Care Center clinics, Kuwait. A triage-based health care delivery model, with rate of overall service usage, were compared before and during the application of triage during COVID-19 pandemic. The control period was from February to December 2019, when the center was working under normal circumstances. Crisis period was from February to December 2020. Data was collected from the primary care information service, Ministry of Health database, for Yarmouk PHCC activities and service utilization pattern, from February 2019 till December 2020.
Due to application of triage system, total number of patient visits were reduced from 151,886 patients in 2019 (pre-Covid) to 72,454 patients in 2020 (CoVID-pandemic), that is 75% reduction in patients visit. The employees were screened 9,511 times for possible COVID-19 symptoms. None of the employees got COVID at workplace because of the effective triage system. Those who got infected with COVID-19 had the exposure from outside workplace. In addition, 105 written reports and a daily follow-up schedule were written. Appointment links were used 102,256 times across various clinics and departments. The link to issue medical reports was used more than 330 times, and more than 70 medical reports were issued. The Chronic Medicines Refill link was used 868 times. Tele-consultation and online consultation were significantly increased, with no change in patient's satisfaction. Applying well planned and monitored triage system at Yarmouk PHCC prioritized services and ensure safety of doctors, staff, patients and visitors, without compromising quality not patient satisfaction.
References
J. Gasana, and M. Shehab, “Coronavirus disease (COVID-19): Handling challenges in Kuwait,” J Sci, vol. 2, no. 3, pp. 63, 2020.
The Public Authority for Civil Information, Kuwai. (2018). Al-Yarmouk, District in Kuwait. Population. Available: https://www.citypopulation.de/en/kuwait/admin/al_%C4%81%E1%B9%A3imah/214__al_yarm%C5%ABk/
Kuwait News Agency (KUNA). Health. ( 2019). Available: https://www.kuna.net.kw/ArticleDetails.aspx?id=2782786&language=en
Q. Wang, X. Wang, and H. Lin, “The role of triage in the prevention and control of COVID-19,” Infect Control Hosp Epidemiol vol. 41, no. 7, pp. 772-776, 2020.
S. Safaai, and I. Mohd Saiboon, “Impact of a binary triage system and structural reorganization of emergency department on health care workers exposed to suspected COVID-19 patients—a single- centre analysis,” J Emerg Med vol. 14, no. 1, pp. 1-10, 2021.
G. Cervino, and G. Oteri, “COVID-19 pandemic and telephone triage before attending medical office: problem or opportunity?,” Medicina, vol. 56, no. 5, pp. 250, 2020.
E. Monaghesh, and A. Hajizadeh, “The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence,” BMC public health, vol. 20, no. 1, pp. 1-9, 2020.
H. L. Tam, S. F. Chung, and C. K. Lou, “A review of triage accuracy and future direction,” BMC Emerg. Med, vol. 18, no. 1, pp. 1-7, 2018.
E. J. Emanuel, G. Persad, R. Upshur, B. Thome, M. Parker, A. Glickman, et al, “Fair allocation of scarce medical resources in the time of Covid-19,” N Engl J Med, vol. 382, no. 21, pp. 2049-2055, 2020.
B. A. Cher, E. A. Wilson, A. M. Pinsky, R. F. Townshend, A. V. Wolski, M. Broderick, et al, “Utility of a Telephone Triage Hotline in Response to the COVID-19 Pandemic: Longitudinal Observational Study,” J. Med. Internet Res, vol. 23, no. 11, pp. e28105, 2021.
N. NeJhaddadgar, A. Ziapour, G. Zakkipour, J. Abbas, M. Abolfathi, and M. Shabani, “Effectiveness of telephone-based screening and triage during COVID-19 outbreak in the promoted primary healthcare system: a case study in Ardabil province, Iran,” J Public Health, pp. 1-6, 2020.
J. N. Kirkpatrick, S. C. Hull, S. Fedson, B. Mullen, and S. J. Goodlin, “Scarce-resource allocation and patient triage during the COVID-19 pandemic: JACC review topic of the week,” J. Am. Coll. Cardiol., vol. 76, no. 1, pp. 85-92, 2020.
G. Peros, F. Gronki, N. Molitor, M. Streit, K. Sugimoto, U. Karrer, et al, “Organizing a COVID-19 triage unit: a Swiss perspective,” Emerg Microbes Infect, vol. 9, no. 1, pp. 1506-1513, 2020.
M. K. Goenka, S. Afzalpurkar, U. Goenka, S. S. Das, M. Mukherjee, S. Jajodia, et al, “Seroprevalence of COVID-19 amongst health care workers in a tertiary care hospital of a metropolitan city from India,” J Assoc Physicians India, 2020.
G. B. Colbert, A. V. Venegas-Vera, and E. V. Lerma, “Utility of telemedicine in the COVID-19 era,” Rev Cardiovasc Med, vol. 21, no. 4, 2020.
J. Wosik, M. Fudim, B. Cameron, Z. F. Gellad, A. Cho, D. Phinney, et al, “Telehealth transformation: COVID-19 and the rise of virtual care,” J Am Med Inform Assoc, vol. 27, no. 6, pp. 957-962, 2020.
S. Rawaf, L. Allen, F. Stigler, D. Kringos, H. Quezada Yamamoto, and C. van Weel, “Global Forum on Universal Health Coverage and Primary Health Care. Lessons on the COVID-19 pandemic, by primary care professionals worldwide,” Eur J Gen Pract, vol. 26, no. 1, pp. 129-133, 2020.
Z. T. Osakwe, “Home care and use of telehealth amidst the COVID-19 pandemic,” Home Healthc. Now, vol. 38, no. 4, pp. 229-230, 2020.
Y. Chen, R. Ismail, M. R. Cheema, D. S. Ting, and I. Masri, “Implementation of a new telephone triage system in ophthalmology emergency department during COVID-19 pandemic: clinical effectiveness, safety and patient satisfaction,” Eye, pp. 1-3, 2021.
V. S. Gupta, E. C. Popp, E. I. Garcia, S. Qashqai, C. Ankrom, T.-C. Wu, et al, “Telemedicine as a component of forward triage in a pandemic,” Healthc (Amst), vol. 9, no. 3, pp. 100567, 2021.
Downloads
Published
How to Cite
Issue
Section
License
Authors who submit papers with this journal agree to the following terms.
