Hospital-based autonomous pre-clinical screening of COVID-19: An emergency triage using a vital signs recording system, Paris-Ile de France region

Abstract

Background: The COVID-19 pandemic has had a dramatic toll worldwide on the populations but also has been essentially supported by the existing public health system, particularly hospital-based emergency wards and intensive care units. In France, the first cases were identified on the 24th of January 2020. The first epidemic sprout emerged in the Eastern part of the country and spread in two weeks towards the center to the Paris-region where it peaked on the 14th of April 2020. In Paris and the region around it, the intensity of the epidemic has increased significantly to have a strong impact on all public and private hospital systems in a few weeks. During France's 2020 COVID-19 epidemic, a private hospital went into a major organizational change of its Emergency Department which mainly included the use of a Telemedicine Booth for vitals automatic recording during triage procedures.Purpose: The purpose of this study is to share a unique exerience centered on the use of a Telemedicine Booth as a screening process during an epidemic. Researche design: The present study is a case report describing the organizational scheme adopted by the hospital and discusses the data of 1844 patients that attended the facility over a month and the results of a questionaire survey adressed to the Emergency Department personnel.Study sample: The study population is the population that Data where collecte.Data collection and analysis: Quantitative activity indicators' data were collected with a specific triage register, patient management software and the Telemedicine Booth activity software and were analysed with basic statistics. Results and Conclusions: Among the 1844 patients, 766 were engaged in an automated triage process supported by a Telemedicine Booth. Patients' clinical characteristics are comparable to those found in international literature during the COVID-19 pandemic. The use of the Telemedicine Booth as a screening process facilitated patients' flow. It usefully participated in the patient rapid orientation, relieving the hospital emergency department, actively contributes in a safe and secure environment highly trusted by the hospital staff and health workers. To our knowledge, the Telemedicine Booth use as a screening process during an epidemic constitutes the first contribution to such an innovative approach.

Keywords: Accident & emergency departments; emergency planning; innovations; operational management; public health; triage.

Figure 1.

Incidence of COVID-19 cases and localization of Paris and the Vert Galant Hospital in the Seine Saint Denis Departement (modified from Santé publique France).

Figure 2.

COVID-19 patient pathway upon admission to the Emergency Department of the hospital during the epidemic of Paris Metropolitan area (March-May 2020).