Management of the diagnostic and treatment process in the admission department of a multiprofile hospital during COVID-19 pandemic

Cover Page

Cite item

Full Text

Abstract

Introduction. High contagiousness of COVID-19 and its unpredictability have radically changed the work pattern in the emergency department of a multidisciplinary hospital.

The purpose of our study is analysis of approaches to managing the diagnostic and treatment process for emergency patients during the COVID-19 pandemic.

Material and methods. We analyzed data of two thousand seven hundred sixty seven patients with suspected coronavirus infection who sought emergency care at the Municipal Clinical Hospital named after. S.P. Botkin and those who underwent triage with further routing in the emergency department.

Results. 112 569 patients were admitted from 01.04.2020 to 01.04.2022 for emergency assistance. 2,767 patients (2.46%) were suspected to have coronavirus infection. According to the results of PCR coronavirus infection was confirmed in 2064 people (1.83% of the total number and 74.59% of those with suspected infection). All patients with suspected COVID-19 were sent to the isolation room (2726 patients, the number differs from the total number of patients suspected with COVID-19). The patients were mostly suffered from emergency neurosurgical (3.65%), pulmonological (2.43%) and therapeutic (2.32%) diseases.

Limitations. The data of 112569 patients with various pathologies who applied for emergency medical care at the admission department were analyzed as part of the study dedicated to introduction of a new model of work of the admission department of a multidisciplinary hospital.

Conclusions. COVID-19 is not a contraindication for emergency care. Separation of patient flows, and correct diagnostics help to prevent the spread of COVID-19, speed up diagnosis and route the patient correctly.

Compliance with ethical standards: the study doesn’t need ethics committee approval.

Contribution of the authors:
Shabunin A.V. — the concept and design of the study, editing, analysis of the literature;
Barinov Yu.V. — the concept and design of the study, editing, collecting material, writing the text;
Dolidze D.D. — research concept and design, editing, literature analysis, text writing;
Bagatelia Z.A. — collection and processing of material, editing, analysis of literature;
Pichugina N.V. — collection and processing of material, statistical processing, writing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 28, 2022 / Accepted: February 09, 2023 / Published: February 26, 2024

About the authors

Alexey V. Shabunin

S.P. Botkin State Clinical Hospital

Author for correspondence.
Email: noemail@neicon.ru
ORCID iD: 0000-0002-4230-8033

MD, PhD, DSci, Professor, academician of RAS, Chief physician of the S.P. Botkin State Clinical Hospital, Moscow, 125284, Russian Federation

Russian Federation

Yurii V. Barinov

S.P. Botkin State Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0001-7381-2710

MD, PhD, deputy chief physician for urgent aid of the S.P. Botkin State Clinical Hospital, Moscow, 125284, Russian Federation

Russian Federation

David D. Dolidze

S.P. Botkin State Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0002-0517-8540

MD, PhD, DSci, Professor, head of the research-clinical division of the S.P. Botkin State Clinical Hospital, Moscow, 125284, Russian Federation

Russian Federation

Zurab A. Bagatelia

S.P. Botkin State Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0001-5699-3695

MD, PhD, DSci, Professor, Professor, Deputy Chief Physician for Medical Affairs, S.P. Botkin State Clinical Hospital, Moscow, 125284, Russian Federation

Russian Federation

Natalia V. Pichugina

S.P. Botkin State Clinical Hospital

Email: chooga@yandex.ru
ORCID iD: 0000-0002-4778-0273

Ultrasound diagnostic doctor, Junior Researcher, S.P. Botkin State Clinical Hospital, Moscow, 125284, Russian Federation

e-mail: chooga@yandex.ru

Russian Federation

References

  1. Avdeev S.N., Adamyan L.V., Alekseeva E.I., Bagnenko S.F., Baranov A.A., Baranova N.N., et al. Prevention, Diagnosis and Treatment of a New Coronavirus Infection (COVID-19): Temporary Guidelines. Version 11 [Profilaktika, diagnostika i lechenie novoy koronavirusnoy infektsii (COVID-19): Vremennye metodicheskie rekomendatsii. Versiya 11]. Moscow; 2021. https://elibrary.ru/cohgoa (in Russian)
  2. Zachariasse J.M., Seiger N., Rood P.P., Alves C.F., Freitas P., Smit F.J., et al. Validity of the Manchester Triage System in emergency care: A prospective observational study. PLoS One. 2017; 12(2): e0170811. https://doi.org/10.1371/journal.pone.0170811
  3. WHO. Mask use in the context of COVID-19; 2020. Available at: https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
  4. CDC. Standard Operating Procedure (SOP) for Triage of Suspected COVID-19 Patients in non-US Healthcare Settings: Early Identification and Prevention of Transmission during Triage. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/sop-triage-prevent-transmission.html
  5. Tolchin B., Latham S.R., Bruce L., Ferrante L.E., Kraschel K., Jubanyik K., et al. Developing a triage protocol for the COVID-19 pandemic: allocating scarce medical resources in a public health emergency. J. Clin. Ethics. 2020; 31(4): 303–17.
  6. Persad G., Wertheimer A., Emanuel E.J. Principles for allocation of scarce medical interventions. Lancet. 2009; 373(9661): 423–31. https://doi.org/10.1016/s0140-6736(09)60137-9
  7. Leclerc T., Donat N., Donat A., Pasquier P., Libert N., Schaeffer E., et al. Prioritisation of ICU treatments for critically ill patients in a COVID-19 pandemic with scarce resources. Anaesth. Crit. Care Pain Med. 2020; 39(3): 333–9. https://doi.org/10.1016/j.accpm.2020.05.008
  8. Terning G., Brun E.C., El-Thalji I. Modeling patient flow in an emergency department under COVID-19 pandemic conditions: a hybrid modeling approach. Healthcare (Basel). 2022; 10(5): 840. https://doi.org/10.3390/healthcare10050840
  9. Sjödin H., Wilder-Smith A., Osman S., Farooq Z., Rocklöv J. Only strict quarantine measures can curb the coronavirus disease (COVID-19) outbreak in Italy, 2020. Euro Surveill. 2020; 25(13): 2000280. https://doi.org/10.2807/1560-7917.es.2020.25.13.2000280
  10. Ulinici M., Covantev S., Wingfield-Digby J., Beloukas A., Mathioudakis A.G., Corlateanu A. Screening, diagnostic and prognostic tests for COVID-19: A comprehensive review. Life (Basel). 2021; 11(6): 561. https://doi.org/10.3390/life11060561

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2024 Shabunin A.V., Barinov Y.V., Dolidze D.D., Bagatelia Z.A., Pichugina N.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ:  ПИ № ФС77-50668 от 13.07.2012 г.