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在新冠疫情中管理患者:一种虚拟多学科方法。

Managing Patients in the COVID-19 Pandemic: A Virtual Multidisciplinary Approach.

作者信息

Ganesh Ravindra, Salonen Bradley R, Bhuiyan M Nadir, Bierle Dennis M, Moehnke Darcie, Haddad Tufia C, Tande Aaron J, Wilson John, Hurt Ryan T

机构信息

Division of General Internal Medicine, Mayo Clinic, Rochester, MN.

Division of Medical Oncology, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 Feb;5(1):118-126. doi: 10.1016/j.mayocpiqo.2020.12.003. Epub 2020 Dec 15.

Abstract

OBJECTIVE

To study the impact of a 60-day pilot of an innovative virtual-care model using general internal medicine physicians and nurses to respond rapidly to more than 1200 coronavirus disease-2019 (COVID-19)-positive nasopharyngeal polymerase chain reaction tests.

PATIENTS AND METHODS

The current study was approved by the Mayo Clinic COVID-19 Research Committee and the Mayo Clinic Institutional Review Board. The data for all SARS-CoV-2-positive patients treated by our team were entered into a prospectively maintained internal research electronic data capture database. We searched this database retrospectively for the first 60 days of our program (March 23, 2020 to May 22, 2020). The data included basic deidentified demographics; symptoms at intake into the program; date of symptom onset; risk factors; location; and outcomes including hospitalization, admission to intensive care unit, and death.

RESULTS

Patients were contacted, on average, 6.3 hours after their results became available. There was a total of 138 ED visits. Of these, 40% were admitted to the hospital, with 36% of those admitted requiring intensive care unit level of care. Of the 849 patients in this sample, there were only 2 deaths (0.23%) at 60 days.

CONCLUSION

Our innovative multidisciplinary COVID team provided excellent clinical care for patients with COVID, with a very low mortality rate compared with the national average. Although data are not available on a national scale for time to contact patient, our team was able to contact patients within the established recommendation for contact within 48 hours of testing, which is optimal.

摘要

目的

研究一项为期60天的创新虚拟护理模式试点的影响,该模式利用普通内科医生和护士对1200多项2019冠状病毒病(COVID-19)阳性鼻咽聚合酶链反应检测结果做出快速反应。

患者与方法

本研究经梅奥诊所COVID-19研究委员会和梅奥诊所机构审查委员会批准。我们团队治疗的所有严重急性呼吸综合征冠状病毒2(SARS-CoV-2)阳性患者的数据被录入一个前瞻性维护的内部研究电子数据采集数据库。我们对该数据库进行回顾性搜索,以获取我们项目的前60天(2020年3月23日至2020年5月22日)的数据。数据包括基本的匿名人口统计学信息;进入项目时的症状;症状出现日期;风险因素;地点;以及包括住院、入住重症监护病房和死亡在内的结局。

结果

患者在结果可用后平均6.3小时就被联系上。总共有138次急诊就诊。其中,40%的患者入院,入院患者中有36%需要重症监护病房级别的护理。在这个样本的849名患者中,60天时仅有2例死亡(0.23%)。

结论

我们创新的多学科COVID团队为COVID患者提供了优质的临床护理,与全国平均水平相比死亡率非常低。虽然全国范围内没有关于联系患者时间的数据,但我们的团队能够在检测后48小时内按照既定的联系建议联系患者,这是最佳的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c70/7930790/06ce6aa34fc2/gr1.jpg

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