Atrium Health's Carolinas Medical Center, Charlotte, NC, USA.
Disaster Med Public Health Prep. 2022 Oct;16(5):2076-2082. doi: 10.1017/dmp.2021.46. Epub 2021 Feb 16.
In this manuscript, we discuss the implementation and deployment of mobile integrated health and community paramedicine (MIH/CP) testing sites to provide screening, testing, and community outreach during the first months of the 2019 coronavirus disease (COVID-19) pandemic in the metropolitan region of Charlotte, North Carolina. This program addresses the need for an agile testing strategy during the current pandemic. We disclose the number of patients evaluated as "persons under investigation" and the proportion with positive severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) results from these sites. We describe how the programs were applied to patient care and include considerations on how additional staffing, scalability, and flexibility of these services may be applied to future patient and health care crises.
This is a descriptive report of the implementation of MIH/CP test sites in our health care system's early response to the COVID-19 pandemic in March 2020. Retrospective data on the number of patients and their associated demographics are reported here as raw data. No statistical analysis was performed.
Between March 15, 2020, and April 15, 2020, our 6 MIH/CP test sites evaluated 4342 patients. Of these, 401 patients (9.2%) had positive test results, 62.8% of whom were women. The estimated duration of each patient encounter under investigation was 3 to 5 minutes. The paramedics were able to perform a brief history, specific physical examination, and screening for signs of hypoxemic respiratory failure. There were no cases of accidental exposure or failure of personal protective equipment for the MIH/CP paramedics.
In our health care system, we pivoted the traditional MIH/CP model to rapidly initiate remote drive-through testing for COVID-19 in pre-screened individuals. This model allowed us to test patients with suspected COVID-19 patients away from traditional health care sites and mitigate exposure to health care workers and other patients.
本文讨论了移动综合健康和社区医疗(MIH/CP)检测站点的实施和部署,以在北卡罗来纳州夏洛特大都市地区 2019 年冠状病毒病(COVID-19)大流行的头几个月提供筛查、检测和社区外展服务。该计划满足了当前大流行期间对灵活检测策略的需求。我们披露了在这些站点评估为“待调查人员”的患者人数以及 SARS-CoV-2 检测呈阳性的比例。我们描述了这些计划如何应用于患者护理,并探讨了如何在未来的患者和医疗保健危机中应用这些服务的额外人员配备、可扩展性和灵活性。
这是我们的医疗系统在 2020 年 3 月对 COVID-19 大流行做出早期反应时实施 MIH/CP 检测站点的描述性报告。这里报告的是患者人数及其相关人口统计学数据的原始数据,未进行统计分析。
在 2020 年 3 月 15 日至 2020 年 4 月 15 日期间,我们的 6 个 MIH/CP 检测站点评估了 4342 名患者。其中,401 名患者(9.2%)检测结果呈阳性,其中 62.8%为女性。每个待调查患者的估计就诊时间为 3 至 5 分钟。护理人员能够进行简要病史、特定体格检查和低氧呼吸衰竭筛查。MIH/CP 护理人员没有发生意外暴露或个人防护设备故障的情况。
在我们的医疗系统中,我们将传统的 MIH/CP 模式转变为对预先筛选的个体进行快速远程驾驶测试 COVID-19。这种模式使我们能够对疑似 COVID-19 患者进行测试,而无需在传统医疗保健场所进行,并减少医护人员和其他患者的暴露风险。