University of Washington Department of Family Medicine, Seattle, WA, USA.
Skagit Regional Health, Mount Vernon, WA, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221085374. doi: 10.1177/21501319221085374.
The emergence of the COVID-19 pandemic and subsequent public health mitigation strategies resulted in rapid and significant changes to delivery of primary care. The field of primary care faced an unprecedented dual challenge of providing routine care to patients while ensuring patient and staff safety and managing patients with a highly transmissible disease. This study describes how a diverse group of primary care practices addressed these challenges at the start of the COVID-19 pandemic, in Spring 2020.
A cross-sectional electronic survey of representatives from primary care practices in the WWAMI region Practice and Research Network (WPRN). Survey topics included clinical workforce, operations, and use of telemedicine in the first 3 months of the COVID-19 pandemic.
To safely manage patients with COVID-19 symptoms all clinics modified operations; 81.3% diverted patients with respiratory symptoms to a telemedicine evaluation, 68.8% diverted these patients to be seen in-person at another location, and 75% made in-clinic changes to maintain safety. The set of operational changes employed by clinics was diverse. To continue to provide routine patient care, all clinics employed telemedicine. Over 80% of clinics had never used telemedicine prior to March 2020.
A diverse group of primary care clinics all rapidly implemented a variety of operational adaptations to address patient needs and maintain patient and staff safety at the onset of the COVID- 19 pandemic. Telemedicine, together with other measures, provided critical pathways for maintaining delivery of care.
COVID-19 大流行的出现以及随后的公共卫生缓解策略导致初级保健服务迅速发生重大变化。初级保健领域面临着前所未有的双重挑战,既要为患者提供常规护理,又要确保患者和员工的安全,还要管理患有高传染性疾病的患者。本研究描述了在 COVID-19 大流行开始时,即 2020 年春季,一个多样化的初级保健实践小组如何应对这些挑战。
对 WWAMI 地区实践和研究网络(WPRN)的初级保健实践代表进行了横断面电子调查。调查主题包括临床劳动力、运营以及在 COVID-19 大流行的前 3 个月中使用远程医疗的情况。
为了安全管理有 COVID-19 症状的患者,所有诊所都修改了运营方式;81.3%将有呼吸道症状的患者分流到远程医疗评估,68.8%将这些患者分流到其他地方进行现场就诊,75%在诊所内进行更改以保持安全。诊所采用的运营变更组合多种多样。为了继续提供常规患者护理,所有诊所都采用了远程医疗。在 2020 年 3 月之前,超过 80%的诊所从未使用过远程医疗。
一组多样化的初级保健诊所都迅速实施了各种运营适应措施,以满足患者的需求并在 COVID-19 大流行开始时维护患者和员工的安全。远程医疗与其他措施一起,为维持护理提供了关键途径。