Effect of a Prioritization Score on the Inter-hospital Transfer Time Management of Severe COVID-19 Patients: a Quasi-experimental Intervention Study

Overview

Journal Int J Qual Health Care

Publisher Oxford University Press

Specialty Health Services

Date 2022 Mar 15

PMID 35289365

Authors

Silvia Sola-Munoz

Youcef Azeli

Josep Trenado

Xavier Jimenez

Roger Bisbal

Angels Lopez

Jorge Morales

Xaime Garcia

Bernat Sanchez

Jose Fernandez

Maria Angeles Soto

Yolanda Ferreres

Cristina Cantero

Javier Jacob

Affiliations

Soon will be listed here.

Abstract

Background: The overburdening of the healthcare system during the coronavirus disease 19 (COVID-19) pandemic is driving the need to create new tools to improve the management of inter-hospital transport for patients with a severe COVID-19 infection.

Objective: The aim of this study was to analyse the usefulness of the application of a prioritization score (IHTCOVID-19) for inter-hospital transfer of patients with COVID-19 infection.

Methods: The study has a quasi-experimental design and was conducted on the Medical Emergency System, the pre-hospital emergency department of the public company belonging to the Autonomous Government of Catalonia that manages urgent healthcare in the region. Patients with a severe COVID-19 infection requiring inter-hospital transport were consecutively included. The pre-intervention period was from 1 to 31 March 2020, and the intervention period with the IHTCOVID-19 score was from 1 to 30 April 2020 (from 8 am to 8 pm). The prioritization score comprises four priority categories, with Priority 0 being the highest and Priority 3 being the lowest. Inter-hospital transfer (IHT) management times (alert-assignment time, resource management time and total central management time) and their variability were evaluated according to whether or not the IHTCOVID-19 score was applied.

Results: A total of 344 IHTs were included: 189 (54.9%) in the pre-intervention period and 155 (45.1%) in the post-intervention period. The majority of patients were male and the most frequent age range was between 50 and 70 years. According to the IHTCOVID-19 score, 12 (3.5%) transfers were classified as Priority 0, 66 (19.4%) as Priority 1, 247 (71.8%) as Priority 2 and 19 (5.6%) as Priority 3. Overall, with the application of the IHTCOVID-19 score, there was a significant reduction in total central management time [from 112.4 (inter-quartile range (IQR) 281.3) to 89.8 min (IQR 154.9); P = 0.012]. This significant reduction was observed in Priority 0 patients [286.2 (IQR 218.5) to 42.0 min (IQR 58); P = 0.018] and Priority 1 patients [130.3 (IQR 297.3) to 75.4 min (IQR 91.1); P = 0.034]. After applying the IHTCOVID-19 score, the average time of the process decreased by 22.6 min, and variability was reduced from 618.1 to 324.0 min.

Conclusion: The application of the IHTCOVID-19 score in patients with a severe COVID-19 infection reduces IHT management times and variability.

Citing Articles

Experiences of Inter-Hospital Transfers (IHT) by Patients and Relatives during the COVID-19 Pandemic in France: A Qualitative Study.

Chauliac N, Salome G, Cheucle J, Cochennec De Biase L, Galia P, Thomas A Int J Environ Res Public Health. 2023; 20(5).

PMID: 36901672 PMC: 10001538. DOI: 10.3390/ijerph20054660.

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