Open AccessSystems Analysis of a Dedicated Ambulatory Respiratory Unit for Seeing and Ensuring Follow-up of Patients With COVID-19 Symptoms
Author(s) -
James C. Benneyan,
Tiantian White,
Nicole Nehls,
Tze Sheng Yap,
Mark D. Aronson,
Scot B. Sternberg,
Tim Anderson,
Kashika Goyal,
Julia Lindenberg,
Hans Kim,
Marc Cohen,
Russell S. Phillips,
Gordon D. Schiff
Publication year - 2021
Publication title -
the journal of ambulatory care management/journal of ambulatory care management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.639
H-Index - 39
eISSN - 1550-3267
pISSN - 0148-9917
DOI - 10.1097/jac.0000000000000390
Subject(s) - workflow , documentation , staffing , ambulatory , medical emergency , phone , ambulatory care , medicine , unit (ring theory) , covid-19 , computer science , nursing , psychology , health care , surgery , database , political science , linguistics , philosophy , mathematics education , disease , pathology , infectious disease (medical specialty) , law , programming language
COVID-19 necessitated significant care redesign, including new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. Opportunities also exist to harvest lessons from workflow innovations to benefit routine care. We describe a dedicated COVID-19 ambulatory unit for closing testing and follow-up loops characterized by standardized workflows and electronic communication, documentation, and order placement. More than 85% of follow-ups were completed within 24 hours, with no observed staff, nor patient infections associated with unit operations. Identified issues include role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns with phone screeners.