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Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway - 01/09/20

Doi : 10.1016/j.urology.2020.04.059 
Alex Borchert, Lee Baumgarten , Deepansh Dalela, Marcus Jamil, Jeffrey Budzyn, Natalija Kovacevic, Grace Yaguchi, Isaac Palma-Zamora, Sara Perkins, Mahdi Bazzi, Phil Wong, Akshay Sood, James Peabody, Craig G. Rogers, Ali Dabaja, Humphrey Atiemo
 Vattikutti Urology Institute, Henry Ford Hospital, Detroit, MI 

Address correspondence to: Lee Baumgarten, M.D., Vattikuti Urology Institute, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202.Vattikuti Urology InstituteHenry Ford Hospital2799 W Grand BlvdDetroitMI48202

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Abstract

Objective

To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care.

Materials and Methods

Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value <.05 was considered significant.

Results

Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection.

Conclusion

During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.

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 Funding: None.
 Disclosure: None of the authors have any relevant disclosures, and none of the authors have any financial or non-financial interests that may be relevant to the submitted work.


© 2020  Elsevier Inc. Reservados todos los derechos.
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Vol 141

P. 7-11 - juillet 2020 Regresar al número
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