COVID-19 Surge Planning: Development and Implementation of an Allied Health Lead Clinical Care Pathway
Genevieve Juj1, Michelle Lin1, Sibin Mathew1, Aruska D’Souza1, Mark Putland1, Nicola Walsham1, Toni Withiel1, Marlena Klaic21The Royal Melbourne Hospital, Parkville, Victoria, Australia2The University of Melbourne, Parkville, Victoria, Australia
Abstract
Background: Reverse triaging is a model of care previously implemented in times of disaster to assist in managing demand in the emergency department setting. We aimed to describe the outcomes of the ‘COVID Community Navigator Team’ (CCNt), a reverse triage model spearheaded by Allied Health, and implemented in response to an increasing number of COVID-19 presentations during the COVID-19 pandemic.
Methods: A retrospective cohort study examined inpatient flow of people with COVID-19 who required CCNt input at The Royal Melbourne Hospital between 20th September 2021 and 20th February 2023.
Results: There were 2164 eligible patient encounters identified, with a workforce peaking at 36 Allied Health clinicians from varying backgrounds (Physiotherapists, Occupational Therapists, and Speech Pathologists). On average most patients referred to CCNt stayed 4.99 hours (SD = 4.57) in ED and the Short Stay Unit and were discharged into a ‘low risk pathway’. ED treating time reduced from 600 to 209 minutes 3 days after the inception of the CCN service in ED. CCNt initially provided 24/7 support during COVID surge however grew to encompass ward support. The greatest number of patients seen in a 24-hour was 22 with 16 of those serviced in the overnight shift. Overall, CCNt were able to facilitate safe & timely discharges, reduce the length of stay for medically stable COVID patients, and link patients in with appropriate supports for self-management at home.
Conclusion: Findings provide support for the clinical utility of an Allied Health led reverse triage approach and transdisciplinary care in surge planning.
Biography
Michelle Lin is a Speech Pathologist and COVID Community Navigator (CCNt) at the Royal Melbourne Hospital. She has a clinical interest in neurosciences and is passionate about using digital health to optimise healthcare.
Sibin Mathew is a Junior Physiotherapist at the Royal Melbourne Hospital, who has stepped up into the CCNt role. He has a special interest in transdisciplinary care in complex discharge planning.