Study evaluates drive-through examinations as a viable alternative during a pandemic
Drive-through medical service is an idea you’ve probably heard of before. It may even be something you’ve tried at your facility. Previously in this space we’ve referenced drive-through flu shots and car waiting rooms as creative and viable options for pandemic preparedness.
But you probably haven’t seen this novel approach as part of a legitimate study. Researchers at the Department of Surgery/Division of Emergency Medicine at Stanford (CA) University School of Medicine studied this alternative process by evaluating simulated drive-through care at Stanford Hospital ED.
Researchers conducted a “full-scale exercise” that tested both the throughput times of simulated patients as well as carbon monoxide levels of staff. The study used charts from 38 patients who were previously treated in the ED for influenza-like illnesses during the H1N1 outbreak in April 2009.
During the simulated exercise physicians identified patients that required hospitalization with 100% accuracy. Furthermore there were no significant increases in carboxyhemoglobin in staff members.
A schematic graphic of the drive-through clinic is included on page three of the brief, but below is a quick overview of the setup:
- Vehicles were initially screened by a nurse under a canopy. Patients who had flu symptoms, but were deemed stable, were sent to the drive-through. The remaining patients were sent to the ED.
- Vehicles were then directed to one of two triage stations which were staffed by an ED
registered nurse who measured blood pressure, pulse, respiratory rate, temperature, and oxygen saturation. - The third stop included a full physical medical examination screening from an ED physician. At this stop patients were required to step out of their car an be physically evaluated in a screened and heated tent.
- The final stop was a discharge station, staffed by a registered nurse who would dispense drugs or give discharge instructions.
- Staff involved with patient care wore a N95 respirator, a gown, and gloves that were changed after each patient.
The entire exercise was conducted in three hours. The total median length of stay was 26 minutes for each patient.
The report notes that this exercise was merely a simulation and did not account for emergencies, interruptions, and included “actors who waited patiently in their cars.” Results may have also been different if the drive-through was full rather than initiated as a start-up, or if staff members were not aware they were being timed.
Regardless, it does provide verifiable evidence that this emergency pandemic plan could be feasible in certain situations. Is this something that your facility would consider? Let us know in the space below.
You can also access free pandemic-related downloads in the Pandemic Planning section of the Tools page, including a new Cold and Flu Symptom Survey.
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Comments
I would be interested in the percentage of accuracy for the patients that were discharged.
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