Door-to-door strategies - A study of healthcare strategies for managing patients, from home to the emergency department during the pandemic.

Abstract

BackgroundThis study aimed investigate and document organizational strategies in prehospital care when dealing with the challenge of assessing patients with suspected COVID-19 when transporting and triaging patients for hospital admission.MethodsData about door-to-door management, i.e., from their homes to the entrance door of an emergency department, of suspected COVID-19 patients, were collected from 50 participants, recruited from staff from Temporary Triage and Treatment areas (TTTs) located outside the hospital emergency departments and ambulance services in Sweden, Poland, and the United States. The data were, analyzed and subjected to a thematic analysis based on the CSCATT framework, i.e. (Command and Control, Safety, Communication, Assessment, Triage, Treatment, and Transport).ResultsThe results revealed a successful collaboration within the healthcare organizations. Team roles were, according to the respondents, distributed efficiently, and staff participated actively in the workflow. Challenges included a shortage of training, and preparedness, inadequate facilities, insufficient facility preparedness, and, at times, a fear of working with COVID-19 patients. Excessive guidelines, frequently changing protocols, and the constant release of new information were other challenges.ConclusionThe conclusion emphasizes the importance of proactive measures, such as robust contingency plans, education, and information dissemination. Future strategies should focus on developing robust, scalable models that can be rapidly deployed. This includes investing in diagnostic tools, enhancing the production capabilities for essential medical supplies, and ensuring a streamlined supply chain. Future healthcare strategies can be more resilient, responsive, and equipped to manage public health emergencies effectively.