Reverse triage in COVID surge planning: a case study of an allied health supported clinical care pathway in an acute hospital setting

Abstract

Objective. This case study describes the development and outcomes of a new integrated and multidisciplinary care pathway. Spearheaded by allied health, the ‘COVID community navigator team’, applied established principles of reverse triage to create additional surge capacity. Methods. A retrospective cohort study examined workflow patterns using electronic medical records of patients who received navigator input at the Royal Melbourne Hospital between 20 September 2021 and 20 December 2021. Results. There were 437 eligible patient encounters identified. On average patients stayed 4.15 h in the emergency departments (ED) (s.d. = 4.31) and 9.5 h (s.d. = 10.9) in the short stay unit. Most patients were discharged into a ‘low risk pathway’ with community general practitioner follow up. Of discharged patients, only 38 re-presented to the ED with symptoms related to their initial COVID-19 diagnosis (34.9% of total re-admissions). Of these re-admissions, more than half did not require admission to a ward. Conclusion. The findings presented here provide support for the clinical utility of a multidisciplinary reverse triage approach in surge planning for anticipated presentation peaks.