Emergency center curbside screening during the COVID-19 pandemic: Retrospective cohort study

Abstract

Background: Coronavirus disease (COVID-19) is a global pandemic that has placed a significant burden on health care systems in the United States. Michigan has been one of the top states affected by COVID-19. Objective: We describe the emergency center curbside testing procedure implemented at Beaumont Hospital, a large hospital in Royal Oak, MI, and aim to evaluate its safety and efficiency. Methods: Anticipating a surge in patients requiring testing, Beaumont Health implemented curbside testing, operated by a multidisciplinary team of health care workers, including physicians, advanced practice providers, residents, nurses, technicians, and registration staff. We report on the following outcomes over a period of 26 days (March 12, 2020, to April 6, 2020): time to medical decision, time spent documenting electronic medical records, overall screening time, and emergency center return evaluations. Results: In total, 2782 patients received curbside services. A nasopharyngeal swab was performed on 1176 patients (41%), out of whom 348 (29.6%) tested positive. The median time for the entire process (from registration to discharge) was 28 minutes (IQR 17-44). The median time to final medical decision was 15 minutes (IQR 8-27). The median time from medical decision to discharge was 9 minutes (IQR 5-16). Only 257 patients (9.2%) returned to the emergency center for an evaluation within 7 or more days, of whom 64 were admitted to the hospital, 11 remained admitted, and 4 expired. Conclusions: Our curbside testing model encourages the incorporation of this model at other high-volume facilities during an infectious disease pandemic.