PMID- 35289365 OWN - NLM STAT- MEDLINE DCOM- 20220331 LR - 20220426 IS - 1464-3677 (Electronic) IS - 1353-4505 (Print) IS - 1353-4505 (Linking) VI - 34 IP - 1 DP - 2022 Mar 28 TI - Effect of a prioritization score on the inter-hospital transfer time management of severe COVID-19 patients: a quasi-experimental intervention study. LID - 10.1093/intqhc/mzac011 [doi] LID - mzac011 AB - BACKGROUND: The overburdening of the healthcare system during the coronavirus disease 19 (COVID-19) pandemic is driving the need to create new tools to improve the management of inter-hospital transport for patients with a severe COVID-19 infection. OBJECTIVE: The aim of this study was to analyse the usefulness of the application of a prioritization score (IHTCOVID-19) for inter-hospital transfer of patients with COVID-19 infection. METHODS: The study has a quasi-experimental design and was conducted on the Medical Emergency System, the pre-hospital emergency department of the public company belonging to the Autonomous Government of Catalonia that manages urgent healthcare in the region. Patients with a severe COVID-19 infection requiring inter-hospital transport were consecutively included. The pre-intervention period was from 1 to 31 March 2020, and the intervention period with the IHTCOVID-19 score was from 1 to 30 April 2020 (from 8 am to 8 pm). The prioritization score comprises four priority categories, with Priority 0 being the highest and Priority 3 being the lowest. Inter-hospital transfer (IHT) management times (alert-assignment time, resource management time and total central management time) and their variability were evaluated according to whether or not the IHTCOVID-19 score was applied. RESULTS: A total of 344 IHTs were included: 189 (54.9%) in the pre-intervention period and 155 (45.1%) in the post-intervention period. The majority of patients were male and the most frequent age range was between 50 and 70 years. According to the IHTCOVID-19 score, 12 (3.5%) transfers were classified as Priority 0, 66 (19.4%) as Priority 1, 247 (71.8%) as Priority 2 and 19 (5.6%) as Priority 3. Overall, with the application of the IHTCOVID-19 score, there was a significant reduction in total central management time [from 112.4 (inter-quartile range (IQR) 281.3) to 89.8 min (IQR 154.9); P = 0.012]. This significant reduction was observed in Priority 0 patients [286.2 (IQR 218.5) to 42.0 min (IQR 58); P = 0.018] and Priority 1 patients [130.3 (IQR 297.3) to 75.4 min (IQR 91.1); P = 0.034]. After applying the IHTCOVID-19 score, the average time of the process decreased by 22.6 min, and variability was reduced from 618.1 to 324.0 min. CONCLUSION: The application of the IHTCOVID-19 score in patients with a severe COVID-19 infection reduces IHT management times and variability. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Sola-Munoz, Silvia AU - Sola-Munoz S AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. AD - Sociedad Espanola de Medicina de Urgencias y Emergencias, Red de Investigacion de Emergencias Prehospitalarias RINVEMER, nunez de balboa 116 3 degrees office 9, Madrid 28020, Spain. FAU - Azeli, Youcef AU - Azeli Y AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. AD - Sociedad Espanola de Medicina de Urgencias y Emergencias, Red de Investigacion de Emergencias Prehospitalarias RINVEMER, nunez de balboa 116 3 degrees office 9, Madrid 28020, Spain. AD - Hospital Universitari Sant Joan de Reus, Institut d'Investigacio Sanitaria Pere Virgili (IISPV), Avda, Josep Laporte, 2 Planta 0 - E2 color taronja, Reus, Tarragona 43204, Spain. FAU - Trenado, Josep AU - Trenado J AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. AD - Intensive Care Unit, Hospital Universitari Mutua de Terrassa, Placa del Doctor Robert, 5, Terrassa, Barcelona 08221, Spain. FAU - Jimenez, Xavier AU - Jimenez X AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. AD - Sociedad Espanola de Medicina de Urgencias y Emergencias, Red de Investigacion de Emergencias Prehospitalarias RINVEMER, nunez de balboa 116 3 degrees office 9, Madrid 28020, Spain. FAU - Bisbal, Roger AU - Bisbal R AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Lopez, Angels AU - Lopez A AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Morales, Jorge AU - Morales J AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Garcia, Xaime AU - Garcia X AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Sanchez, Bernat AU - Sanchez B AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Fernandez, Jose AU - Fernandez J AD - Fundacio Institut Universitari per a la recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), Av. Colom 16-20, Tortosa, Tarragona 43500, Spain. AD - Unidat de Recerca, Gerencia Territorial Terres de l Ebre, Institut Catala de la Salut, Ctra. de la Simpatica, 44, Tortosa, Tarragona 43500, Spain. FAU - Soto, Maria Angeles AU - Soto MA AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Ferreres, Yolanda AU - Ferreres Y AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Cantero, Cristina AU - Cantero C AD - Area of Research and Development, Clinical Department, Sistema d'Emergencies Mediques de Catalunya, C. Pablo Iglesias 101-155, L'Hospitalet de Llobregat, Barcelona 08908, Spain. FAU - Jacob, Javier AU - Jacob J AD - Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Universitat de Barcelona, Carrer de la Feixa Llarga, s/n, Barcelona 08907, Spain. LA - eng PT - Journal Article PL - England TA - Int J Qual Health Care JT - International journal for quality in health care : journal of the International Society for Quality in Health Care JID - 9434628 SB - IM CIN - Int J Qual Health Care. 2022 Apr 28;34(2):. PMID: 35470859 MH - Aged MH - *COVID-19/epidemiology MH - Female MH - Hospitals MH - Humans MH - Male MH - Middle Aged MH - Time Management PMC - PMC8992311 OTO - NOTNLM OT - COVID-19 OT - critical illness OT - dispatch centre OT - emergency care OT - triage management EDAT- 2022/03/16 06:00 MHDA- 2022/04/01 06:00 PMCR- 2022/03/15 CRDT- 2022/03/15 08:43 PHST- 2021/10/04 00:00 [received] PHST- 2022/02/21 00:00 [revised] PHST- 2022/03/12 00:00 [accepted] PHST- 2022/03/16 06:00 [pubmed] PHST- 2022/04/01 06:00 [medline] PHST- 2022/03/15 08:43 [entrez] PHST- 2022/03/15 00:00 [pmc-release] AID - 6548674 [pii] AID - mzac011 [pii] AID - 10.1093/intqhc/mzac011 [doi] PST - ppublish SO - Int J Qual Health Care. 2022 Mar 28;34(1):mzac011. doi: 10.1093/intqhc/mzac011.