To address coronavirus-related capacity management challenges, a care delivery model has been designed and implemented using an algorithm and alternate workflow to limit inpatient care and use a Covid-19 ED observation unit for patients well-suited to recover at home.
Summary To care for an increasing number of symptomatic Covid-19 patients who seek care at the Hospital of the University of Pennsylvania (HUP) Emergency Department (ED), the interdisciplinary team at HUP developed a Covid-19 short-stay pathway. This pathway aims to identify and provide protocolized, high-efficiency, high-quality care for patients who are not suitable for discharge directly from the ED due to medical or social needs that can be addressed relatively quickly, within 48 hours. The authors report their experience with the first 51 patients who were cared for via this pathway during its inaugural 5-week period, from December 14, 2020, to January 18, 2021. In that time, the average hospital length of stay for Covid-19 patients through this pathway was approximately 23 hours, leading to more than 1,220 hours of inpatient bed-hours saved, attributable to the Emergency Department Observation Unit disposition instead of inpatient admission.