Establishing a standardized FUO emergency department: design and practice in dealing with COVID-19

Construction of a 5G-based, three-dimensional, and efficiently connected emergency medical management system

Background

Shenzhen is unique in its need for ad hoc responses to emergencies. The need for emergency medicine also demonstrates a trend of sustained growth.

Objective

A three-dimensional and efficiently connected emergency medical management model using fifth generation mobile communication technology (5G) was established to improve the efficiency and level of management in emergency medicine.

Method

A mixed-frequency band private network collaborative emergency treatment mode was built under daily emergency scenarios using 5G. The efficiency of a three-dimensional telemedicine treatment mode was tested using prehospital emergency medicine. Also, the feasibility of quickly establishing a temporary network information system using unmanned aerial vehicle (UAV) and/or high-throughput communication satellites under disaster-caused power outages and network interruptions was examined. A monitoring system was constructed for suspected cases using 5G amid public health emergencies, which raised the Emergency Department's efficiency and security in responding to the pandemic.

Results

The three-dimensional rescue system supported by 5G showed that the radius of the emergency medical rescue services expanded from 5 to 60 km, and the cross-district emergency reaction time reduced from 1 h to <20 min. Thus, it was feasible to construct a communication network expeditiously with devices carried by UAV under disastrous scenarios. The system developed based on 5G could be used in managing suspected cases of public emergencies. Among the 134 suspected cases in the early stage of the pandemic, no nosocomial infection was detected.

Conclusion

A three-dimensional, efficiently connected emergency medical management system based on 5G was constructed, following which the emergency rescue radius quickly expanded and the emergency response time reduced. Thus, with the aid of new technology, an emergency information network system was built expeditiously under specific scenarios, such as a natural disaster, and the level of management under public health emergencies advances. The confidentiality of patient information is a critical issue regarding the application of new technology.

Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic has strongly affected the dynamics of Emergency Departments (EDs) worldwide and has accentuated the need for tackling different operational inefficiencies that decrease the quality of care provided to infected patients. The EDs continue to struggle against this outbreak by implementing strategies maximizing their performance within an uncertain healthcare environment. The efforts, however, have remained insufficient in view of the growing number of admissions and increased severity of the coronavirus disease. Therefore, the primary aim of this paper is to review the literature on process improvement interventions focused on increasing the ED response to the current COVID-19 outbreak to delineate future research lines based on the gaps detected in the practical scenario. Therefore, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform a review containing the research papers published between December 2019 and April 2021 using ISI Web of Science, Scopus, PubMed, IEEE, Google Scholar, and Science Direct databases. The articles were further classified taking into account the research domain, primary aim, journal, and publication year. A total of 65 papers disseminated in 51 journals were concluded to satisfy the inclusion criteria. Our review found that most applications have been directed towards predicting the health outcomes in COVID-19 patients through machine learning and data analytics techniques. In the overarching pandemic, healthcare decision makers are strongly recommended to integrate artificial intelligence techniques with approaches from the operations research (OR) and quality management domains to upgrade the ED performance under social-economic restrictions.

Lean-ing Method in an Emergency Department of the Italian Epicenter of the COVID-19 Outbreak: When the Algorithm Makes Difference

The Lean method entails a set of standardized processes intending to optimize resources, reduce waste, and improve results. Lean has been proposed as an operative model for the COVID-19 outbreak. Herein, we summarized data resulted from the Lean model adoption in an Emergency Department of the Lombardy region, the Italian epicenter of the pandemic, to critically appraise its effectiveness and feasibility. The Lean algorithm was applied in the Humanitas Clinical and Research Hospital, Milan, north of Italy. At admission, patients underwent outdoor pre-triage for fever, respiratory, and gastrointestinal symptoms, with a focus on SpO2. Based on these data, they were directed to the most appropriate area for the COVID-19 first-level screening. High-risk patients were assisted by trained staff for second-level screening and planning of treatment. Out of 7.778 patients, 21.9% were suspected of SARS-CoV-2 infection. Mortality was 21.9% and the infection rate in health workers was 4.8%. The lean model has proved to be effective in optimizing the overall management of COVID-19 patients in an emergency setting. It allowed for screening of a large volume of patients, while also limiting the health workers’ infection rate. Further studies are necessary to validate the suggested approach.