Effective Response to a Regional Outbreak of COVID-19: Experience of a Tertiary Emergency Center

Moon, Sungbae; Ryoo, Hyun Wook; Cho, Jae Wan; Jung, Haewon

OBJECTIVE: This study evaluates the usefulness, safety, and outcomes of operating a pretriage screening clinic and an expanded preemptive quarantine area in the emergency department (ED) during a regional coronavirus disease 2019 (COVID-19) outbreak. METHODS: A descriptive cross-sectional, retrospective study conducted in a single institution. General patient demographic data, initial vital sign, symptoms, and patient outcome was collected from January to March of 2020. Data were compared according to the implementation of a new protocol involving pretriage screening and risk stratification. Outcome was also analyzed according to quarantine areas, including conventional, negative pressured, cohort, or preemptive quarantine area. RESULTS: The pretriage clinic lowered the volume of low severity patients entering emergency department. Preemptive and cohort quarantine area provided more care to febrile patients compared with conventional quarantine area with longer length of hospital stay and lower mortality. After implementing the new protocol, emergency department in the study hospital was not closed again. CONCLUSIONS: In a regional outbreak of an epidemic, pretriage clinic safely screened infectious patients from entering ED. Expanded preemptive quarantine area increased surge capacity on quarantine area. An infectious disease protocol implementing 2 treatment areas may contribute to preserve and maintain ED function.