COVID-19 Screening and Triage Using a Unified Approach to the Management of Relevant Healthcare Workers，Procedure and Goals within a Regional Medical Consortium：a Development from Disorderly to Orderly

doi:10.12114/j.issn.1007-9572.2020.00.545

Abstract

Abstract: Background　It was difficult for primary care to take emergency actions to contain COVID-19 at the beginning of its outbreak，and the management of screening and triage procedure was disorderly. To address the situation，it is critical to make a sound management method for appropriately screening，triage，treat and transfer the patients. Objective　To evaluate the effect of an approach for unified management of COVID-19 screening and triage in members within a regional medical consortium. Methods　This study was carried out in a regional medical consortium with five unified features including unified goal，legal person，information platform，service team and salary scheme. An approach developed by our research group，has been used for unified management（of relevant goals，healthcare workers and procedure） of COVID-19 screening and triage in this consortium led by a tertiary hospital，together with 18 stations of a community health center，and the implementation results between January 25 and April 4，2020 were analyzed. Results　During this period，of the 173 841 cases screened and triaged in the tertiary hospital，440 were triaged to the COVID-19 fever clinic，2 051 to the general fever clinic，271 to the quarantine ward due to suspected COVID-19 symptoms，and 4 were confirmed and referred to the designated hospital. The 18 stations of community heath centers screened and triaged 52 525 cases，including 25 who were triaged to the COVID-19 fever clinic，and 122 to the general fever clinic. There were no missed screening of suspected COVID-19 cases and cross infections within the medical consortium. Conclusion　Our unified management approach has effectively facilitated the development of COVID-19 screening and triage from disorderly to orderly within the regional medical consortium，demonstrating good effects in containing the COVID-19 pandemic.

Key words: COVID-19, Coronavirus infections, Communicable disease control, Medical consortium, Triage management

摘要： 背景　新型冠状病毒肺炎（新冠肺炎）疫情暴发，基层医疗卫生机构紧急应对，初期预检分诊管理混沌无序。如何精准预检分诊流程、正确安排患者就诊和转诊是疫情防控的关键。目的　探索新冠肺炎医共体预检分诊管理模式。方法　于2020-01-25至2020-04-04，通过发挥具有五统一（统一目标、法人、信息平台、服务团队和薪酬方案）特征的医共体内1家三级医院牵头作用，联动社区卫生服务中心18个站点，对新冠肺炎预检分诊进行统一管理，包括统一预检分诊目标、统一和迭代预检分诊人员管理、统一和迭代预检分诊工作流程。结果　医共体内三级医院累计预检分诊173 841例，其中特殊发热门诊患者440例，普通发热门诊患者2 051例，新冠肺炎疑似患者收治隔离区271例，确诊新冠肺炎并转诊患者4例；社区卫生服务中心18个站点累计预检分诊52 525例，其中特殊发热门诊患者25例，普通发热门诊患者122例。期间，医共体内新冠肺炎疑似患者零漏检、交叉感染零发生。结论　医共体三统一预检分诊管理模式有效促进新冠肺炎预检分诊从混沌向有序转化，在疫情防控中发挥重要作用。

关键词: 新型冠状病毒肺炎, 冠状病毒感染, 传染病控制, 医共体, 预检分诊管理

XIONG Ziyu,CHEN Yanfang,ZHANG Yinglan, et al. COVID-19 Screening and Triage Using a Unified Approach to the Management of Relevant Healthcare Workers，Procedure and Goals within a Regional Medical Consortium：a Development from Disorderly to Orderly　[J]. Chinese General Practice, 2020, 23(31): 3912-3916. DOI: 10.12114/j.issn.1007-9572.2020.00.545.
熊紫玉,陈彦芳,张颖兰等. 新型冠状病毒肺炎疫情期间从混沌到有序的医共体三统一预检分诊管理实践[J]. 中国全科医学, 2020, 23(31): 3912-3916. DOI: 10.12114/j.issn.1007-9572.2020.00.545.

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