Evaluation of a virtual ward model of care and readmission characteristics during the COVID‐19 pandemic within an Australian tertiary hospital

Background Virtual ward (VW) models of care established during the coronavirus disease 2019 (COVID‐19) pandemic provided safe and equitable provision of ambulatory care for low‐risk patients; however, little is known about patients who require escalation of care to hospitals from VWs. Aim To assess...

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Veröffentlicht in:Internal medicine journal 2024-04, Vol.54 (4), p.551-558
Hauptverfasser: Farquhar, Drew, Choong, Keat, Anderson, James, Peters, Sandra, Subedi, Shradha
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container_title Internal medicine journal
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creator Farquhar, Drew
Choong, Keat
Anderson, James
Peters, Sandra
Subedi, Shradha
description Background Virtual ward (VW) models of care established during the coronavirus disease 2019 (COVID‐19) pandemic provided safe and equitable provision of ambulatory care for low‐risk patients; however, little is known about patients who require escalation of care to hospitals from VWs. Aim To assess our VW model of care and describe the characteristics of patients admitted to the hospital from the VW. Methods Observational study of all patients admitted to a tertiary hospital COVID‐19 VW between 1 December 2021 and 30 June 2022. Utilisation and epidemiological characteristics were assessed for all patients while additional demographics, assessments, treatments and outcomes were assessed for patients admitted to the hospital from the VW. Results Of 9494 patient admissions, 269 (2.83%) patients identified as Aboriginal and Torres Strait Islander and 1774 (18.69%) were unvaccinated. The median length of stay was 5.10 days and the mean Index of Relative Socio‐economic Advantage and Disadvantage decile was 5.73. One hundred sixty (1.69%) patients were admitted to the hospital from the VW, of which 25 were adults admitted to medical wards. Of this cohort, prominent comorbidities were obesity, hypertension, asthma and frailty, while the main symptoms on admission to the VW were cough, fatigue, nausea and sore throat. High Pandemic Respiratory Infection Emergency System Triage (PRIEST), Veterans Health Administration COVID‐19 (VACO), COVID Home Safely Now (CHOSEN) and 4C mortality scores existed for those readmitted. Conclusions This VW model of care was both safe and effective when applied to a broad socioeconomic population during the COVID‐19 pandemic. While readmission to the hospital was low, this study identified key characteristics of such presentations, which may assist future triaging, escalation and resource allocation within VWs during the COVID‐19 pandemic and beyond.
doi_str_mv 10.1111/imj.16302
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Aim To assess our VW model of care and describe the characteristics of patients admitted to the hospital from the VW. Methods Observational study of all patients admitted to a tertiary hospital COVID‐19 VW between 1 December 2021 and 30 June 2022. Utilisation and epidemiological characteristics were assessed for all patients while additional demographics, assessments, treatments and outcomes were assessed for patients admitted to the hospital from the VW. Results Of 9494 patient admissions, 269 (2.83%) patients identified as Aboriginal and Torres Strait Islander and 1774 (18.69%) were unvaccinated. The median length of stay was 5.10 days and the mean Index of Relative Socio‐economic Advantage and Disadvantage decile was 5.73. One hundred sixty (1.69%) patients were admitted to the hospital from the VW, of which 25 were adults admitted to medical wards. Of this cohort, prominent comorbidities were obesity, hypertension, asthma and frailty, while the main symptoms on admission to the VW were cough, fatigue, nausea and sore throat. High Pandemic Respiratory Infection Emergency System Triage (PRIEST), Veterans Health Administration COVID‐19 (VACO), COVID Home Safely Now (CHOSEN) and 4C mortality scores existed for those readmitted. Conclusions This VW model of care was both safe and effective when applied to a broad socioeconomic population during the COVID‐19 pandemic. While readmission to the hospital was low, this study identified key characteristics of such presentations, which may assist future triaging, escalation and resource allocation within VWs during the COVID‐19 pandemic and beyond.</description><identifier>ISSN: 1444-0903</identifier><identifier>ISSN: 1445-5994</identifier><identifier>EISSN: 1445-5994</identifier><identifier>DOI: 10.1111/imj.16302</identifier><identifier>PMID: 38064529</identifier><language>eng</language><publisher>Melbourne: John Wiley &amp; Sons Australia, Ltd</publisher><subject>Asthma ; Comorbidity ; Coronaviruses ; Cough ; COVID-19 ; Epidemiology ; escalation ; Pandemics ; Patients ; Pharyngitis ; readmission ; Resource allocation ; Respiratory tract infection ; telemedicine ; virtual ward</subject><ispartof>Internal medicine journal, 2024-04, Vol.54 (4), p.551-558</ispartof><rights>2023 Royal Australasian College of Physicians.</rights><rights>2024 Royal Australasian College of Physicians</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3132-67c8d8ed264c56a75dc5fe40f6c725c68c38b7f12051da4065a2a41acf6d85bc3</cites><orcidid>0009-0001-1227-1495 ; 0000-0002-6593-1717</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fimj.16302$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fimj.16302$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38064529$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farquhar, Drew</creatorcontrib><creatorcontrib>Choong, Keat</creatorcontrib><creatorcontrib>Anderson, James</creatorcontrib><creatorcontrib>Peters, Sandra</creatorcontrib><creatorcontrib>Subedi, Shradha</creatorcontrib><title>Evaluation of a virtual ward model of care and readmission characteristics during the COVID‐19 pandemic within an Australian tertiary hospital</title><title>Internal medicine journal</title><addtitle>Intern Med J</addtitle><description>Background Virtual ward (VW) models of care established during the coronavirus disease 2019 (COVID‐19) pandemic provided safe and equitable provision of ambulatory care for low‐risk patients; however, little is known about patients who require escalation of care to hospitals from VWs. Aim To assess our VW model of care and describe the characteristics of patients admitted to the hospital from the VW. Methods Observational study of all patients admitted to a tertiary hospital COVID‐19 VW between 1 December 2021 and 30 June 2022. Utilisation and epidemiological characteristics were assessed for all patients while additional demographics, assessments, treatments and outcomes were assessed for patients admitted to the hospital from the VW. Results Of 9494 patient admissions, 269 (2.83%) patients identified as Aboriginal and Torres Strait Islander and 1774 (18.69%) were unvaccinated. The median length of stay was 5.10 days and the mean Index of Relative Socio‐economic Advantage and Disadvantage decile was 5.73. One hundred sixty (1.69%) patients were admitted to the hospital from the VW, of which 25 were adults admitted to medical wards. Of this cohort, prominent comorbidities were obesity, hypertension, asthma and frailty, while the main symptoms on admission to the VW were cough, fatigue, nausea and sore throat. High Pandemic Respiratory Infection Emergency System Triage (PRIEST), Veterans Health Administration COVID‐19 (VACO), COVID Home Safely Now (CHOSEN) and 4C mortality scores existed for those readmitted. Conclusions This VW model of care was both safe and effective when applied to a broad socioeconomic population during the COVID‐19 pandemic. 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Aim To assess our VW model of care and describe the characteristics of patients admitted to the hospital from the VW. Methods Observational study of all patients admitted to a tertiary hospital COVID‐19 VW between 1 December 2021 and 30 June 2022. Utilisation and epidemiological characteristics were assessed for all patients while additional demographics, assessments, treatments and outcomes were assessed for patients admitted to the hospital from the VW. Results Of 9494 patient admissions, 269 (2.83%) patients identified as Aboriginal and Torres Strait Islander and 1774 (18.69%) were unvaccinated. The median length of stay was 5.10 days and the mean Index of Relative Socio‐economic Advantage and Disadvantage decile was 5.73. One hundred sixty (1.69%) patients were admitted to the hospital from the VW, of which 25 were adults admitted to medical wards. Of this cohort, prominent comorbidities were obesity, hypertension, asthma and frailty, while the main symptoms on admission to the VW were cough, fatigue, nausea and sore throat. High Pandemic Respiratory Infection Emergency System Triage (PRIEST), Veterans Health Administration COVID‐19 (VACO), COVID Home Safely Now (CHOSEN) and 4C mortality scores existed for those readmitted. Conclusions This VW model of care was both safe and effective when applied to a broad socioeconomic population during the COVID‐19 pandemic. 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subjects Asthma
Comorbidity
Coronaviruses
Cough
COVID-19
Epidemiology
escalation
Pandemics
Patients
Pharyngitis
readmission
Resource allocation
Respiratory tract infection
telemedicine
virtual ward
title Evaluation of a virtual ward model of care and readmission characteristics during the COVID‐19 pandemic within an Australian tertiary hospital
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