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 |
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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 |
format | Article |
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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.</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 & 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. 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><subject>Asthma</subject><subject>Comorbidity</subject><subject>Coronaviruses</subject><subject>Cough</subject><subject>COVID-19</subject><subject>Epidemiology</subject><subject>escalation</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Pharyngitis</subject><subject>readmission</subject><subject>Resource allocation</subject><subject>Respiratory tract infection</subject><subject>telemedicine</subject><subject>virtual ward</subject><issn>1444-0903</issn><issn>1445-5994</issn><issn>1445-5994</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kUtOHDEQhi1EFB7JggtEltiERYPf3b1EE0gmImIT2Fo1tjvjkbt7YrsZseMInDEniYchWURKbapkffXJpR-hE0rOaakL36_OqeKE7aFDKoSsZNuK_ZdZVKQl_AAdpbQihNa8FW_RAW-IEpK1h-j56gHCBNmPAx47DPjBxzxBwBuIFvejdWH7biA6DIPF0YHtfUpb3iwhgsku-pS9SdhO0Q8_cF46PLu9n3_69fRMW7wua673Bm98XvqhWPDllHKE4MtYtrOH-IiXY1r7DOEdetNBSO79az9Gd9dX32dfqpvbz_PZ5U1lOOWsUrVpbOMsU8JIBbW0RnZOkE6ZmkmjGsObRd1RRiS1IIiSwEBQMJ2yjVwYfow-7rzrOP6cXMq6nGVcCDC4cUqatYS1iglBC3r6D7oapziU32lOBGlUowgr1NmOMnFMKbpOr6Pvy2maEr2NSZeY9EtMhf3wapwWvbN_yT-5FOBiB2x8cI__N-n5t6875W85-J44</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Farquhar, Drew</creator><creator>Choong, Keat</creator><creator>Anderson, James</creator><creator>Peters, Sandra</creator><creator>Subedi, Shradha</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0001-1227-1495</orcidid><orcidid>https://orcid.org/0000-0002-6593-1717</orcidid></search><sort><creationdate>202404</creationdate><title>Evaluation of a virtual ward model of care and readmission characteristics during the COVID‐19 pandemic within an Australian tertiary hospital</title><author>Farquhar, Drew ; Choong, Keat ; Anderson, James ; Peters, Sandra ; Subedi, Shradha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3132-67c8d8ed264c56a75dc5fe40f6c725c68c38b7f12051da4065a2a41acf6d85bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Asthma</topic><topic>Comorbidity</topic><topic>Coronaviruses</topic><topic>Cough</topic><topic>COVID-19</topic><topic>Epidemiology</topic><topic>escalation</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Pharyngitis</topic><topic>readmission</topic><topic>Resource allocation</topic><topic>Respiratory tract infection</topic><topic>telemedicine</topic><topic>virtual ward</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farquhar, Drew</creatorcontrib><creatorcontrib>Choong, Keat</creatorcontrib><creatorcontrib>Anderson, James</creatorcontrib><creatorcontrib>Peters, Sandra</creatorcontrib><creatorcontrib>Subedi, Shradha</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Internal medicine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farquhar, Drew</au><au>Choong, Keat</au><au>Anderson, James</au><au>Peters, Sandra</au><au>Subedi, Shradha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of a virtual ward model of care and readmission characteristics during the COVID‐19 pandemic within an Australian tertiary hospital</atitle><jtitle>Internal medicine journal</jtitle><addtitle>Intern Med J</addtitle><date>2024-04</date><risdate>2024</risdate><volume>54</volume><issue>4</issue><spage>551</spage><epage>558</epage><pages>551-558</pages><issn>1444-0903</issn><issn>1445-5994</issn><eissn>1445-5994</eissn><abstract>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.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>38064529</pmid><doi>10.1111/imj.16302</doi><tpages>8</tpages><orcidid>https://orcid.org/0009-0001-1227-1495</orcidid><orcidid>https://orcid.org/0000-0002-6593-1717</orcidid></addata></record> |
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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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