Evidence map›Paper›PMID 36570369›Full record

ArticleJournal of the American College of Emergency Physicians open2022

Effectiveness, safety, and efficiency of a drive-through care model as a response to the COVID-19 testing demand in the United States.

Shashank Ravi, Anna Graber-Naidich, Stefanie S Sebok-Syer, Ian Brown, Patrice Callagy, Karen Stuart, Ryan Ribeira, Laleh Gharahbaghian, Sam Shen, Vandana Sundaram and 1 more

Abstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Changes in low-acuity patient volume in an emergency department after launching a walk-in clinic.Journal of the American College of Emergency Physicians open · 2023
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shashank RaviDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Anna Graber-NaidichQuantitative Sciences Unit Stanford University Palo Alto California USA.
Stefanie S Sebok-SyerDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Ian BrownDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Patrice CallagyEmergency Services Stanford Health Care Palo Alto California USA.
Karen StuartEmergency Services Stanford Health Care Palo Alto California USA.
Ryan RibeiraDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Laleh GharahbaghianDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Sam ShenDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Vandana SundaramQuantitative Sciences Unit Stanford University Palo Alto California USA.
Maame Yaa A B YiadomDepartment of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Here we report the clinical performance of COVID-19 curbside screening with triage to a drive-through care pathway versus main emergency department (ED) care for ambulatory COVID-19 testing during a pandemic. Patients were evaluated from cars to prevent the demand for testing from spreading COVID-19 within the hospital. Methods: We examined the effectiveness of curbside screening to identify patients who would be tested during evaluation, patient flow from screening to care team evaluation and testing, and safety of drive-through care as 7-day ED revisits and 14-day hospital admissions. We also compared main ED efficiency versus drive-through care using ED length of stay (EDLOS). Standardized mean differences (SMD) >0.20 identify statistical significance. Results: Of 5931 ED patients seen, 2788 (47.0%) were walk-in patients. Of these patients, 1111 (39.8%) screened positive for potential COVID symptoms, of whom 708 (63.7%) were triaged to drive-through care (with 96.3% tested), and 403 (36.3%) triaged to the main ED (with 90.5% tested). The 1677 (60.2%) patients who screened negative were seen in the main ED, with 440 (26.2%) tested. Curbside screening sensitivity and specificity for predicting who ultimately received testing were 70.3% and 94.5%. Compared to the main ED, drive-through patients had fewer 7-day ED revisits (3.8% vs 12.5%, SMD = 0.321), fewer 14-day hospital readmissions (4.5% vs 15.6%, SMD = 0.37), and shorter EDLOS (0.56 vs 5.12 hours, SMD = 1.48). Conclusion: Curbside screening had high sensitivity, permitting early respiratory isolation precautions for most patients tested. Low ED revisit, hospital readmissions, and EDLOS suggest drive-through care, with appropriate screening, is safe and efficient for future respiratory illness pandemics.

Identifiers

PMID36570369
PMCPMC9767858

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.