Protected Discharge Model for Mild to Moderate Covid Patients in a North-East Italian Hospital

The Covid-19 emergency has determined an unpredictable increase in the number of patients with Covid-like symptoms in the Emergency Department (ED) of Italian hospitals. A continuity of care pathway between hospital and territorial services that defines the possibility of activating a protected discharge model has been implemented in the ULSS 6 Euganea – Health Trust (District of Padua) for patients with a mild-moderate degree of respiratory insufficiency (phenotyped according to clinical-functional and radiological criteria). The protected discharge model integrates territorialservices (active surveillance of General Practitioners and Covid Special Units) and hospital services (provided by Pulmonology and Emergency Department) and aims to guarantee a coordinated healthcare pathway for Covid patients (daily interaction, early identification of risk factors and constant monitoring of the respiratory function), in order to efficiently use the human and technological resources available and reduce inappropriate hospitalizations. The prescription and monitoring of oxygen home therapy (with an oxygen concentrator) is part of the therapeutic process for the home management of this patients. Between November 2020 and April 2021 at the Hospital of Cittadella (ULSS 6 Euganea) the above mentioned discharge model was activated for 205 patients with a mild-moderate degree of respiratory insufficiency (average age 66.5). The average duration of hospital telemonitoring was 8.2 days. Up to April 30, in 86/205 patients (42.0%) no access to the ED nor hospitalization were reported;for 69/205 patients (33.7%) one or more accesses to the ED and no hospitalization were reported;38/205 patients were later hospitalized (18.5%), 3/205 patients (1.5%) died. Preliminary analysis of our data suggests that the protected discharge model implemented is proving to be efficient in the management of mild-moderate Covid patients. © 2021, Springer Nature Switzerland AG.

Risk stratification for the safety of patients and hospital health workers during Covid-19 emergency

Covid-19 emergency has forced hospitals to face enormous organizational challenges in order to implement solutions to minimize the impact of the infection and guarantee at the same time the quality of health services provided and the safety of patients and health workers. ULSS 6 Euganea - Health Trust (District of Padua) has defined four levels of risk for Hospital Units (from the highest to the lowest risk: Red, Yellow, Green and White) based on the following parameters: type of patients hospitalized (SARS-CoV-2 positive, Covid-like, negative), type of health services provided, time of assistance and care for hospitalized patient.