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NEWS2 to assess suspected COVID-19 in the community: a service evaluation of a primary care assessment centre.
Zaman, Imran; Beevers, Zachary C R; Ahmed, Ridwan; Lasserson, Daniel; Knight, Thomas.
  • Zaman I; Aston Medical School, Birmingham, UK.
  • Beevers ZCR; Heath Street Health Centre, Birmingham, UK.
  • Ahmed R; School of Medicine University of Leeds, Leeds, UK.
  • Lasserson D; Aston Pride Community Health Centre, Sandwell and West Birmingham Clinical Commissioning Group, Birmingham, UK.
  • Knight T; University of Warwick, Warwick, UK.
Fam Pract ; 38(Suppl 1): i3-i8, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1376297
ABSTRACT

BACKGROUND:

Primary care has played a central role in the community response to the coronavirus disease-19 (COVID-19) pandemic. The use of the National Early Warning Score 2 (NEWS2) has been advocated as a tool to guide escalation decisions in the community. The performance of this tool applied in this context is unclear.

AIM:

To evaluate the process of escalation of care to the hospital within a primary care assessment centre (PCAC) designed to assess patients with suspected COVID-19 in the community. DESIGN AND

SETTING:

A retrospective service evaluation of all adult patients assessed between 30 March and 22 April 2020 within a COVID-19 primary care assessment centre within Sandwell West Birmingham CCG.

METHOD:

A database of patient demographics, healthcare interactions and physiological observations was constructed. NEWS2 and CRB65 scores were calculated retrospectively. The proportion of patients escalated was within risk groups defined by NHSE guidelines in place during the evaluation period was determined.

RESULTS:

A total of 150 patients were identified. Following assessment 13.3% (n = 20) patients were deemed to require escalation. The proportion of patients escalated with a NEWS2 greater than or equal to 3 was 46.9% (95% CI 30.8-63.6%). The proportion of patients escalated to secondary care using NHSE defined risk thresholds was 0% in the green group, 22% (n = 4) in the amber group, and 81.3% (n = 13) in the red group.

CONCLUSION:

Clinical decisions to escalate care to the hospital did not follow initial guidance written for the COVID-19 outbreak but were demonstrated to be safe.
In most cases, coronavirus disease-19 (COVID-19) is a mild illness that resolves on its own. Some patients develop severe disease requiring hospital treatment. Identifying which patients are likely to need hospital treatment is a challenge. Many GP practices have developed specific services designed to assess patients with suspected COVID-19 and establish whether hospital treatment is necessary. We evaluated a service providing this function in Birmingham. We examined the care pathway of 150 patients assessed within the service to established factors associated with the need for hospital assessment. We found a national decision tool designed to aid the process was a poor descriptor of what happened in practice.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Primary Health Care / Referral and Consultation / Early Warning Score / COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Fam Pract Year: 2021 Document Type: Article Affiliation country: Fampra

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Primary Health Care / Referral and Consultation / Early Warning Score / COVID-19 / Hospitalization Type of study: Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Fam Pract Year: 2021 Document Type: Article Affiliation country: Fampra