Secondwave of the 2019 coronavirus epidemic (COVID-19) and accesses for cardiopalmo or arrhythmia: Analysis of a lombarded

ABSTRACT

Background: Crowding has been defined as a global problem and causes a reduction in the quality of care and patient satisfaction. It is due and identified by means of three orders of factors those at access (input);those referable to the patient's process (throughput);and those leaving the PS (output). The latter are held to be the main culprits of Crowding. Purpose: To assess the impact of the second wave of the CoViD pandemic on the population who went to the emergency room for heartache. Materials and Methods: We evaluated all patients who accessed our emergency room for heartbeat from 20 October to 30 November 2020 and in the same period of 2019. Results and Discussion: We enrolled 744 patients. There was a severe reduction in the total number of accesses for acute neurological disorders 101 in the CoViD period and 208 in 2019. The vital signs were comparable. Patients in the CoViD pandemic are more frequently accompanied by ambulance (49% vs 30%). Patients of the CoViD pandemic have priority codes at the medical examination similar to those of 2019 while they have high severity codes at discharge (yellow and red) more frequently (16% vs 10%) and more frequently need hospitalization (14% vs 10%). Crowding input factors are lower in the period of the pandemic reduced attenders (101 vs 208) and reduced average waiting times (83min vs 117 min). The percentage of patients who exceeded the waiting time target set by priority code for the medical examination also decreased (49% vs 35%). Crowding throughput factors worsened LOS (449 vs 379 min). Crowding output factors also worsened the percentage of access blocks, low for this disease, however doubled during the pandemic (5% vs 2%). The Total Access Block Time is significantly higher in the CoViD period for the examination rooms (2.331 vs 1.859 min). Conclusion: the epidemic has led to a reduction in access for heart disease, especially of self-reported. Patients have more frequent hospitalization needs and more severe exit codes. The period of the pandemic presented a worse crowding for these patients due to the Exit Block resulting in an increased workload for the emergency room operators.