Impact of a Structured Pandemic Protocol on Safe Testing in a Community Vascular Ultrasound Facility

ABSTRACT

Introduction: Safe in-person care during the COVID-19 pandemic requires protection of personnel and patients. The aim of this study was to relate pandemic protocols to outcomes in a community vascular ultrasound facility. Methods: A multi-phase protocol was developed from published guidance, evolving understanding of the disease, consensus documents and local considerations. All staff were involved in the development of the protocol. All patients underwent triage, primary, secondary and final screening, as well as, instruction regarding safe behavior, distancing and PPE at arrival, testing and departure. Just-in-time arrival, final screening, traffic streaming, modified testing protocols, controlled time with the technologist and immediate departure was used. Environment cleaning was performed by the technologist. Patients were asked about their satisfaction with the process. Results: 1153 of 1260 patients were accepted for testing. Triage excluded 55 patients;40 had had recent testing and 15 were re-directed. Ninety patients declined to come in for testing. Ninety patients were excluded on primary, 0 in secondary and 0 at final screening. Thirty seven patients refused to come in and 25 were cancelled due to illness. One patient converted to positive one day after the visit and was reviewed in detail;no break in protocol had occurred and no transmission to staff or other patients occurred. No staff developed COVID-19 by symptoms or testing. Education was well-received by 90% of the patients. Language issues were a challenge in 250 patients;100 had an interpreter. All interpreters screened clear on the same protocol. Two patients refused to follow instructions upon arrival and were asked to leave. Modified testing resulted in required results in 92% of patients. Patients rated the preparation and protocols to be good 20%, very good 30% and excellent 50%. Conclusion/Discussion: Structured protocols can efficiently screen and safely manage patients for ultrasound testing in a community setting during the pandemic.