[A model of continuity of care for not residents through medical-nursing teleconsultation in a Hub & Spoke network]. / Un modello di continuità assistenziale per turisti e non residenti tramite teleconsulto medico-infermieristico in rete Hub & Spoke.

ABSTRACT

. A model of continuity of care for not residents through medical-nursing teleconsultation in a Hub & Spoke network. INTRODUCTION: The Seasonal Continuity of Care (CAS) is a service of the Bergamo Health Protection Agency that provides medical and healthcare services, guaranteeing outpatient or home care to Italian and foreign tourists and seasonal workers during the months of July and August. The Covid-19 pandemic and the shortage of doctors made it impossible to provide the service in 2021 as in previous summer seasons. AIMS: To activate a CAS service with the involvement of nurses. METHODS: A "Hub-Spoke" network model was activated; nurses in the Spoke sites, with the patient in attendance, through teleconsultation by video call, made remote contact with a doctor in the Hub. RESULTS: In the 3 Spoke CASs, from 2 to 22 August 2021, 274 services (of which 14.3% were teleconsultations between the nurse at the Spoke CAS site and the doctor at the Hub site) and 162 repeat prescription requests were made. Teleconsultation was mainly performed for patients with acute pathology (71.8%), mainly for arthralgia and fever. In the majority of cases, it was sufficient to answer to the needs of the patient (87.2%); a small number of cases were referred to a doctor's appointment (10.3%) or to Emergency Department (2.6%). CONCLUSIONS: Nurse triage reduced the time of medical visits, allowing more patients to be taken care of. The need for digital infrastructure, training and integration with district services emerged.