Quality Assessment of the Management of Suspected and Probable COVID-19 Cases in the Health Center of VARIS

Michael Dandoulakis, Dimitra Iosifina Papageorgiou, Dimitris Nesseris, Eleftherios Thireos, Maria Kanelou, Efthimia Goutopoulou, Efi Tsintsilida, Paolo Sklavounos, George Varsamis, Zoi Chrona, Dimitris Drosos

Keywords: COVID-19 cases, pandemic, quality assessment, primary care, Health Balanced Scorecard

Background:
Health Center of Varis (HCV), developed a Health Balanced Scorecard (HBS). Infection control is part of the clinical quality domain, adapted to the official COVID-19 guidelines.

Research questions:
To evaluate whether the management of COVID-19 cases has been effective in the HCV and according to the proposed performance framework.

Method:
A protocol was developed for the examination of COVID-19 case, following the Ministry of Health guidelines for the management of the suspected and/or confirmed COVID-19 cases not requiring hospitalization. In the protocol, demographic data, symptoms and signs classified according to the ICPC-3 (International Classification of Primary Care) system, criteria for requesting a PCR testing, were included. The performance of the Emergency Department (ED) of the facility was assessed for every suspected and probable COVID-19 case, examined during the period 1/12/2020-12/1/2021.

Results:
During the study period, 91 patients were examined, 38 (41,7%) males and 53 (58.3%) females with an average age of 47.75 years. A total of 91 PCR tests were requested, of which 61 (67%) in patients without symptoms, as contact tracing, and 30 tests in symptomatic patients classified according to the ICPC-3 system as RS.07(COUGH) (n=3), RD.02.01(COMMON COLD) (n=6), RS.02(SHORTNESS OF BREATH) (n=15), RD.06 (ACUTE BRONCHITIS OR BRONCHIOLITIS) (n=2), RD.02.00(ACUTE PHARYNGITIS) (n=1), RS.12.00 (PAIN IN THROAT) (n=2) and RD08(CORONAVIRUS DISEASE) (n=1). In these 30 symptomatic cases, 63.3% (n=19) were low-risk 36.7% (n=11) were intermediate risk patients.

Conclusions:
A significant number of PCR tests were requested without patients having symptoms for contact tracing since at this stage of the pandemic, PCR can be requested without any symptoms. During the study period, the management of suspected and probable COVID-19 cases in the ED of HCV was in line with the official guidelines and the HCV protocol. Assessments should be performed regularly in order to ensure the quality of care in the facility.

Points for discussion:
QUALITH ASSESSEMENT IN COVID 19 PANDEMIC