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Kaiser Permanente Southern California COVID-19 Home Monitoring Program
Article: Huynh, D. N., Millan, A., Quijada, E., John, D., Khan, S., & Funahashi, T. (2021). Description and Early Results of the Kaiser Permanente Southern California COVID-19 Home Monitoring Program. The Permanente journal, 25, 20.281.
I. Summary
COVID- 19 pandemic took a surge at the beginning of 2020 in the United States. The influx of patients to the primary care and emergency department with the unknown highly communicable disease increased several folds. This presented several challenges to the healthcare systems and the ove
urden on the hospital capacities. Prolonged wait at the emergency departments leads to increased mo
idity and mortality (Derlet,2002). During the time of the COVID 19 out
eak, a long wait time at the emergency department could do more harm because of the spread of infection than any good. In order to manage the surge and minimize the spread of coronavirus, the public health advisory recommended avoiding unnecessary healthcare use (Emanuel et al., 2020).
To combat the anticipated surge Kaiser Permanente Southern California fa
icated a COVID-19 Home Monitoring program, with aim of reducing the burden on the health care, specifically the emergency departments and also reducing the hospital-derived spread of the deadly virus. The patients were provided substitutes for admission. This prevented patients’ families and healthcare from getting infected by COVID-19. This program was designed as per the national guidelines that recommend that mildly ill patients be at home or as outpatients (COVID-19 Treatment Guidelines Panel, 2020). The program enabled high-quality, safe, and quick care to the patients at home. Clinical identifications were routinely done for the signs of deterioration in the patient’s condition so as to intervene at the earliest (Huynh et al., 2021).
Positive COVID-19 patients with age less than 60 years, mild symptoms, oxygen saturation of more than 92 %, heart rate less than 100 bpm, respiratory rate 20/minute, and low disease burden were considered. Older patients and patients with como
idities such as diabetes, respiratory disorders, and coronary heart disease were recommended to be hospitalized in recent research (Zhou et al.,2020; Yang et al., 2020). Approximately 15000 patients are included in the program until today and around 1500 patients were sent to the hospital for enhanced treatment after regular monitoring (Huynh et al., 2021).
The results suggest that 95.5 % (12,461/13,055) of the patients enrolled in the study recovered and completed the home monitoring program. Around 10.6% (1387) patients were hospitalized and 0.2% (20) patients died during home monitoring. Approximately 42 % of patients enrolled in the program were above 60 years of age. It has been observed during the study that males and patients over 60 years of age were more hospitalized. 30 days mortality rate was found to be 1.6 %. The majority of the dead or hospitalized patients were suffering from co-mo
idities. The average length of patient’s stay in the hospital was 5.4 days for patients who required only oxygen, however, for the patients who required remdesivir, dexamethasone, and oxygen was 3.1 days in the COVID-19 home monitoring program.
COVID 19 home monitoring could manage a large number of patients in a very short time at home, who were otherwise restrained to the emergency care of hospitalization. This came up as a safe alternative to hospitalization and looks promising in decreasing the length of stay in the hospital and the burden on emergency care. This led to a reduction in the wait at emergency units and also helped in managing and reducing the spread of COVID. As the emergence of new variants is observed, the effect and burden on healthcare will increase, hence home monitoring is a better alternative in managing the pandemic and its aftereffects (Huynh et al., 2021).
II. Situational Analysis
A. Kaiser Permanente Southern California fa
icated a COVID-19 Home Monitoring program that was built with a vision to reduce the burden on the hospitals specifically the emergency departments and also prevent the spread of COVID-19.
The organization made sure to assess the patient at the entry point on all the required parameters. The COVID-19 positive patients were examined and oxygen saturation, respiratory rate, and heart rate were measured. The patients with more than 60 years of age and co-mo
idities, and the patients not fulfilling the eligibility criteria for the home monitoring were refe
ed to the hospitals. The patients were regularly monitored remotely for any aggravated symptoms, and in case of deterioration in the symptoms were immediately sent to the hospital. The approach of the program was very specific and aimed toward providing the best healthcare services to the patients without making their families at risk of the infection. The program also succeeded in reducing the burden on the emergency units.
B. The increasing burden on the hospitals and the emergency units due to the o COVID-19 pandemic as well as the spread of COVID-19 is the prevailing issue.
C. The overall strategic planning of the program delivered immediate relief to the influx of patients to the emergency unit. This also developed the objective of providing the best of healthcare...