Triage system for newly diagnosed coronavirus 2019 cases during the pandemic between May to October 2021, Mueang district, Ratchaburi province, Thailand

Abstract

This is an action research aimed primarily to develop the system process for triaging newly diagnosed coronavirus 2019 cases. The study population were new cases of laboratory-confirmed COVID-19 during the 12 weeks before and after the establishment of "Screening Center Field Hospital (at Officers Club of Army Engineer Department in Ratchaburi province)" and operation team personnel. The study consists of five stages: 1) conduct a cross-sectional study to determine the problems that exist prior to receiving medical care; 2) review related literature and theories to determine a possible solution that complies with the guidelines implemented by the Ministry of Public Health; 3) design and develop "the operating system"; 4) implement the operating system and evaluate its performance; and 5) adjust the system and re-evaluate its performance periodically. The quantitative technique was used to examine the quantitative data, which included frequency distribution, percentages, and mode. The qualitative data was collected from information during meetings and observation. These data were analyzed by content analysis. There was a total of 9,496 new patients during the study period.  Of these, 2,174 patients and 7,322 patients were identified before and after the triage system development, respectively. After the outbreaks of large clusters, the proportion of "patients who have access to treatment within 1 day" declined substantially from above 95% to the lowest at only 15%. Insufficient cohort wards and an ineffective admission system were the causes. This problem was resolved after the "Screening Center Field Hospital" with an effective operation system had been set up, in parallel with active case finding for laboratory-confirmed cases and a COVID-19 care system reorganization, thus resulting in patient safety and prevention of community transmission