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A Single View of Vitals Aids Rapid Triage in a COVID-19 Hot Spot

Yale New Haven Health System used Epic to quickly adapt in the face of an unprecedented influx of critically ill patients

In March of 2020, more than a quarter of the patients in the Yale New Haven Health System had COVID-19. The health system had to rapidly double the number of ICU beds to accommodate the influx of patients and direct resources like ventilators and infectious disease specialists to the most critically ill. YNHHS used Epic to quickly adapt their triage process and provide clinicians with a single view of patients’ vital signs and available resources.

With so many acutely ill patients to care for, clinicians needed to keep an eye on everyone’s needs at once and escalate care quickly when a patient appeared to be worsening. Each department has a centralized list of patients in Epic, which shows which patients need oxygen or ventilators and other relevant information for COVID-19 treatment. The list also indicates when a patient is likely in the cytokine release syndrome phase of COVID-19—a time when patients are especially at risk of deterioration.

Despite having more patients to monitor, YNHHS clinicians made sure every patient was reviewed frequently by referring to the centralized list, which shows which patients are due for a vitals check. Each time a clinician opens a patient’s chart, the counter resets automatically, so others can easily see which patients are due for review.

“COVID-19 tested our health system in ways it has never been tested before,” said Lisa Stump, Yale New Haven Health’s CIO. “This triage process helped us adapt to a brand-new disease and use our resources effectively to care for patients even when a significant portion were COVID-19 positive.”

Read more from the journal Infection Control & Hospital Epidemiology. Epic community members can learn about strategies other health systems use to deal with increased ICU capacity in the Managing Coronavirus Disease 2019 (COVID-19) with Epic documentation on the UserWeb.