Knock Before You Enter: How to Get Patients in the Door Safely

For many Americans, getting inside a hospital can feel like a tall order. If you live in Arizona, Florida, Texas, or another coronavirus hotspot, your patients may have to wait in line for hours just to get inside the facility. People may be hesitant to seek medical care if it means waiting in line for hours on end, especially if they have to stand near people who could be infected with the virus.

So, what’s the hold up?

Providers must screen incoming patients for coronavirus symptoms before they can enter the facility, leading to delays, confusion, and what feels like endless waiting. From having patients knock to opening new entrances and mobile triage checkpoints, find out how the pandemic is changing the face of hospitals across the country.

The Waiting Game

Accessing medical care amid a global pandemic can feel like a wild goose chase. Many facilities have changed their admitting protocols to preserve resources, beds, and PPE for the most severe cases of COVID-19. Such was the case with Luis Arellano from Brooklyn, NY.

After coming down with flu-like symptoms, he went to a nearby hospital to get tested for the virus, but they told him to come back if his condition worsened.

It did. Soon his family rushed him to another hospital in New Jersey where they ended up waiting over 8 hours. They ended up leaving when the staff told them they would probably have to wait another 7 to 9 hours to see a doctor.

The family ended up taking Arellano to another hospital. This time he was sick enough to get in right away, but it was too late. The virus had ravaged his body. He died of cardiopulmonary arrest on April 5th after five days in the hospital, just two days after testing positive for COVID-19.

Redesigning Entrances

This is not an isolated incident. The U.S. was known for long wait times before the pandemic. According to the latest statistics, the average hospital emergency department (ED) patient in the United States waits more than an hour and half before being seen.

The pandemic has exacerbated this trend across the country. Disorganized triage centers, poor signage, rowdy patients, and PPE shortages have all made matters worse in recent months.

Many facilities have tried to set up mobile triage centers, either in parking lots or outside, but this requires additional PPE and other resources that may be in short supply. These mobile triage centers should be self-contained and well-staffed, so providers don’t leave the post unattended. 

If creating a mobile triage center isn’t an option, it’s best to create a separate entrance to the facility. Creating a new doorway may sound expensive, but it’s often easier than you might think. Having one entrance for virus patients and another for non-virus patients can reduce bottlenecks and pinch points inside the facility. This will also make it easier to enforce social distancing.

Automatic screening systems can also help with the flow of incoming patients. The system will automatically take the person’s temperature, so providers don’t have to physically interact with these individuals, thus preserving PPE.

Experts also suggest keeping a refrigerator close to triage centers in case providers need to collect samples. They can store the samples without having to run back into the facility.

It’s also good to have a mobile cart when operating a triage checkpoint instead of setting up a folding table. Nurses and providers should be able to move around as the layout of the space changes over the course of the day.

Keep signage up high instead of relying on those at waist-height. Everyone approaching the facility should have a view of these signs.

Hospital layouts will likely change over the course of the year as administrators look for ways to keep patients safe while limiting bottlenecks, long wait times, and other potential hazards. Do your best to get patients in the door safely and quickly.