Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-26T17:15:58.643Z Has data issue: false hasContentIssue false
  • English
  • Français

Influenza assessment centres: a case study of pandemic preparedness to alleviate excess emergency department volume

Published online by Cambridge University Press:  04 March 2015

Geoffrey G. Hall ,
Alexander G. Perry ,
Adam vanDijk  and
Kieran M. Moore
Geoffrey G. Hall*
Affiliation:
Queen's Public Health Informatics Group, Queen's University, Kingston, ON Department of Civil Engineering, Queen's University, Kingston, ON Department of Emergency Medicine, Queen's University, Kingston, ON
Alexander G. Perry
Affiliation:
Queen's Public Health Informatics Group, Queen's University, Kingston, ON Department of Electrical and Computer Engineering, Queen's University, Kingston, ON
Adam vanDijk
Affiliation:
Queen's Public Health Informatics Group, Queen's University, Kingston, ON Kingston, Frontenac, Lennox and Addington Public Health, Kingston, ON
Kieran M. Moore
Affiliation:
Queen's Public Health Informatics Group, Queen's University, Kingston, ON Department of Emergency Medicine, Queen's University, Kingston, ON Kingston, Frontenac, Lennox and Addington Public Health, Kingston, ON
*
Queen's Public Health Informatics Group, Kingston, Frontenac, Lennox and Addington Public Health, 221 Portsmouth Avenue, Kingston, ON K7M 1V5; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

Influenza assessment centres (IACs) were deployed to reduce emergency department (ED) volumes during the pH1N1 influenza outbreak in the Kingston, Frontenac, Lennox and Addington (KFL&A) public health region of Ontario, Canada, in the fall of 2009. We present a case study for the deployment of IACs to reduce ED visit volume during both periods of pandemic and seasonal communicable disease outbreak.

Methods:

An emergency department syndromic surveillance system was used to trigger the deployment of eight geographically distributed IACs and to time their staggered closure 3 weeks later. We compared actual and expected ED visit volumes in the KFL&A region to neighbouring regions where no IACs operated by time series regression analysis before, during, and after IAC operation.

Results:

The deployment of IACs was triggered with a rise in overall ED volume at the hospitals in the KFL&A region to a level 10% above the 6-month running average. The IACs assessed 2,284 patients during 3 weeks of operation. Thirtythree patients were admitted directly to the hospital from the IACs, bypassing the EDs. During the operation of the IACs, the hospitals in the KFL&A region experienced a modest decrease in daily visits when compared to the 3 previous weeks. Overall ED visit volume in the hospitals in the neighbouring regions increased 105% during the period of IAC operation.

Conclusions:

Operating stand-alone influenza IACs may reduce ED volumes during periods of increased demand, as observed during an anticipated pandemic situation.

Keywords

emergency department overcrowdinginfluenzasyndromic surveillance
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 4 , July 2013 , pp. 198 - 205
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

REFERENCES

1.Glaser, CA, Gilliam, S, Thompson, WW, et al. Medical care capacity for influenza outbreaks, Los Angeles. Emerg Infect Dis 2002;8:569–74, doi:10.3201/eid0806.010370.Google Scholar
2.Grumbach, K, Keane, D, Bindman, A. Primary care and public emergency department overcrowding. Am J Public Health 1993;83:372–8, doi:10.2105/AJPH.83.3.372.CrossRefGoogle ScholarPubMed
3.Darr, K. Beyond triage: avian flu and the impending services demand crisis. Hosp Top Res Perspect Healthc 2006;84:32–5.Google Scholar
4.Schull, MJ, Mamdani, MM, Fang, J. Community influenza outbreaks and emergency department ambulance diversion. Ann Emerg Med 2004;44:61–7, doi:10.1016/j.annemergmed.2003.12.008.CrossRefGoogle ScholarPubMed
5.Public Health Agency of Canada. The Canadian Pandemic Influenza Plan for the Health Sector. Ottawa: Public Health Agency of Canada; 2009. Available at: http://www.phacaspc.gc.ca/cpip-pclcpi/index-eng.php.Google Scholar
6.New South Wales Public Health Network. Progression and impact of the first winter wave of the 2009 pandemic H1N1 influenza in New South Wales, Australia. Eur Surveill 2009;14:pii519365. Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId519365.Google Scholar
7.Ontario Ministry of Health and Long-Term Care. OntarioHealth Plan for an Influenza Pandemic 2008. Toronto: Ontario Ministry of Health and Long-Term Care; 2008. Available at: http://www.health.gov.on.ca/en/pro/programs/emb/pan_flu/docs/plan_full.pdf.Google Scholar
8.Lam, C, Waldhorn, R, Toner, E, et al. The prospect of using alternative medical care facilities in an influenza pandemic. Biosecurity Bioterrorism Biodefence Strategy Pract Sci 2006;4:384–91, doi:10.1089/bsp.2006.4.384.Google Scholar
9.Hick, JL, Hanfling, D, Hanfling, JL, et al. Health care facility and community strategies for patient surge capacity. Ann Emerg Med 2004;44:253–61, doi:10.1016/j.annemergmed.2004.04.011.Google Scholar
10.Moore, KM, Edgar, BL, McGuinness, D. Implementation of an automated, real-time public health surveillance system linking emergency departments and health units: raionale and methodology. Can J Emerg Med 2008;10:114–9.Google Scholar
11.Silka, PA, Geiderman, JM, Goldberg, JB, et al. Demand on ED Resources during periods of widespread influenza volume. Am J Emerg Med 2003; 21:535–9.Google Scholar