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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; gh26@queensu.ca

Abstract

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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

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