Feasibility and Safety of a Field Care Clinic as an Alternative Ambulance Destination During the Covid-19 Pandemic
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Abstract
Background:
Anticipating increased volume on healthcare facilities during the COVID-19 surge, the San Francisco Department of Public Health developed a plan to deploy neighborhood-based Field Care Clinics (FCCs) that would decompress emergency departments by addressing low acuity complaints. These clinics would receive patients directly from the Emergency Medical Services (EMS) system. In this study, we evaluated the outcomes of EMS patients who were transported to the Bayview-Hunters Point (BHP) neighborhood FCC.
Methods:
We performed a retrospective study of all patients transported to the BHP FCC by EMS between 4/11/2020 and 12/16/2020. Descriptive statistics and Chi Square Tests were used to analyze patient data.
Results:
In total, 35 patients (20 men, 15 women, average age 50.9 years) were transported to the FCC. Of these, 16 were Black/African American, 7 White, 3 Asian, with 9 identifying as other races and 9 of Hispanic ethnicity. Approximately half (n=20) of calls originated within the BHP neighborhood. The most frequent patient complaint was “Pain.”
Of patients transported to the BHP FCC, 23 were treated and discharged. The 12 remaining patients required hospital transfer, with 3 patients subsequently discharged from the emergency department.
Conclusion:
Three-fourths of patients who required hospital transfer were admitted or required specialized services, suggesting that the FCC was able manage low acuity conditions. However, underutilization of the FCC by EMS as a transport destination and a high rate of hospital transfer indicates opportunities for training and protocol refinement.
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