The cars, minivans and sports-utility vehicles began lining up and slowly moving forward, just as they would at a busy fast food drive-thru. But there weren’t any burgers or fries on the menu. Instead, drivers and passengers were examined by a team of Stanford doctors and nurses, all without getting out of their cars. In what is believed to be the first training exercise in the country, a team of healthcare professionals at Stanford Hospital and Clinics turned the first floor of a parking garage into a drive-through emergency room in hopes of creating a more efficient way to treat a large number of patients during an influenza pandemic or other emergency. The hospital’s medical director for disaster planning believes that drive-through triage can serve as a blueprint for hospitals nationwide and across the globe. During the flu season, emergency departments are bursting at the seams as people with limited health insurance use the emergency department as their primary care physician. According to Dr. Eric Weiss, medical director of disaster planning at Stanford Hospital and Clinics and Lucille Packard Children’s Hospital: “We have to have a new mechanism to take care of large numbers of patients during a pandemic and I think that this is going to be it.”
HOW IT WORKS
Stanford physicians at first thought of creating a tent outside the emergency department but discarded that idea since it would require people to stand outdoors during the winter. Since everyone arrives by car, the drive-thru idea seemed like a great way to use the automobile as a self-contained contamination enclosure. People are comfortable in their cars and if they are not feeling well, they don’t have to get out and walk. The volunteer patients made their way through the drive-thru triage just as they would at the emergency department. As cars entered the parking garage, patients registered and were given paperwork. They then drove through one of two lines and stopped at the first station, triage, where nurses and emergency department technicians checked for vital signs — temperature, heart rate, blood pressure, and respiration — and gathered the patient’s medical history. Physicians, nurses, and other staff wore gowns and gloves throughout the exercise. From there, patients drove another 10 to 15 feet for a medical screening exam where physicians reviewed the symptoms and made a diagnosis. Finally, they were discharged or admitted to the hospital.
During the exercise, the team observed and evaluated the process. Over the next several days, they reviewed the data to try to find ways to streamline the process. The results will likely be published in a journal and begin to spread throughout the medical community.
Source: From an article in the San Jose News by Mark Gomez on June 12, 2009.