Effectiveness of a telephone-based nursing intervention to reduce hospital utilization by COVID-19 patients

With the surge of COVID-19 cases in the United States in the early months of the pandemic, the availability of hospital resources became a concern. To reduce the strain on health systems, it is important to decrease the number of COVID-19 patients requiring hospital care. Since most patients with COVID-19 only develop mild symptoms, remote monitoring and assessment of symptoms of COVID-19 patients at home may help reduce preventable hospital utilization, morbidity, and mortality. Henry Ford Allegiance Health in Jackson, Michigan implemented a nurse-led, telephone-based, active management protocol for patients that tested positive for SARS-CoV-2 at their drive through testing site and who were self-isolating at home. The objective of this retrospective study was to assess the effectiveness of the protocol in reducing hospital utilization by patients who tested positive for SARS-CoV-2 between March 23, 2020 and May 31, 2020. The study included a total of 293 patients, with 154 patients in the pre-implementation group and 139 patients in the post-implementation group. Although the difference in the 30-day probability of hospital utilization between the study groups was not statistically significant, there was a reduction seen in the post-implementation group. The protocol also allowed ongoing assessment of COVID-19 patients with limited in-person interactions, thereby reducing the risk of infection for health care workers. With the increased use of telemedicine, this protocol could be used as a guide for other health systems looking to improve access to care for COVID-19 patients without increasing hospital utilization.