Steps for Effective Patient and Staff Contact Tracing to Defend Against COVID-19 Spread

由于新型冠状病毒在社区中迅速传播，在找到疫苗或有效治疗方法之前，预防疾病传播可能是最好的管理策略。由于导致COVID-19的病毒(SARS-CoV-2)似乎主要通过人与人之间接触(如咳嗽、打喷嚏或说话)的呼吸道飞沫传播，了解受感染患者曾在哪里以及他们与谁接触过至关重要。

Contact tracing follows COVID-19-confirmed patients through the health system, informing surveillance teams where patients have been in the facility and with which staff members they’ve interacted. These vital insights support transmission management by informing testing, quarantine efforts, and decontamination activities.

在COVID-19之前，许多卫生系统没有优先考虑积极监测传染病的内部传播。虽然基于纸张的手动跟踪流程已经成为常态，但它们只能生成医院各部门患者自然流程模式的有限图像，并且无法推动预防性工作流修改。随着COVID-19的出现，迫切需要更好地跟踪患者，各组织必须采用有能力的患者和工作人员接触者跟踪流程。

Patient and Staff Contact Tracing: Part of an Active Infection Surveillance Strategy

Contact tracing aligns existing patient flowdata(from manual tracking) with indicators of potential staff exposure from the clinical record, such as which parts of the facility the patient entered and the types of treatments or testing they underwent.

These rich insights into the patient journey help organizations plan their strategy as they progress through the following phases:

1. Preparation: Provides baseline information about the natural flow of patients through a hospital setting.
2. Growth: Identifies infected patient volume and gives insights into any emerging irregular patient flow patterns.
3. Infection surge: Tracing allows incident command centers to develop and revise patient flow while putting other services (e.g., elective procedures) on hold.
4. 恢复:随着感染发生率下降，卫生系统需要观察患者流动模式何时恢复到自然节奏，并作出改变，避免使未感染者接触病毒。

为了履行上述追踪COVID-19接触者的关键职责，Health Catalyst在2020年大流行期间早期创建了患者和工作人世界杯葡萄牙vs加纳即时走地员追踪器。该追踪器对患者的活动以及工作人员与确诊或疑似感染的患者之间的互动提供分析见解。这些数据可以鼓励采取知情、数据驱动和及时的行动。

From Identification to Action

The first step of contact tracing is to identify the initial population of infected individuals. Health Catalyst leverages cohort discovery tools, such as its Population Builder™, to allow searches for patients according to customizable criteria. Users can identify an initial population, typically from diagnostic testing or diagnosis codes, then enrich the results with additional data, including the following:

• 入院-出院-转院数据，描述患者在医院的移动情况，理想情况下是在病床层面。
• 来自电子文档的数据，可以唯一地标识工作人员及其与患者的交互(例如，与患者的活动式交互、订单、记录等)。

Once patient tracing insights are available, dashboards provide visualizations to inform infection prevention teams, incident command leadership, infectious disease experts, hospital unit leaders, employee health, and risk management departments.

COVID-19 response teams can then leverage tracing data to drive actionable insights. The following questions can inform these insights:

• Are unnecessary departmental transfers minimized to reduce exposure risk to other patients and staff?
• Are there unrealized ancillary staff (e.g., environmental, dietary, or transport services) interacting with infected patients?
• Have additional patients been exposed through sharing a room or other location with an infected individual?
• 员工是否遵守感染缓解和遏制措施?

Patient and Staff Contact Tracing Data Supports Multiple Processes

组织如何将接触追踪纳入其接触调查工作，取决于特定医院及其支持的社区的独特需求。一些网站可能会选择将暴露监测纳入门诊病例管理工作流程，针对独特的高危人群。如果从外部设施获得详细的转移数据，将其包括在接触者追踪数据策略中可能会减少暴露风险和不必要的测试。

Additionally, contact tracing can help employee health departments at health systems understand whether infected staff members were possibly exposed at work, as their treatment may become a workers’ compensation claim. And risk management teams may want to conduct risk assessment activities on potentially exposed patients and staff and collect more in-depth data regarding personal protective equipment usage or perceived exposure length of time.

A Must-Have Short- and Long-Term Capability

由于许多COVID-19治疗方案的长期影响仍不清楚，接触者追踪中获取的患者经验可以支持正在进行的准备工作。通过揭示医院各部门针对不同护理事件的最常见途径，联系追踪为预测方法提供了依据，使各组织能够根据疾病爆发的严重程度制定灾害规划方法。追踪见解还可能提高工作流程的效率，以限制未来的暴露风险，而接触者追踪数据的某些方面，例如受感染的患者在一个部门待了多长时间，可能与终生结果有意义的关系。

COVID-19不太可能是美国卫生系统面临的最后一场传染病危机，目前的大流行还没有已知的结束。一些模型表明，在疫情季节性波动时，需要滚动封锁期。对于致力于持续改进的组织来说，历史联系数据对未来的灾难规划工作将是无价的。

The Bigger Picture of Emergency Management Planning

While patient-staff contact tracing is a focus for the current COVID-19 pandemic, health systems can use many of the same strategies to prepare for future outbreaks with the potential for similar capacity strains. Organizations must strengthen their data-driven emergency planning and monitoring capability to react in an appropriate, efficient, and timely manner. For many organizations, COVID-19 has highlighted gaps in their patient flow data strategy. Looking towards contact tracing using existing data sources is a meaningful first step in growing an active infection surveillance strategy.

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

1. How Data Transforms the Hospital Command Center to Pandemic Proportions
2. Cross-State Nurse Licensing: One Way to Improve Care During COVID-19
3. How to Scale Telehealth Solutions to Increase Patient Access During COVID-19
4. What Health Systems Need to Know About COVID-19 Relief Funding
5. Activity-Based Costing in Healthcare During COVID-19: Meeting Four Critical Needs

---

PowerPoint Slides

Would you like to use or share these concepts? Download the presentation highlighting the key main points.

Click Here to Download the Slides

Steps for Effective Patient and Staff Contact Tracing to Defend Against COVID-19 Spreadfrom世界杯葡萄牙vs加纳即时走地