Background and importance Adapt the outpatients care activity to the scenario arising out of the COVID-19 pandemic.
Aim and objectives Reorganisation of the area, non in-person consultation, medication home delivery (MHD) and reduce patient attendance at day hospitals.
Material and methods Phase 1 (P1): reinforcement of human resources, increase and easy the presential and telepharmacy schedule, adaptation of the facilities.
Phase 2 (P2): advanced preparation of the medication, MHD, substitution of intravenous treatments by subcutaneous treatments.
The telepharmacy and MHD were conducted at patients’ request. Delivery routes and alternative urgent delivery systems were established. P1 activities began 2 weeks prior to the announcement of the State of Alarm (SoA, 16 March 2020) and P2 began and continues for vulnerable patients. Our project is currently underway in a proactive, selective and continuous way.
Results Activities were analysed during 2020, weeks 12–19 (16 March to 10 May 2020) and compared with theoretical activity during the same period in 2019, with an increase in activity (+21%). The difference between the sum of in-person and telematic consultations and the theoretical consultations for the period was named after omitted consultations.
Overall activity in weeks 12–19 was 5550 consultations, of which 4414 (79.5%) were in-person and 1136 (20.5%) telematic. The estimated activity would have been 7030 consultations, and 1480 (21% of the theoretical ones) have been omitted. In-person activity decreased from 5973 patients between weeks 12 and 19 in 2019 to 4414 in 2020 (−23.3%).
Distribution of the 1136 MHD: week 12 (30), week 13 (131), week 14 (232), week 15 (190), week 16 (168), week 17 (155), week 18 (115) and week 19 (115). Waiting times for in-person consultation were reduced from an average of 5.2 min/patient in the pre-alarm period to 3 min during the alarm (−42.3%).
Conclusion and relevance Our data may be used to detect areas for improvement; consultations should be made proactively and tools are needed to qualitatively analyse omitted activity. A system is needed to account for tele-assistance that has not resulted in dispensing medication or MHD.
Conflict of interest No conflict of interest
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