{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:42:20Z","timestamp":1786999340391,"version":"build-2736575974"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1935789322001665_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The transfer rate for patients from an Alternate Care Site (ACS) back to a hospital may serve as a metric of appropriate patient selection and the ability of an ACS to treat moderate to severely ill patients accepted from overwhelmed health-care systems. During the coronavirus infectious disease 2019 (COVID-19) pandemic, hospitals worldwide experienced acute surges of patients presenting with acute respiratory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789322001665_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An ACS in Imperial County, California was re-established in November 2020 to help decompress 2 local hospitals experiencing surges of COVID-19 cases. The patients treated often had multiple comorbid illnesses and required a median supplemental oxygen of 3 L\/min (LPM) on admission. Numerous interventions were initiated during a 2-wk period to improve clinical care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789322001665_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The objectives of this retrospective observational study are to evaluate the impact of these clinical and staff interventions at an ACS on the transfer rate and to provide issues to consider for future ACS sites managing COVID-19 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789322001665_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The data suggest that continuous, real-time process-improvement interventions helped reduce the transfer rate back to hospitals from 36.7% to 14.5% and that an ACS is a viable option for managing symptomatic COVID-19 positive patients requiring hospital-level care when hospitals are overburdened.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2022.166","type":"journal-article","created":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T23:51:20Z","timestamp":1656892280000},"source":"Crossref","is-referenced-by-count":1,"title":["Reduction in Hospital Transfers at a US COVID-19 Alternate Care Site: Maintaining Surge Capacity Support in Imperial County, California"],"prefix":"10.1017","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5615-7686","authenticated-orcid":false,"given":"Frank W.","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin A.","family":"Meghoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Staats","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Perkins","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitch","family":"Metzner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sobel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hultquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Noste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4175-0820","authenticated-orcid":false,"given":"Asha","family":"Devereaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6868-2664","authenticated-orcid":false,"given":"Howard","family":"Backer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"S1935789322001665_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-020-00363-4"},{"key":"S1935789322001665_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.01.084"},{"key":"S1935789322001665_ref12","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.32.545"},{"key":"S1935789322001665_ref13","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/1475-6773.01104","article-title":"Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project","volume":"37","author":"Morey","year":"2002","journal-title":"Health Serv Res."},{"key":"S1935789322001665_ref15","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.4103\/ijri.IJRI_967_20","article-title":"Role of chest radiography in the management of COVID-19 pneumonia: an overview and correlation with pathophysiologic changes","volume":"31","author":"Kohli","year":"2021","journal-title":"Indian J Radiol Imaging."},{"key":"S1935789322001665_ref7","unstructured":"7. COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. National Institutes of Health. Accessed August 17, 2021. https:\/\/www.covid19treatmentguidelines.nih.gov\/"},{"key":"S1935789322001665_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.22717"},{"key":"S1935789322001665_ref8","doi-asserted-by":"crossref","unstructured":"8. Kadri, SS , Sun, J , Lawandi, A , et al. Association between caseload surge and COVID-19 survival in 558 U.S. hospitals, March to August 2020. Ann Intern Med. Accessed July 30, 2021. https:\/\/www.acpjournals.org\/doi\/10.7326\/M21-1213","DOI":"10.7326\/M21-1213"},{"key":"S1935789322001665_ref3","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2020.12.49237"},{"key":"S1935789322001665_ref6","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1056\/NEJMcp2009249","article-title":"Mild or moderate COVID-19","volume":"383","author":"Gandhi","year":"2020","journal-title":"N Engl J Med."},{"key":"S1935789322001665_ref16","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.10799"},{"key":"S1935789322001665_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2022.93"},{"key":"S1935789322001665_ref9","doi-asserted-by":"crossref","unstructured":"9. Devereaux, AV , Backer, H , Salami, A , et al. Oxygen and ventilator logistics during California\u2019s COVID-19 surge-when oxygen becomes a scarce resource. Disaster Med Public Health Prep. 2021:1-7. doi:10.1017\/dmp.2021.267","DOI":"10.1017\/dmp.2021.267"},{"key":"S1935789322001665_ref1","unstructured":"1. Federal Healthcare Resilience Task Force. Alternate care site toolkit. Third edition. Accessed July 12, 2021. https:\/\/files.asprtracie.hhs.gov\/documents\/acs-toolkit-ed1-20200330-1022.pdf"},{"key":"S1935789322001665_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(99)70134-4"},{"key":"S1935789322001665_ref4","unstructured":"4. Imperial County. Public Health Department (2015-2016). Imperial County health status report. Accessed July 16, 2022. www.icphd.org\/media\/managed\/medicalproviderresources\/HEALTH_STATUS_2015_2016_final.pdf"},{"key":"S1935789322001665_ref5","unstructured":"5. CAL-MAT. Alternate Care Site Field Guidance First Edition. Nov 2020. Accessed July 16, 2022. https:\/\/emsa.ca.gov\/wp-content\/uploads\/sites\/71\/2020\/12\/CALMAT-Alternate-Care-Center-ACS-Field-Guide-Draft-11.24.20-v1-sje.pdf"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789322001665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T05:44:35Z","timestamp":1675662275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789322001665\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,4]]},"references-count":17,"alternative-id":["S1935789322001665"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2022.166","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"value":"1935-7893","type":"print"},{"value":"1938-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,4]]},"article-number":"e231"}}