{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T08:40:10Z","timestamp":1748680810194,"version":"3.41.0"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Background: During the COVID-19 pandemic, rapid, at-home testing for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was inconsistently available. Consequently, for some patients, emergency departments (ED) became the preferred site to access COVID-19 testing. To improve operational efficiency, our ED implemented a \u201cCOVID-19 Test\u201d chief concern (CC). Our primary objective in this analysis was to broadly assess the utilization of the new \u201cCOVID-19 Test\u201d CC and associated clinical care. Methods: We conducted a retrospective analysis of ED encounters from an academic ED and an affiliated, community-based ED of all patients after the establishment of a CC of \u201cCOVID-19 Test\u201d from October 11, 2021\u2013July 31, 2022. The data were extracted from the electronic health record. We calculated descriptive demographic statistics and ran a univariate and multivariate logistic regression with additional diagnostic or therapeutic interventions (binary) as the outcome variable to generate odds ratios (OR) and 95% confidence intervals (CI). Results: A total of 320 patients were assigned a \u201cCOVID-19 Test\u201d CC by a triage nurse. This was 0.5% of all ED encounters in this time frame. Of those, 45% were found to be SARS-CoV-2 positive. Admission or repeat ED visit at 72 hours occurred in 5.3% of patients. Nearly half (46.9%) of patients assigned a \u201cCOVID-19 Test\u201d CC underwent additional ED interventions. Patients on Medicaid and those who self-identified as Black or Hispanic\/Latino were disproportionately represented in the \u201cCOVID-19 Test\u201d CC group as compared to the overall ED population. In multivariate analysis, an Emergency Severity Index of 1, 2 or 3 was associated with significantly higher odds of receiving additional interventions compared to ESI of 4 or 5 (adjusted OR: 46.85; 95% CI 13.28-165.26; P &amp;lt;0.001). Conclusion: Patients assigned a chief concern of \u201cCOVID-19 Test\u201d had a high COVID-19 positivity rate, often underwent additional ED interventions, and were at low risk of return ED visits or admission. Minoritized and low-income patients were disproportionately represented in the \u201cCOVID-19 Test\u201d CC group, highlighting potential disparities in access to at-home COVID-19 testing and implementation of this CC.<\/p>","DOI":"10.5811\/westjem.34850","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T23:19:18Z","timestamp":1746227958000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Implementation of a \u201cCOVID-19 Test\u201d Chief Concern in the Emergency Department"],"prefix":"10.5811","volume":"26","author":[{"given":"Collin","family":"Michels","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Hekman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca J.","family":"Schwei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan E.","family":"Tsuchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Gauger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Hurst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Glazer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Brink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciara","family":"Barclay-Buchanan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish N.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azita G.","family":"Hamedani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Pulia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2025,5,2]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt6fn127r2\/qt6fn127r2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T08:24:27Z","timestamp":1748679867000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/6fn127r2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,5,31]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.34850","relation":{},"ISSN":["1936-9018"],"issn-type":[{"type":"electronic","value":"1936-9018"}],"subject":[],"published":{"date-parts":[[2025,5,2]]}}}