NKCH Begins Testing All Admissions for COVID-19

On May 14, North Kansas City Hospital began testing all admissions to the hospital for COVID-19.

NKCH Chief Medical Officer James L. Stewart, MD, CHCQM, noted testing is imperative for the safety of patients and staff. "This is an unprecedented time, and we understand people are concerned about the spread of the virus," Dr. Stewart said. "Our patients can rest assured our policies position our experienced and dedicated physicians and staff to continue their commitment to provide a safe hospital environment."

Since most admissions come through the Emergency Department, ED physicians will write most orders for COVID-19 tests. Scheduled admissions for surgery should have already been tested as part of the pre-op evaluation process. Attending physicians need to order tests for direct admissions that do not go through the ED.

Rapid Testing

"At this time, we feel we have an adequate supply of the rapid NKCH Cepheid tests to test all persons under investigation, as well as anyone who will need a procedure within 24 hours," Dr. Stewart said.

All other non-symptomatic, non-PUI admissions will be tested with a MAWD test, which now can be done with sputum or saliva. The rapid NKCH Cepheid tests still require a nasopharyngeal swab.

On-site Cepheid test results are available, on average, within 90-120 minutes. "In addition to affording physicians with the ability to speed their treatment determinations, the rapid tests help us avoid unnecessary use of personal protective equipment and thus allow us to appropriately allocate our PPE," Dr. Stewart added.

Orders

If a patient is symptomatic and therefore a PUI, the physician should select "suspect COVID" for a routine PUI admit and those needing a procedure. This will trigger an order for isolation. If the patient needs a procedure but is not symptomatic or is a routine non-PUI admission, the physician should select "pre-procedure testing" or "admission screening." This will not trigger the isolation order. (See flowchart.)

If an admitted patient is discharged before results are available, the attending physician will be responsible for notifying the patient about the results.

"Our physicians, staff and administrators have worked tirelessly to address the challenges of COVID-19 and to provide patients with optimal patient care while protecting staff and the community," Dr. Stewart said. "This vigilance is crucial in our to COVID-19 response."

James L. Stewart, MD, CHCQM

Dr. Stewart earned his medical degree from Saint Louis University School of Medicine. He completed his residency at the University of Kansas Medical Center.