COVID Monitor Quick Reference Guide

COVID Monitor Quick Reference Guide INTAKE ASSESSMENT (Health Direct Staff)

Please use the following guidance when completing an Intake Assessment on COVID Monitor if you are a Monash Health or Health Direct employee assisting with COVID Positive Care Pathways. Please see the COVID Monitor Login Quick Reference Guide if you need assistance to login.

Patient Allocation Patients are allocated to Monash Health twice daily from SEPHU, before 9am and before 3pm. Patients are allocated based on their home postcode. At times patients from outside the Monash Health catchment will be allocated to the Monash pathway (for example if they are complex paediatric patients, if they are maternity patients or if they are Monash Health employees). So you will see some patients with an address outside the Monash catchment.

As soon as patients are allocated to Monash Health, they will receive a short survey with 4 questions – vaccination status, symptom start date, pregnancy status (if applicable) and if they have comorbidities. They then get a symptom survey. The answers provided allow us to prioritise the Intake Assessment (i.e. who we need to call first).

Intake Assessment We aim for all patients coming into the pathway to have an Intake Assessment. However, at times of very

high demand, there may be some patients that do not receive a personal phone call, but these patients will

be well (no or mild symptoms) and with no co-morbidities or social complexity, so unlikely to require

medical care or referral for social assistance.

The aim of the Intake Assessment is to stream patients into a Care Pathway, that defines the type of care

they will receive and who will provide that care. Details are in the below table:

Care Pathway Care Provider Care Provided

Community

Health /

Primary Care

LOW

General Practitioner

Community Health Service

Telehealth GP appointments

Symptom monitoring

Monash Health

MEDIUM

Complex Care

Plus MC@H for paeds

Plus Maternal Fetal Medicine

(MFM) for maternity

Symptom monitoring

Telehealth from medical or nursing

Home visits (as required)

Monash Health

HIGH

Inpatient Unit Inpatient care, usually at a Monash Health facility

It is the assessors role to complete the Intake Assessment for their allocated patients and decide which Care

Pathway the patient should be steamed to. There is an algorithm behind the assessment on COVID Monitor,

however clinical reasoning should be applied in addition to ensure the patient receives the right care from

the right provider, and that health service resources are reserved for the patients who need it most.

Pending Assessment List Patients who require an Intake Assessment will appear on the Pending Assessment list, found by clicking on

the 3 horizontal bars in the top left of the screen.

COVID Monitor Quick Reference Guide – INTAKE ASSESSMENT V1.6 November 4, 2021 2

Select Pending Assessment.

The Pending Assessment list looks like this:

Each colum heading is explain in the below table:

COLUMN HEADING FUNCTION

Priority Gives ability to sort the list by priority (criteria on next page)

Type P1, P2 etc in the box below the column heading to sort the list by priority

TREVI ID This is the unique patient identifier

UR This is the Monash UR number that most patients will not require

First name / Surname

/ DOB / Address /

Suburb

Self-explanatory – can be edited in the Patient Details screen if incorrect

Model of Care Standard for majority of patients

If patient is marked for Monash Children’s at Home, will say MC@H – Central

Bayside should not complete intake for these patients

Paediatric / Maternity Yes/No – enables filtering for paediatric and maternity patients

Last Obs Date When the patient last entered their observations

Symptomatic NA/Normal/Mild/Moderate/Severe – enables filtering for symptom severity by

typing the severity in the box below the column heading

SOB / Chest Pain Key symptoms that patient will have entered themselves

Self-symptom Onset /

TREVI Symptom Onset

These will help identify the date on which a patient can be discharged from the

pathway (Day 14 in most cases) – this cannot be edited in COVID Monitor

Day of Illness This is dictated by the date of symptom onset or their first positive swab date – you

cannot edit it

History Risk If the patients have answered YES to the pre-intake comorbidities question, it

means they have one or more of: respiratory disease, diabetes,

immunocompromised, cancer treatment in last 6 months, obesity (it is a Yes/No


questions, so specific detail of which one will be captured in your assessment)

Vax Status Vaccination status – Not yet, one dose, two doses. Specific detail will be captured in

your assessment.

Clinical Pathway /

Pathway Severity

All new patients will default to Community and Low. As part of your intake

assessment, you may change the pathway to Monash Health and you may upgrade

severity to medium or high, depending on the outcome of your assessment.

Day of Allocatoin The date upon which the patient was allocated to the COVID Care Pathway

Assessment Should be NO for all cases on this list.

Discharged Should be NO for all cases on this list.

Deceased Hopefully NO for all cases on this list but if the patient is deceased you can note this

during your assessment.

Each assessor will have a pre-defined list of patients on which to complete Intake Assessment.

Intake Assessment Priority Criteria P1-4 is automatically set in the Pending Assessment list based on the criteria in the below diagram:

P1 cases should be assessed ideally within 4 hours and P2 should be assessed within 24 hours.

Within the P1 category, sub-priority should be given as follows: P1 (severe symptoms), P1 (moderate

symptoms with comorbidities), P1 (pregnant, no severe or moderate symptoms), P1 (very old, very young),

P1 (all remaining).

Within the P2 category, sub-priority should be given as follows: P2 (moderate symptoms), P2 (adults who

have not responded), P2 (adults or unvaccinated children overe 12 years with comorbidities and

mild/normal symptoms).

The prioritisation is dynamic, so patients will move between levels depending on the symptoms they enter.

Patient Details To perform your assessment you need to click on a patient in the Pending Assessment list and this will take

you to the Patient Details screen. This is where you complete you Intake Assessment. Please check that the


patient hasn’t already had an Intake Assessment completed by scrolling to the bottom of the screen. If this

documentation appears, they have already been assessed:

The patient details appear as per below.

There are a number of buttons on the right side of the screen:


You may need to use the following buttons as part of your Intake Assessment:

Button Used For

Edit Patient If any of the patient details are incorrect, or if you need to add a UR to the patient

record (MC@H will use this)

Left Message / No

Answer

If you call the patient to complete your Intake Assessment and you can’t get onto

them – you choose to escalate or await a call back or call them again

Record Notes If you need to record something specific in addition to the Intake Assessment

documentation

Request Clearance /

Discharge

This can be used if your patient needs to be discharged from the pathway for any

reason (transfer to other health service as they are living out of catchment,

moved to hotel quarantine, withdrawn consent, declines assessment / care,

duplicate record, false positive, deceased)

USE THIS FUNCTION CAREFULLY AS THEY WILL BE DISCHARGED FROM THE

COVID CARE PATHWAY ONCE YOU SELECT ANY OF THE PURPLE OPTIONS

Change Care Pathway Once you have completed your assessment, use this button to allocate the patient

to the right care pathway – Monash Health (high, medium, low) or Community

Health (low).

Change Model of Care Can select if patient is under Adult HITH, Monash Children’s at Home or Maternal

Fetal Medicine

Patient Deceased Use to mark patient as deceased if required

Complete Intake

Assessment

Use this to launch the Intake Assessment. It will launch a new tab with a series of

questions that forms your assessment. Once you have answered all the questions,

select ‘Submit Triage Assessment’

Completing the Intake Asssessment You are now ready to phone the patient. Ensure your phone is set to not show your caller ID, so the patient

cannot see the number you are calling from. Use hands free or a headset to ensure you can type while you

are talking to the patient. The patient’s demographics are in the Patient Details screen, including their age.

For paediatric cases, you may be speaking to a parent or guardian.

Provide a brief introduction – “Hi, my name is … I’m calling from the Monash Health COVID Positive Care

Pathway program. I understand you have been diagnosed with COVID-19 recently. The purpose of this call is

to see how you are feeling and check if you need any other supports while you are isolating. Are you happy

to proceed with the assessment over the phone?”

Most patients will be cooperative and grateful. Some will decline the assessment. See the section below

‘Patients who Decline the Assessment’ for what to do in this situation.

Some patient may need an interpreter. See the section below ‘Patients who Require an Interpreter’ for what

to do in this situation.

For patients who are ready to proceed with the assessment, launch the Intake Asssessment from within the

Patient Details screen using the below button:

This will open a new tab in your browser.


Complete all questions in the Patient Information, Patient History and Intake Screening Questions sections .

No questions are mandatory but please fill in as much information as you can and use the free text fields to

add information not captured elsewhere.

Patient Information Please check the patient information on the Patient Details screen, particularly their home address, to

ensure we have up to date details for the patient. Please complete all sections in the Patient Information,

especially the Next of Kin details so we have an alternative contact number in case we cannot contact the

patient directly. Update any general demographics via the Edit Patient button.

Once you launch the Intake Assessment, ensure you select the correct screening organisation and put your

name in correctly.

Fill in all the fields in the Patient Information section, particularly the Next of Kin details.

Note that all patients who are Refugees or Aboriginal / Torres Strait Islanders should be in the MEDIUM

SEVERITY PATHWAY.

Patient History The table below explains the relevance of the Patient History questions for adult patients. The following co-

morbidities are risk-factors for severe COVID-19. Unless otherwise specified, patients who have one of the

following comorbidities should be in the MEDIUM SEVERITY PATHWAY.

History

Question

Definition Explanation

Pregnant Pregnancy confirmed by biochemical test

or ultrasound

Pregnant women are at increased risk of severe

disease and may have increased frequency of

preterm birth or Caesarean delivery.

Age Age > 55 years Older age is associated with severe disease and

increased mortality.

Cardiac

Disease

Previous Acute Myocardial Infarct

History of angina

History of cardiac failure

Cardiomyopathy

Ischaemic heart disease (+/-

CABG/stents)

Patients with cardiovascular disease are at

increased risk of a poor prognosis.

Patients with severe infection may require

higher cardiac output, which may not be met in

patients with pre-existing cardiac disease.

In some patients, COVID-19 may result in

myocardial injury.

High Blood History of hypertension. Patients Hypertension may be a risk factor for severe


Pressure requiring a single antihypertensive

medication with a well-controlled BP can

remain in the LOW SEVERITY PATHWAY

COVID-19.

Cancer Patients with a diagnosis of active solid

tumour cancer (excluding isolated skin

cancers) OR haematological cancer e.g.

lymphoma, leukemia, myeloma.

They may be currently receiving

chemotherapy, radiotherapy or other

treatments, or recently completed

treatment in the last 6 months.

Patients that have been treated for

cancer more than 6 months ago and now

completely recovered can remain in the

LOW SEVERITY PATHWAY

Patients with hematologic and non-hematologic

malignancy may be at increased risk of severe

COVID-19.

Liver Failure Liver failure

Cirrhosis

Hepatitis B or C without liver disease can


Patients with liver disease may be at higher risk

of severe COVID-19.

Patients with cirrhosis may have a higher risk of

mortality.

Diabetes Patients with Type 2 Diabetes Mellitus on

oral hypoglycaemic agents and/or

receiving insulin therapy

Diet controlled Type 2 Diabetes

Patients with Type 1 DM

Patients with Type 2 diabetes are more likely to

have serious complications, more ICU

admissions and have higher mortality rates

from COVID-19.

There is little data to inform whether poor

glycaemic control prior to COVID-19 infection

impacts on the risk of severe infection.

Patients with Type 1 DM may be at higher risk

of severe COVID-19.

Renal Failure Patient with chronic kidney disease:

eGFR<30 mls/min if known, or currently

under review by a kidney specialist at

least twice a year.

Patients with end stage kidney disease

receiving haemodialysis or peritoneal

dialysis.

Patients with chronic kidney disease are at

increased risk of severe COVID-19.

Patients receiving haemodialysis at an

outpatient facility will require specialised

infection control measures when attending

outpatient haemodialysis.

Respiratory

Disease

Asthma

- Requiring blue puffer or reliever

medication (such as Ventolin, Asmol,

Airomir, Apo-Salbutamol or Bricanyl)

multiple times per week

- Asthma symptoms which wake them up

at night more than once/week

Chronic lung disease has been associated with

severe COVID-19.


- Poor asthma control in the previous 4

weeks

- Childhood asthma that has resolved can


COPD

Pulmonary fibrosis

Bronchiectasis

Cystic fibrosis

Other lung diseases

If patient is requiring home oxygen,

please ensure to note this

Immuno-

suppressed

Patient is receiving medication that will

suppress their immune system, often for

autoimmune disease such as rheumatoid

arthritis, SLE, RA, Crohn’s Disease,

ulcerative colitis. Common medications

include but are not limited to:

- Prednisolone - Methotrexate - Azathioprine - Cyclophosphamide - Tacrolimus - Biological therapies for arthritis

Or patients with conditions

that cause immunosuppression such as

HIV, hypogammaglobulinemia,

congenital immunodeficiencies.

Patients receiving immunosuppressive therapy

for rheumatic disease may be at risk for severe

COVID-19, although this is not clear.

Transplant

History

Patient has received a solid-organ

transplant e.g. kidney, heart, lung,

pancreas, liver

Patient has undergone a bone‐ marrow

transplant (allograft or autograft)

Patients receiving immunosuppressive therapy

may be at risk for severe COVID-19 and its

complications.

Transplant recipients have been reported to

have higher mortality rates in some studies.

Haema-

tological

disease

Blood disorders such as Thalassemia

major, Sickle cell disease, ITP requiring

ongoing treatment, myelofibrosis,

splenectomy.

These conditions may be associated with severe

COVID-19.

Recent or

current

Psychiatric /

Mental

Health

Treatment

Psychiatric conditions receiving ongoing

therapy by a psychiatrist.

Patients with a history of depression or

anxiety disorders but well-controlled

(including on medication) can remain in

the LOW SEVERITY PATHWAY.

Among patients with psychiatric illness,

deterioration may occur because routine visits

are not available, or patients may have reduced

access to medication.

BMI BMI >/= 30 kg/m2 Obese or very overweight patients are at

increased risk of severe disease.


Vaccination Status A patient’s vaccination status has been incorporated into the risk algorithm in COVID Monitor to determine

their risk of severe disease. A patient must be 14 days post their second dose of vaccination to be considered

fully vaccinated. Some patients remain at high risk of severe disease despite being fully vaccinated.

Vaccination status Clinical Pathway

Less than 75yo:

>14 days post 2nd dose

These patients will automatically be in the LOW SEVERITY PATHWAY

UNLESS they have any of the following conditions, in which case they will

remain in the Medium Pathway regardless of vaccination status:

- Pregnancy - Respiratory disease - Immunosuppressed (as defined in Table 1) - Renal replacement therapy - BMI >/= 30 mg/kg2 - Diabetes mellitus

Older than 75yo:

>14 days post 2nd dose

Patients > 75yo will remain in the MEDIUM SEVERITY PATHWAY

regardless of vaccination status

Intake Screening Questions The Intake Screening questions include both physical symptoms and social/welfare questions. Please answer

all questions to ensure a complete set of data.

Paediatric Patients The Intake Assessment is modified automatically for all patients less than 18 years of age. Questions are

phrased for a parent/carer to answer the questions about the child, however if the child is a teenager and

able to answer the questions for themselves, the questions can be asked directly to the patient.

The following table indicates which clinical pathway is suitable for paediatric patients based on age,

vaccination status, symptoms and comorbidities.

LOW SEVERITY MEDIUM SEVERITY HIGH SEVERITY

Age >1 month

(corrected)

<1 month (corrected)

If febrile, high severity

Any

Vaccination

status

Any Any Any

Symptoms Asymptomatic

Normal or mild

work of breathing,

OR

Normal or mildly

reduced feeding or

hydration OR mild

gastro symptoms

Moderate symptoms

Increased work of breathing OR

Poor feeding and hydration (~50% of

normal but not requiring NGIV fluids)

OR

Multiple episdoes of gastro

symptoms AND

Normal conscious state

Moderate to severe work of

breathing OR

Febrile neonate (<1 month

corrected)

Very poor feeding and

hydration (<50% of normal)

OR drowsy/abnormal

conscious state OR

persistent/severe chest pain

Kawasaki’s Disease/PIMS-TS

symptoms (rash with fever)


Comorbidities Nil Immunosuppression

Severe/complex medical, cardiac,

respiratory or neurodevelopmental

chronic disease

Significant disability

Extreme obesity (>95 percentile)

Afebrile neonates (<1 month

corrected)

Pregnancy (maternity pathway)

Any

Social /

Welfare

Out of Home Care

The algorithm will recommend the correct pathway for the patients based on the answers to the Patient

History and the Screening questions. Most children should remain in the LOW SEVERITY PATHWAY. From an

age perspective, only babies less than one month in age will routinely be referred to the MEDIUM SEVERITY

PATHWAY (i.e. Monash Children’s at Home).

Contact details for paediatric escalations are below:

Service Reason for Contact Contact Details

Paediatrician on call Urgent medical escalation 0487 019 649 (24 hours, 7 days)

Monash Children’s at Home To advise of medium severity

case or to confirm eligibility

for medium pathway

0414 427 371 (0730-1930)

[email protected]

When asking if parents need help and if there is anyone that could help them, please specify “If you are too

unwell to care for your child”. Please record the name and contact phone number of the adult able to

provide care in the event of parents being too unwell in the ‘Other Details’ text box at the end of the intake

assessment. If no contingency carer is available please refer to the Family Finding service – see section

below.

Maternity Patients Currently all pregnant patients should be classified as MEDIUM SEVERITY and referred to Complex Care and

the COVID Liaison Midwife at Monash Health (details below).

Contact details for maternity escalations are below:

Service Reason for Contact Contact Details

COVID Obstetric Fellow Urgent obstetric escalation Via Monash Switchboard

03 9594 6666 (24 hours, 7 days)

COVID Liaison Midwife To advise of new obstetric

cases and any obstetric

related queries

0423 790 756

[email protected]

(Monday – Friday service only)

On the weekends, please continue to send emails to the COVID Liaison Midwife, and these cases will be

picked up Monday morning. If there is an urgent clinical escalation over the weekend, contact the COVID

Obstetric Fellow using the above details.

mailto:[email protected]



Submission of the Intake Assessment Once you are finished all sections, select Submit Triage Assessment.

A summary of your assessment will appear, alongside a recommendation for the Care Pathway – LOW,

MEDIUM or HIGH.

Close this window and refresh your browser, and you will see the Intake Assessment will have appeared at

the bottom of the Patient Details screen. Use the scroll bar to scroll right across to see all the data.

A PDF of the assessment will appear in your Downloads folder. You will need this if you are referring patients

to the medium severity pathway.

Allocating the Care Pathway At this point, you need to apply your clinical reasoning as to whether the severity recommendation should

be upgraded based on the patient’s symptoms (as this is based on an algorithm). Do not allocate a lower

severity pathway than that determined based on the algorithm.

Patients with comorbidities as detailed in the Patient History section above, should always be classified as

MEDIUM SEVERITY.

A reminder of the Care Pathways:

Care Pathway Care Provider Patient Description

Community

Health LOW

General Practitioner

Community Health Service

Patient is otherwise well and symptoms are mild-

moderate and suitable for GP leve of care

Not likely to deteriorate

Monash Health

MEDIUM

Complex Care

Plus MC@H for paeds

Plus Maternal Fetal Medicine

(MFM) for maternity

Patient has comorbidities that makes them at risk of

deterioration OR patient has symptoms of concern but

can still remain at home OR patient has a highly complex

social situation OR patient is pregnant

Monash Health Inpatient Unit Patient needs urgent inpatient care (or is already an


HIGH inpatient)

Patients who meet the criteria for medium severity pathway based on age or co-morbidities must not

remain on the low pathway UNDER ANY CIRCUMSTANCES.

The Care Pathway is default set to Community Health LOW, so if you need to change the Care Pathway, use

the Change Care Pathway button and select the appropriate option.

Identifying the Patient’s General Practitioner (GP) All patients, regardless of their clinical pathway, should have their usual GP identified as part of the Intake

Assessment. Ask the patient ‘do you have a regular GP practice that you attend?’

Conplete this by clicking on the blue tick in the GP Practice section of the Patient Details screen.

Select the relevant practice from the dropdown list. If the patient does not have a GP, leave this as NONE.

Advise the patient that a GP will be arranged for them to provide care during their COVID episode if they

remain on the Low Severity pathway.

Low Severity Patients Low severity patients will receive telehealth care through their usual GP (if required) or their allocated GP

practice, as identified by our community partner, Central Bayside Community Health Service. They should

continue to enter their symptoms daily via the SMS that they will receive each morning around 8.30am.

Their symptoms will continue to be monitored by Central Bayside until they are discharged at Day 14.

Medium Severity Patients If patients have been identified as Medium Severity, they will receive care as per the below:

Patient Type Care Provider Contact

Adults Monash Complex Care 0404 084 273

[email protected]

Paediatrics Monash Children’s at Home 0414 427 371

[email protected]

Please let the relevant service know via email if you refer a medium severity patient to them. Attach the PDF

of your Intake Assessment so you don’t have to transpose any clinical details.

If you want to confirm your allocation decision, please phone the respective team as above, noting that all

pregnant patients will be MEDIUM SEVERITY as default.

If a case needs to be urgently discussed, please phone the doctor on call (details in Clinical Escalation

section). Do not send emails about urgent patients as these emails are not monitored all the time.




High Severity Patients High Severity Patients by definition require inpatient care. If when you call the patient they advise you that

they are already in hospital, change their Care Pathway to Monash Health HIGH. You do not need to

complete the Intake Assessment on these patients.

If during the Intake Assessment you feel that the patient needs urgent inpatient care (i.e. transfer to ED),

please don’t hesitate to call 000. If the transfer is not time critical, escalate the issue with the COVID Positive

Care Pathway Medical Team. See the Clinical Escalation section for further details.

Additional Information Use the ‘Record Notes’ button to record any additional information about the patient, as required.

Clinical Escalations The below table and flow chart details criteria for clinical escalation based on reported patient symptoms.

The below diagram illustrates what to do based on the reported patient symptoms.

The pathway has medical staff on call daily for urgent escalations.

Doctor phone 1: 0407 899 263 (10.30am – 8.00pm)

Doctor phone 2: 0408 331 953 (11.00am – 8.30pm)


Paediatric Doctor: 0487 019 649 (24 hours)

This is for advice only. Telehealth consultations with the patient are not available for patient undergoing

Intake Assessment.

Social and Welfare Needs If you identify that patients need support with the following issues:

Email Relief and Community Support on [email protected] and include the following information:

• Full name, address, phone number and TREVI number

• Number of household members (include ages of children)

• Urgent relief needs and timescale: Rapid (within 3 hours), Urgent (same day or within 24 hours) or

Non-urgent (24-48 hours)

If medication is required, low severity pathway patients should contact their GP for a prescription and

engage their local pharmacy to arrange contact-free delivery. For medium severity patients, medication

requirements should be handed over to Complex Care (or Monash Children’s at Home for paediatrics) so

they can be addressed.

Family Finding Service Family Finding is a service that can support parents/guardians plan alternative care arrangements for their

children with family or friends in the event that they require hospitalisation due to COVID-19.

The workflow is illustrated below.

Families involved with Child Protection are not in scope for Family Finding and should be referred to the

local Department of Families, Fairness and Housing Child Protection office.

Referrals can be sent to [email protected] with the subject line ‘Family Finding’. Email must

contain the following information:

• Name and contact number of the parent/guardian




• Names and ages of all children

• Confirmation that the parents/guardians can identify a care options however the identified carer will

require support such as transport, food and other relief to maintain care arrangements OR the

parents/guardians cannot identify anyone who would be able to care for their children and require

support in identifying a care option

• Advice as to whether the family requires an interpreter

Referrals for Aboriginal children can be sent to the Victorian Aboriginal Child Care Agency (VACCA) via

[email protected]. VACCA can be contacted on their response number 0488 930 509.

Difficulty Isolating If you identify that a patient has difficulty isolating or if you suspect that the patient is not isolating as

instructed, please escalate to SEPHU so they can address the issue [email protected]

You can also make a direct referral to the IIATS service to request Hotel Quarantine, however the service is

significantly oversubscribed and it is not uncommon for referrals to go unanswered. Refer here.

If you have urgent issues with isolation (i.e. family violence) email [email protected]

Patients who Decline the Assessment If the patient declines the Intake Assessment, offer to call back later in the day or the next day. Record this

using the ‘Record Notes’ button in the Patient Details screen.

If the patient does not want you to call them back (i.e. does not want to be part of the pathway) then you

can discharge them using the ‘Request Clearance/Discharge’ button in the Patient Details Screen.

Select ‘Discharge: Declined assessment/clinical care’

The patient will receive a text message confirming that they have declined care. The message includes a

contact number if they change their mind and want to be included in the pathway.

Patients who Require an Interpreter Health Direct can utilise their own internal interpreting arrangement or call TIS National Interpreting Service

on 131 450.

Uncontactable Patients If you are attempting to complete an Intake Assessment and you cannot contact the patient, mark as Left

Message / No Answer (dark blue button). Do not discharge them as unable to contact at this point.



https://iiatsreferral.justice.vic.gov.au/iiatsreferral?id=hq_cat_item_public&sys_id=e8d6ad331b2f181036fba68b274bcb65



A repeat attempt should be make to contact them later in the day and then again on the following day.

If after 2-3 attepmpts over 24 hours, they are still not-contactable, and they are not entering any symptoms,

then you can discharge them as unable to contact.

They will get a text to say that we have been unable to contact them, with a contact number should they

wish to join the pathway.

If they are entering symptoms, then do not discharge them, but leave them on the Pending Assessment list.

If they do continue to enter symptoms, but do not answer the phone, they can be left on the pathway until

day 14, when they will be routinely discharged. If their symptoms deteriorate to the point they become a P1,

attempts to contact them should continue.

Wrong Number / Number Disconnected / No Phone Number If you come across a patient where the phone number is incorrect or disconnected, please remove the

number from the patient’s file so that we do not continue to contact an incorrect number.

Do this via the Edit Patient button in the Patient Details screen:

The admin team will regularly check the whole patient list for patients who do not have phone numbers and

attempt to find alternative numbers where possible.

Release from Isolation and Discharge from the Pathway Patients are usually discharged from the COVID Positive Care Pathway at Day 14, provided they have no or

mild symptoms. Patients are also released from isolation on Day 14 via text message from the Public Health

Unit. Most patients do not need a repeat swab to be released from isolation and cleared of COVID.

Patients can be vaccinated (if not already) once they are fully recovered from their acute illness, unless they

have had a Sotrovimab infusion, in which case they need to wait 3 months.

Please see the Discharge QRG for further information on discharging patients from the pathway.


Ten Steps of the Intake Assessment Process To ensure an effective and clinically appropriate Intake Assessment, complete the following steps

1 Ensure you know which patients you are allocated to call to avoid duplication of effort

2 During the call, check the patient’s demographics (especially current address and NOK)

3 Complete all sections of the Intake Assessment accurately

4 Identify the patient’s usual GP (if they don’t have one, leave as NONE)

5 Ensure you choose the correct care pathway – Low, Medium or High and ensure this is

documented in the ‘Change Care Pathway’ section within the Patient Details screen

6 If High (and not already in hospital), arrange emergency medical assistance via 000 if

time critical and escalate to the relevant COVID doctor

7 If Medium, ensure you have emailed a referral to the relevant team including the PDF of

your Intake Assessment and escalate to the relevant COVID doctor (if clinically required)

8 If Low, encourage the patient to connect with their GP (if they have one) and remind

them to continue to enter their symptoms daily via the SMS so we can monitor their

symptoms and provide care, should they need it

9 Complete any relevant referrals – Relief and Community Support, Hotel Quarantine etc

10 If patients are uncontactable, try them again later in the shift, they wil be called again

the following day, document any attempts to contact

Questions about the Intake Process? Email Sarah Lorentzen at [email protected]


Documents

COVID Monitor Quick Reference Guide