Triaging COVID-19 patients

Maastricht University Medical Center deploys Avola Decision to assist medical staff in quickly triaging COVID-19 patients at the ER.

Giving patients the best possible care is a top priority for the Maastricht University Medical Center. This also applied at the start of the COVID-19 pandemic. In order to assess the best medical care and protect the medical staff and non-COVID-19 patients, the aim was to strictly shift COVID-19 and non-COVID-19 patients at the ER. Incoming COVID-19 patients in the emergency rooms needed swift assessment and action from the medical staff. However, there were many uncertainties about how to triage these patients and guidelines and protocols were changing on a daily basis. We Are Not, a consultancy in the healthcare industry, leveraged Avola Decision as a triage tool. They applied it to assist the medical staff in quickly screening patients for COVID-19 status and making the right decisions about their triage according to the latest protocols.

Challenge: Consistent decision making in an uncertain adaptive situation

The biggest challenge the Maastricht University Medical Center faced was that there was a lot of complexity and uncertainty about the best triage for patients that were being rushed into the emergency rooms at the beginning of the pandemic.

Therefore the protocols on how to triage these patients to the proper wards were complex and changed frequently. They were also often interpreted differently by the medical staff with inconsistencies in triage as a consequence. Besides that, ambiguity arose about the logistics of COVID-19 patients.

The Maastricht University Medical Center then asked We Are Not if they could assist them to reduce the complexity of screening these patients. We Are Not specializes in developing intelligent solutions that assist medical professionals in guaranteeing the quality and safety of healthcare. They selected Avola Decision for this assignment because it allows Decision Modelling and because Avola was very cooperative and willing to expand their platform to meet their specific needs.

Solution: Use decision models to translate protocols into clear rules
During several meetings, We Are Not discussed the complexity of medical decisions that needed to be made for COVID-19 patients with the medical staff. The bottlenecks in the current process were identified and some crucial inconsistencies were discovered.

The next step was to translate the triage rules into decision models which were then automated in Avola Decision within a week. The result was that the medical staff and the other hospital staff now had access to a clear and consistent triage tool for COVID-19 patients. If the protocols changed, the rules could quickly be adapted in Avola Decision. As a result the healthcare staff at the ER just had to follow the application, knowing that it would consequently guide them through the latest version of the protocol.

Advantages: Informed speed of triage and improved transparency

By leveraging Avola Decision as a triage tool the medical staff in the Maastricht Medical Center benefitted from various advantages. First of all, they no longer had to plough through the latest versions of the protocols themselves. If changes occurred they were immediately added to Avola Decision enabling the hospital to ‘go live’ with a new protocol with the push of a button. This enabled the medical staff, but also the rest of the hospital staff involved with COVID-19 patients, to make informed decisions at speed.

Putting the patient first

Furthermore, the platform improved transparency of the complex decision-making process of the medical staff. For the first time, their knowledge, usually hidden in their heads, was translated into clear rules. Their decision-making process regarding the triage of patients was no longer a black box but became fully transparent.

The consultants of We Are Not hope that deploying Avola Decision as a triage tool puts more changes in motion in the healthcare industry. Popke Rein

Munniksma, co-founder of We Are Not: “By capturing complex decisions made by healthcare professionals in systems like Avola Decision they no longer have to keep this complex knowledge in their heads. This makes their decision-making process transparent and brings clarity and peace of mind. Moreover, it allows healthcare professionals to spend more time on themselves and their patients.”

Pandemic protocol

We Are Not also applied Avola Decision to develop a pandemic protocol for the intensive care unit of the hospital. In this protocol, they captured the rules that apply in case there are no more beds available on intensive care. Based on these rules the medical staff can make decisions on which patients to admit to intensive care. Fortunately, this protocol hasn’t been used so far.

 Eventually, about fifty staff members working in the emergency rooms used the triage tool based on a daily basis until the number of COVID-19 infections decreased in the summer.