Challenges of Biological Triage Management in the COVID-19 Pandemic: Barriers and Solutions

The substantial changes in the COVID-19 epidemic around the world and its impact have repeatedly changed the management, diagnostic, and even treatment protocols. The meaning of changing the concept of triage is adjusting the process of ordinary hospital triage to a gray and two-layer triage. In this study, the field evaluation of the strengths and weaknesses of the management and triage of COVID-19 patients and the design of a biological triage model in a selected military hospital has been conducted.

This research was a descriptive study in terms of its purpose and method; it is a qualitative study. The Delphi method was used. The studied community, specialists, and elites related to the treatment of COVID-19 included emergency, infectious, internal medicine, lung, and anesthesia specialists, as well as experts and senior hospital managers in the scientific committee of the university. Sampling was done using a targeted and available method. Focused group discussions, expert panels, and qualitative interviews people used to obtain were optional. Delphi results were analyzed in three rounds with content analysis to identify the main topics and use collective agreement indicators.

By holding a panel of experts, the results of research findings in qualitative panels were presented in three categories. First, the weaknesses and strengths of the existing and notified protocols of the Ministry of Health were identified. Then, the experts in the scientific committee of Corona presented the implementation solutions to improve and enhance the treatment protocol in the hospital. Finally, the implementation algorithm agreed upon by most experts was presented. The maximum isolation of patients from the beginning of entering the gray triage unit, the use of the maximum emergency capacity in a pandemic, and the use of home care methods to accelerate the discharge process of recovered patients were among the most important features of the proposed algorithm.

Proper and continued training based on the latest findings, complete isolation of the triage area until hospitalization of COVID-19 patients, use of resistant structures, development of support beds in the emergency room, and conducting preparation maneuvers in biological pandemics based on an algorithm are of particular importance.