Background: The COVID-19 pandemic has necessitated innovations in the delivery of general practice. GP-led respiratory clinics and drive through facilities have been developed to clinically assess and test people with mild to moderate COVID-19 symptoms. However, the safety and efficacy of these models have not been evaluated. This study evaluated a GP-led respiratory clinic with a drive-through testing clinic, in Melbourne, Australia, to identify risks and risk mitigation strategies.
Method: Evaluation over two six-week periods (April-May 2020 and July-September 2020) included: observations, field notes, infection control checklists, opportunistic interviews and in-depth interviews with clinic staff and patients, patient satisfaction surveys, and protocol review sessions with clinic staff. Video recordings, interviews and field notes were thematically analysed. Risks and mitigation strategies were discussed with clinic staff.
Results: Infection control risks included: appropriate hand-hygiene and personal protective equipment use, and need for social distancing in areas of congregation. Ergonomic, psychological and OH&S risks were also identified. Public safety risks included safety around moving vehicles. Risk mitigation needed to be responsive to on-going changes in infection prevalence as well as changing policy. This included splitting the workforce into two teams to reduce the impact on the operation of the clinic should a staff member contract COVID-19. Both staff and patients expressed feelings of safety and satisfaction working and attending the clinic.
Discussion: This GP-led respiratory clinic model provided a flexible framework to respond to constantly evolving regulations, restrictions and risks. The collaboration between academic Department of General Practice and the clinic has resulted in research which can be rapidly translated into practice.
Implications for practice: The evaluation supports the finding that a GP-led respiratory clinic, with drive-through testing facility, is a safe and effective model of care if adequately resourced. Protocols that minimise risk can be adapted to other primary care settings.