Operationalizing a Pandemic-Ready, Telemedicine-Enabled Drive-Through and Walk-In Coronavirus Disease Garage Care System as an Alternative Care Area: A Novel Approach in Pandemic Management.

This was a single-site quality improvement evaluation using before-and-after charts, so other changes in the emergency department or pandemic period could have contributed to the observed reductions. The Tele-Garage bundled screening, remote registration, nurse triage and swabbing, telemedicine, discharge instructions, and follow-up calls, so the contribution of any single component cannot be separated. PPE savings were estimated from expected PPE sets before and during implementation, not directly measured. The garage required physical space next to the emergency department, wireless IT, equipment, and a generator, and it was not climate controlled, so it may not be feasible elsewhere. Eligibility was limited to patients aged 2 to 65 years, classified as low acuity, without heart disease, lung disease, diabetes, or immunocompromised status, so it does not address higher-acuity, older, or medically complex patients. The paper did not report patient or staff satisfaction, and it could not perform a cost analysis because supply-chain data were unreliable.

Do not conclude that telemedicine alone reduced emergency department length of stay or PPE use. The garage model bundled drive-through routing, remote registration, nurse triage and swabbing, telemedicine visits, discharge instructions, and follow-up calls, and the paper did not test these components separately. The PPE reduction was estimated from expected PPE use, not directly measured.