Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 21;S0090-4295(20)30395-2.
doi: 10.1016/j.urology.2020.04.059. Online ahead of print.

Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway

Free PMC article

Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway

Alex Borchert et al. Urology. .
Free PMC article


Objective: To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care.

Materials and methods: Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value <.05 was considered significant.

Results: Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection.

Conclusion: During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.


Figure 1:
Figure 1
New Algorithm for Triaging Inpatient Urology Consultations during COVID-19 pandemic
Figure 2:
Figure 2
Consultation type, and COVID-19 cases, by day, from March 16-April 2, 2020

Similar articles

See all similar articles

Cited by 1 article


    1. World Health Organization . 2020. Coronavirus disease 19 (COVID-19)- Situation Report 80. PublishedAccessed April 10, 2020.
    1. Governor Whitmer Signs Executive Order Expanding COVID-19 Emergency Declaration and Declaring State of Disaster. Accessed April 7, 2020,9753,7-406-98158-523989–,00.html
    1. Mack Julie. “Michigan Has Become a U.S. Epicenter for Coronavirus. Why?”. Mlive. 2020 PublishedAccess April 6, 2020.
    1. Gooch Kelly. “'We Are Not Immune': Henry Ford Health Says 734 Employees Positive for COVID-19. More than 700 Employees of Detroit-Based Henry Ford Health System Have Tested Positive for COVID-19.”. Becker's Hospital Review. 2020 Published.
    1. Li Ruiyun, Pei Sen, Chen Bin. “Substantial Undocumented Infection Facilitates the Rapid Dissemination of Novel Coronavirus (SARS-CoV2) Science. 2020 doi: 10.1126/science.abb3221. - DOI

LinkOut - more resources