Sanford inspires drive-thru COVID-19 testing in Costa Rica

Sanford partner Hospital Metropolitano gets creative to limit virus exposure

Written by
August 6, 2020
7 min read
A health care worker conducts a COVID drive-through test in Costa Rica
  • SLIDE SHOW (1/5): A health care worker does an auto COVID test in a Paez Laboratorios drive-thru site in Costa Rica. Paez Laboratorios is affiliated with Hospital Metropolitano. (Photo courtesy of Hospital Metropolitano)
    SLIDE SHOW (1/5): A health care worker does an auto COVID test in a Paez Laboratorios drive-thru site in Costa Rica. Paez Laboratorios is affiliated with Hospital Metropolitano. (Photo courtesy of Hospital Metropolitano)
  • This is a Hospital Metropolitano auto COVID-19 testing tent in Costa Rica. (Photo courtesy of Hospital Metropolitano)
    This is a Hospital Metropolitano auto COVID-19 testing tent in Costa Rica. (Photo courtesy of Hospital Metropolitano)
  • Triage tents were put into place to restrict traffic into the hospitals. All staff and visitors must enter the screening triage tent, answer screening questions and get their temperature taken. If they are cleared, they are allowed to enter the hospital. If they are screened suspicious for COVID-19, they are moved into the respiratory triage tent. The provider in full PPE then comes and completes an assessment within the tent to determine next steps. COVID-19 tests are done here as well. (Photo courtesy of Hospital Metropolitano)
    Triage tents were put into place to restrict traffic into the hospitals. All staff and visitors must enter the screening triage tent, answer screening questions and get their temperature taken. If they are cleared, they are allowed to enter the hospital. If they are screened suspicious for COVID-19, they are moved into the respiratory triage tent. The provider in full PPE then comes and completes an assessment within the tent to determine next steps. COVID-19 tests are done here as well. (Photo courtesy of Hospital Metropolitano)
  • A Hospital Metropolitano health care worker screens a patient in a triage tent in Costa Rica. (Photo courtesy of Hospital Metropolitano)
    A Hospital Metropolitano health care worker screens a patient in a triage tent in Costa Rica. (Photo courtesy of Hospital Metropolitano)
  • A roof is being built across the parking area at the entrance of Hospital Metropolitano in San Jose. Because rain and wind took a toll on triage tents, the roof is intended to help protect them, shelter patients coming in and out of the hospital or being loaded or unloaded into ambulances. (Photo courtesy of Hospital Metropolitano)
    A roof is being built across the parking area at the entrance of Hospital Metropolitano in San Jose. Because rain and wind took a toll on triage tents, the roof is intended to help protect them, shelter patients coming in and out of the hospital or being loaded or unloaded into ambulances. (Photo courtesy of Hospital Metropolitano)
A health care worker conducts a COVID drive-through test in Costa Rica

Drive-thru COVID-19 testing has served Sanford Health and its patients so well, the health system helped expand the idea to Costa Rica, too.

Sanford Health created Sanford World Clinic to partner with entities in locations worldwide to help improve care for certain populations. Those include Costa Rica.

In 2018, Sanford Health began a collaboration with Hospital Metropolitano, a private health care organization with hospitals, clinics and laboratories. The collaboration aims to help provide high-value care for middle-income families.

Sanford Health has been helping identify potential improvements and enhancements. As manager of clinical services at Sanford World Clinic, Johna Kern has a workplace that can span from Sioux Falls, South Dakota, to San Jose, Costa Rica, when she’s conducting a clinical operational assessment of aspects of a facility there.

Kern has looked at areas from pharmacy to radiology and everything in between. Now she’s helping her Hospital Metropolitano colleagues plan for an ICU, which the hospital in San Jose doesn’t currently have. They’ve also worked to set up an electronic medical record system.

“It has been a pleasure building a relationship with the staff at Hospital Metropolitano. As a partner, Sanford World Clinic plants the seeds and watches them grow,” Kern said.

Coronavirus in Costa Rica

Kern has helped bring a couple of exciting developments to Hospital Metropolitano recently. One implemented a head-to-toe nursing assessment when patients come in. A basic nursing task in the United States, an assessment wasn’t customary for nurses in Costa Rica.

The other development is auto COVID-19 testing, or drive-thru testing. When COVID-19 cases began appearing, Hospital Metropolitano set up a couple of “triage tents” outside facilities to keep potential COVID-19 cases from entering the building, Kern explained. One tent screens everyone who walks in. If the screening indicates a further COVID-19 concern, the person enters the second tent to get masked and possibly tested.

Related: Health care heroes: Sanford’s mobile testing teams

In Costa Rica, the majority of COVID-19 cases are handled by the public health system. However, Hospital Metropolitano and affiliated Laboratorios Paez are an option for those patients who for some reason cannot access the public system and are looking for an accessible and faster option.

After Sanford Health began holding drive-thru testing at various locations in the Upper Midwest, Kern brought up the concept with her Hospital Metropolitano colleagues. She pointed out they could be the first in the country to do it.

“It was quite a farfetched idea — like, is this even a possibility here?” Kern said.

Albin Badilla Mora, director of clinical laboratories in 20 locations for Hospital Metropolitano and Laboratorios Paez, first thought drive-thru testing seemed a little difficult to carry out. “However, in conversations with Sanford and through Johna in our weekly meetings, we started to value the idea,” Dr. Badilla Mora said.

“It could be a very convenient option for our patients.”

And as it turned out, it was. Dr. Badilla Mora said it has been well-received, especially among asymptomatic people who want to find out whether they have COVID-19.

Busy lab time

During Costa Rica’s first, relatively light surge of cases, the auto COVID option was available a short time each day at San Jose and Santa Ana. Hospital Metropolitano conducted about 500 total tests in the month of June. Now, however, a second surge with higher case numbers led to 500 tests conducted in just the first nine days of July, Kern said. The hours for auto COVID testing have been extended to help keep people in their cars and away from others.

The lab that processes the tests has begun to run on a 24-hour schedule, and so has Dr. Badilla Mora. Getting the lab set up to run COVID-19 “has been a strenuous but very enriching experience,” he said. It can process up to 150 tests per day.

The pandemic also has added more urgency and communication to Dr. Badilla Mora’s role.

“I and my team must always be innovating and looking for new test options as well as keeping the operational order of each process, that each test is carried out under strict quality and safety standards,” he said.

A point of pride came for Hospital Metropolitano when representatives from the Costa Rican Ministry of Health and the World Health Organization came to review one of the health system’s facilities. They “endorsed our actions in patient care, the placement of tents to triage as well as the protection measures implemented in the facilities,” Dr. Badilla Mora said.

He has appreciated Kern’s support, as she offers information about Sanford Health policies — such as drive-thru testing — that then get adapted in Costa Rica. “We have also received her feedback about the good clinical and safety practices that we have implemented,” he said.

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Posted In COVID-19, Family Medicine, Internal Medicine, World Clinic

Jane Thaden Lawson
Jane Lawson was a senior communications specialist with Sanford Health.