11
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      New Approach to Managing the COVID-19 Pandemic in a Complex Tertiary Care Medical Center in Madrid, Spain

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The coronavirus disease 2019 (COVID-19) pandemic is putting health-care systems under unprecedented stress to accommodate unexpected numbers of patients forcing a quick re-organization. This article describes the staff management experience of a third level referral hospital in the city of Madrid, Spain, one of the cities and hospitals with the largest number of COVID-19 cases.

          A newly created COVID-19-specific clinical management unit (CMU) coordinated all clinical departments and conducted real-time assessments of the availability and needs of medical staff, alongside the hospital’s general management board. The CMU was able to (i) redeploy up to 285 physicians every week to bolster medical care in COVID-19 wards and forecast medical staff requirements for the upcoming week so all departments could organize their work while coping with COVID-19 needs, (ii) overview all clinical activities conducted in a medicalized hotel, and (iii) recruit a team of roughly 90 volunteer medical students to accelerate data collection and evidence generation.

          The main advantage of a CMU composed by a member of every job category—its ability to generate rapid, locally adapted responses to unexpected challenges—made it perfect for the unprecedented increase in health-care need generated by the COVID-19 pandemic.

          Related collections

          Most cited references5

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe

          Background: Since the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the region of Madrid. This article describes the first 2226 adult patients with COVID-19, consecutively admitted to La Paz University Hospital in Madrid. Methods: Our cohort included all patients consecutively hospitalized who had a final outcome (death or discharge) in a 1286-bed hospital of Madrid (Spain) from 25 February (first case admitted) to 19 April 2020. The data were manually entered into an electronic case report form, which was monitored prior to the analysis. Results: We consecutively included 2226 adult patients admitted to the hospital who either died (460) or were discharged (1766). The patients’ median age was 61 years, and 51.8% were women. The most common comorbidity was arterial hypertension (41.3%), and the most common symptom on admission was fever (71.2%). The median time from disease onset to hospital admission was 6 days. The overall mortality was 20.7% and was higher in men (26.6% vs. 15.1%). Seventy-five patients with a final outcome were transferred to the intensive care unit (ICU) (3.4%). Most patients admitted to the ICU were men, and the median age was 64 years. Baseline laboratory values on admission were consistent with an impaired immune-inflammatory profile. Conclusions: We provide a description of the first large cohort of hospitalized patients with COVID-19 in Europe. Advanced age, male sex, the presence of comorbidities and abnormal laboratory values were more common among the patients with fatal outcomes.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Clinical Management of Ebola Virus Disease in the United States and Europe.

            Available data on the characteristics of patients with Ebola virus disease (EVD) and clinical management of EVD in settings outside West Africa, as well as the complications observed in those patients, are limited.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Reported barriers to evaluation in chronic care: experiences in six European countries.

              The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
                Bookmark

                Author and article information

                Journal
                Disaster Med Public Health Prep
                Disaster Med Public Health Prep
                DMP
                Disaster Medicine and Public Health Preparedness
                Cambridge University Press (New York, USA )
                1935-7893
                1938-744X
                03 March 2021
                : 1-6
                Affiliations
                [ 1 ]Service de Medecine Interne, Centre Hospitalier Universitaire Caen Normandie , Caen, France
                [ 2 ]Department of Medicine, Nazarbayev University School of Medicine , Nur-Sultan, Kazakhstan
                [ 3 ]Department of Epidemiology, Columbia University Mailman School of Public Health , New York, NY, USA
                [ 4 ]Unidad de Gestión Apoyo COVID-19, Servicio Medicina Intensiva, Hospital Universitario La Paz , Madrid, Spain
                Author notes
                Corresponding author: Laura M. Artiga-Sainz, Email: lmartigasainz@ 123456gmail.com .
                Author information
                https://orcid.org/0000-0002-6599-2050
                Article
                S193578932100063X
                10.1017/dmp.2021.63
                8129686
                33653427
                c12c253f-0e0f-4c6c-a9e6-0fea8e052604
                © Society for Disaster Medicine and Public Health, Inc. 2021

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 November 2020
                : 23 December 2020
                : 03 February 2021
                Page count
                Figures: 3, Tables: 1, References: 13, Pages: 6
                Categories
                Concepts in Disaster Medicine

                Comments

                Comment on this article