Impact of the COVID-19 Pandemic on Healthcare Activity in the Regional Hospitals of Andalusia (Spain)

(1) Background: The large global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overloaded the public health systems and reduced the regular healthcare activity, leading to a major health crisis. The main objective of this study was to carry out a comparative evaluation of the healthcare activities in the hospitals of Eastern Andalusia, Spain. (2) Methods: In this study, an observational, multicentered, and retrospective approach was adopted to compare the healthcare activities of the Poniente Hospital (PH) and the Alto Guadalquivir Health Agency (AGHA). Data was collected over a period of 24 months, i.e., from 1 January 2019 to 31 December 2020, and the variables evaluated were: patients seen in the hospital emergency service (HES), X-ray tests performed, patients cited in outpatient consultations, surgical interventions performed, and patients included in the waiting list. (3) Results: The analysis of the above-mentioned variables revealed a significant reduction in the number of patients registered in 2020 at HES as compared to that in 2019 for both PH (p = 0.002) and AGHA (p < 0.001). Moreover, the number of surgical interventions in 2020 was significantly reduced from that in 2019 for both PH (p = 0.001) and AGHA (p = 0.009). Moreover, for PH (p < 0.001), a significant reduction was observed in the waiting list admissions in 2020 compared to that in 2019; however, no significant difference in the waiting list admissions between the years 2020 and 2019 was observed for AGHA (p = 0.446). In 2020, the number of teleconsultations was significantly increased from that in 2019 for both PH (p < 0.001) and AGHA (p = 0.006). (4) Conclusion: The analysis carried out indicates that in 2020, compared to 2019, healthcare activity was significantly reduced in most of the parameters included in this study.

DİCLE ÜNİVERSİTESİ TIP FAKÜLTESİ ARAŞTIRMA HASTANESİ ACİL SERVİSİNDE YAPILAN KAN VE KAN ÜRÜNLERİ TRANSFÜZYONLARININ DEĞERLENDİRİLMESİ

This study was designed prospectively to investigate the demographic data of the patients who had blood and blood products in Dicle University Medical Faculty Research Hospital Emergency Service between 01 November 2014- 01 November 2015, also to investigate the indications for blood products used, the amount and the type of the products used. When we look at the diagnosis of patients who underwent transfusion in the emergency department; It was determined that 26.2% were transfused for malignancy, 32.6% for anemia, 18.3% for trauma, 12.5% for GIS bleeding, and 10.4% for other reasons. The patients who had blood product transfusion were 623; 53.8% were male and 46.2% were female. The mean age of the patients was determined 47.87±23.66. The percentage of transfused blood products were as following: 83.6% erythrocyte suspension (ES), 17.3% fresh frozen plasma (FFP), 17.3 % platelet suspension(PS), 0.6% whole blood(WB), %4.3 other blood components (OBC). As a result, we can say that in our study, a large number of transfusions were performed in the emergency department, a specific protocol was not adhered to in determining the indication, and transfusion was performed in support of patients who were mostly under outpatient follow-up. Emergency transfusion decisions should be performed with true emergency indication, follow-up with clinical response rather than laboratory response, and consciousness about the aim of transfusion.

São Felipe Hospital: Capacity Management Challenge in a Hospital Emergency

ABSTRACT In July 2017, the board of directors of Hospital São Felipe, a traditional hospital located in Minas Gerais, met to discuss the results of the satisfaction survey conducted at the hospital, where it was clear there was great customer dissatisfaction with the emergency service. In the previous year, the hospital emergency service received, on average, about 6,300 patients a month, divided in three specialties: general clinic, orthopedics, and ophthalmology. The director of emergency services had twenty days to submit a plan of action to address the problems identified in the emergency area, particularly those related to the waiting lines: wait time, lack of comfort, inattention of employees, and so on. The first action taken by the director was to collect data that would enable him to analyze wait times during the process: What time did the patient arrive at the emergency service? How long the patient waited to be attended by the receptionist? How long the patient waited for triage? and so on. With these data, he believed that he would have a better understanding of the process flow and would be able to propose solutions to the problem of waiting lines in the emergency area. The case was written with the educational goal of working with the concept of capacity management in services and with ways to deal with the demand variability, especially in high-touch and unpredictable services, as in the case of an emergency service.

Hospital São Felipe: Desafio da Gestão da Capacidade em uma Emergência Hospitalar

ABSTRACT In July 2017, the board of directors of Hospital São Felipe, a traditional hospital located in Minas Gerais, met to discuss the results of the satisfaction survey conducted at the hospital, where it was clear there was great customer dissatisfaction with the emergency service. In the previous year, the hospital emergency service received, on average, about 6,300 patients a month, divided in three specialties: general clinic, orthopedics, and ophthalmology. The director of emergency services had twenty days to submit a plan of action to address the problems identified in the emergency area, particularly those related to the waiting lines: wait time, lack of comfort, inattention of employees, and so on. The first action taken by the director was to collect data that would enable him to analyze wait times during the process: What time did the patient arrive at the emergency service? How long the patient waited to be attended by the receptionist? How long the patient waited for triage? and so on. With these data, he believed that he would have a better understanding of the process flow and would be able to propose solutions to the problem of waiting lines in the emergency area. The case was written with the educational goal of working with the concept of capacity management in services and with ways to deal with the demand variability, especially in high-touch and unpredictable services, as in the case of an emergency service.

Telemedicine in Times of the Pandemic Produced by COVID-19: Implementation of a Teleconsultation Protocol in a Hospital Emergency Department

Since the first case of COVID-19 was reported in Spain, almost 22% of healthcare professionals have been infected. Among the main causes are exposure during the care of suspected patients and asymptomatic patients, which caused a greater lack of protection in some cases, and to the global shortage of personal protective equipment due to the strong demand for it. The main objective of this study was to evaluate the effectiveness of a teleconsultation protocol with patients who had respiratory symptoms in the reduction of the consumption of personal protective equipment (PPE) in a hospital emergency service (HES) during the COVID-19 pandemic. This is a descriptive and retrospective study that analyzes the implementation of a teleconsultation protocol with patients with respiratory problems treated in the HES at the Hospital de Poniente (Almeria), between 18 March and 30 April 2020. In the selected study period, 5353 patients were treated in the HES of the Hospital de Poniente; of these, 15.43% showed respiratory symptoms and were referred to the Respiratory Circuit, of which 42.2% did so via teleconsultation. Sixty-six cases of COVID-19 were diagnosed, 57.6% were male, and the median age was 71 years old. The main disease related was pneumonia (89.4%), symptoms more frequent were cough (77.3%), fever (77.3%), and dyspnea (60.6%). Lastly, 56.1% of the patients that attended had one or more comorbidities, high blood pressure (53%), and diabetes (36.4%), which became the main risk factors. The results showed that the implementation of teleconsultation in the HES reduced the possibility of infection and allowed for a more efficient consumption of personal protective equipment.