ABSTRACT
La humanidad, que a lo largo de la historia ha sufrido pandemias que han ocasionado la muerte de millones de personas, es actualmente azotada por la pandemia de COVID-19. El propósito de este artículo es brindar estrategias para un manejo oportuno y eficiente que contribuya a disminuir la morbilidad y mortalidad a nivel hospitalario. Para la elaboración de este artículo se revisó bibliografía de instituciones certificadas en el tema, encontrando que la mayor parte de publicaciones se centran en el abordaje de una pandemia como país; es muy poca la literatura que se centra en el abordaje hospitalario. Es por ello que, de acuerdo con la experiencia actual, en la que hemos observado serias debilidades en los hospitales de la red hospitalaria del sector público, se sugieren estrategias, adecuadas a nuestro medio, para que las autoridades hospitalarias puedan hacerle frente a una pandemia...(AU)
Subject(s)
Humans , Coronavirus Infections , Hospital Administration/methods , Surge Capacity , Hospital Planning/methodsABSTRACT
PURPOSE: In this study, we determined the long-term effects of the Independent Capacity Protocol (ICP), in which the emergency department (ED) is temporarily used to stabilize patients, followed by transfer of patients to other facilities when necessary, on crowding metrics. MATERIALS AND METHODS: A before and after study design was used to determine the effects of the ICP on patient outcomes in an academic, urban, tertiary care hospital. The ICP was introduced on July 1, 2007 and the before period included patients presenting to the ED from January 1, 2005 to June 31, 2007. The after period began three months after implementing the ICP from October 1, 2007 to December 31, 2010. The main outcomes were the ED length of stay (LOS) and the total hospital LOS of admitted patients. The mean number of monthly ED visits and the rate of inter-facility transfers between emergency departments were also determined. A piecewise regression analysis, according to observation time intervals, was used to determine the effect of the ICP on the outcomes. RESULTS: During the study period the number of ED visits significantly increased. The intercept for overall ED LOS after intervention from the before-period decreased from 8.51 to 7.98 hours [difference 0.52, 95% confidence interval (CI): 0.04 to 1.01] (p=0.03), and the slope decreased from -0.0110 to -0.0179 hour/week (difference 0.0069, 95% CI: 0.0012 to 0.0125) (p=0.02). CONCLUSION: Implementation of the ICP was associated with a sustainable reduction in ED LOS and time to admission over a six-year period.
Subject(s)
Aged , Female , Humans , Male , Clinical Protocols , Crowding , Efficiency, Organizational , Emergency Service, Hospital/organization & administration , Hospital Planning/methods , Hospitals, Urban/organization & administration , Length of Stay/statistics & numerical data , Outcome and Process Assessment, Health Care , Patient Admission/statistics & numerical data , Patient Transfer/statistics & numerical data , Regression Analysis , Time , Time Factors , TriageABSTRACT
Esta es una revisión que trata sobre la técnica y aplicación del triage durante un incidente. Se enfoca la reorganización hospitalaria para manejar la efectividad de la atención. Se hace un análisis del sistema START, del código de colores y de la categorización quirúrgica de los pacientes. Se menciona también los criterios para realizar transferencias de acuerdo al triage prehospitalario