ABSTRACT
L'arrivée brutale de l'épidémie sanitaire liée au SARS-CoV-2 dans la région Grand Est a conduit les services de soins de cette région à s'adapter rapidement à la situation. Le Plan blanc a été déployé dans les hôpitaux de Strasbourg et Nancy dès le 13 mars 2020 afin de faire face à un afflux massif de patients. Face à cette urgence sanitaire d'un type nouveau, la maternité de Nancy s'est réorganisée forte de l'expérience des services strasbourgeois rapidement mis en tension afin d'assurer l'accueil et de dispenser les meilleurs soins possible aux parturientes dans un environnement limitant au maximum leur risque de contamination. Du fait du haut risque de transmission virale, un suivi anténatal par téléconsultations et visites à domicile par le réseau de ville (sages-femmes libérales, généralistes) a été organisé pour les grossesses à bas risque. Sur site, un triage des admissions a rapidement été mis en place ainsi que la création d'un circuit spécifique dédié aux patientes à risque ou confirmées porteuses du SARS-CoV-2. Des procédures de prise en charge gynéco-obstétricales, anesthésiques et pédiatriques ont été rédigées et révisées par les différentes équipes au fur et à mesure de l'évolution des connaissances et des recommandations émises par les sociétés savantes. L'objectif de cet article est de détailler l'ensemble de l'organisation mise en place, de décrire les difficultés de fonctionnement rencontrées lors du pic de l'épidémie et d'analyser les points d'amélioration mis en évidence.Alternate abstract: The sudden arrival of the SARS-CoV-2 outbreak conducted healthcare departments to rapidly adapt their organizations. The White Plan has been activated in Strasbourg and Nancy the March 13, 2020 to deal with a massive influx of patients. Due to this new kind of sanitary emergency, build on Strasbourg's experience, the University Maternity of Nancy has been reorganized in order to propose the best care conditions for women in an environment limiting the risk of contamination. In view of the high risk of viral transmission, antenatal follow-up by teleconsultations and home visits provided by independent midwives and general practitioners was promoted for low-risk pregnancies. A pre-admission triage system and a specific circuit for patients suspected or infected with SARS-CoV-2 have been created. Specific procedures of care in anesthesiology, obstetrics and pediatrics have been drawn up and regularly revised according to national recommendations and literature. The aim of the article is to describe our health care organization, to highlight operational difficulties and points of improvement identified.
ABSTRACT
Under the impetus of the Regional Health Agencies, the organization of the health system was redeployed throughout the health crisis linked to Covid-19. Mostly supported by coordination support mechanisms, post-Covid coordination units were activated in 2021 in each region, at the departmental level, to meet the needs of professionals and users. This article reports on the deployment of the Covid long devices in the Occitanie region.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiologyABSTRACT
Telemedicine has been recognized since 2010 as a constitutive element of care, however, it was not until 2016 that the first national experiments were able to be launched with the aim of validating a framework allowing a possible rapid passage in the common right. These experiments, which are due to end in December 2021, have succeeded in involving more than 100,000 patients, mainly suffering from cardiac pathologies. The arrival of COVID-19 has made it possible to measure the usefulness of practices at a distance both from teleconsultation and telemonitoring, with the appearance of organizational and technical innovations that must now be maintained and developed in order to integrate the telemedicine of tomorrow into our actual medicine.
Subject(s)
COVID-19/epidemiology , Pandemics , Telemedicine/organization & administration , COVID-19/therapy , Diabetes Mellitus/therapy , Heart Failure/therapy , Humans , Kidney Failure, Chronic/therapy , Patient Satisfaction , Remote Consultation/methods , Remote Consultation/organization & administration , Respiratory Insufficiency/therapy , Telemedicine/economics , Telemedicine/trendsABSTRACT
Covid-19 did not spare the psychiatric care services. At the Sainte-Anne Hospital, as in the medicine-surgery-obstetrics departments, several care units had to be transformed and organised in order to accommodate positive patients who did not need to be admitted to intensive care. Feedback on the transformation of a care structure of the "Clinique des maladies mentales et de l'encéphale" for more than two months.
Subject(s)
COVID-19 , Female , Hospitalization , Humans , Pregnancy , SARS-CoV-2ABSTRACT
The renal disease center of the university hospital of Caen Normandy (14) is dedicated to the ambulatory care of patients with chronic renal disease, including those treated by dialysis or transplanted. These are fragile patients and, for many of them, coming to the center is inevitable for their care. Faced with the COVID-19 pandemic, the care teams have shown a great capacity to adapt, even to be creative, in order to welcome and care for them in optimal safety conditions.
Subject(s)
COVID-19 , Kidney Failure, Chronic , Renal Insufficiency, Chronic , Humans , Kidney Failure, Chronic/therapy , Pandemics , Renal Dialysis , SARS-CoV-2ABSTRACT
The emergence of the Coronavirus Disease 2019 (COVID-19) has caused profound upset in health systems around the world. As cancer patients seem to be at greater risk, the organization of oncological care had to be adapted. We first report the progress of the "first wave" of COVID-19 at the Institut Curie, a French comprehensive cancer center, by describing the measures implemented to limit the risk of transmission of COVID-19 while ensuring as much as possible the continuation of anticancer treatments. Then, we present the results of a prospective institutional database in which the characteristics and outcome of our patients with cancer and suffering from COVID-19 were collected. From March 13 to April 25, 2020, 141 patients followed at Institut Curie for cancer developed COVID-19, of which 26 (18%) died from it. The minimum incidence of COVID-19 in Institut Curie is estimated at 1.4% over this period. No risk factors for developing a severe form of COVID-19 related to cancer have been identified. Cancer patients do not appear to be at greater risk of developing COVID-19, nor of having a more severe form than the general population. With the current increase of COVID-19 cases, it seems essential to share the experience already acquired to minimize the impact of this crisis on the long-term outcome of patients followed for cancer.
Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/statistics & numerical data , Neoplasms/complications , Aged , COVID-19/mortality , COVID-19/prevention & control , COVID-19/transmission , Cancer Care Facilities/organization & administration , Cause of Death , Databases, Factual , Female , France/epidemiology , Humans , Incidence , Male , Middle Aged , Neoplasms/mortality , Neoplasms/prevention & control , Neoplasms/therapy , Prospective StudiesABSTRACT
OBJECTIVES: The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD: This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS: Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION: COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.
Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Restructuring , Hospitals, Psychiatric/organization & administration , Mental Health Services/organization & administration , Pandemics , Pneumonia, Viral , Psychotherapy/organization & administration , Ambulatory Care/organization & administration , Bed Conversion , COVID-19 , France/epidemiology , Health Personnel/psychology , Health Services Accessibility , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Mental Health Services/supply & distribution , Occupational Health , Patients' Rooms , Psychotherapy/statistics & numerical data , SARS-CoV-2 , Social Change , Stress, Psychological/etiology , Stress, Psychological/therapy , TelemedicineABSTRACT
A real organisational challenge for the teams working alongside people being treated for cancer, the continuity of treatment and care has mobilised all those involved in care since the beginning of the COVID-19 epidemic. To ensure the safety of these patients, who are more vulnerable due to their illness, and to ensure that they do not lose any chances against their cancer, the care providers of the Lyon Regional Cancer Centre have innovated and adapted their practices, both in the city and in the hospital.