Adaptation and restructuring of an academic anesthesiology department during the COVID-19 pandemic in New York City: Challenges and lessons learned.

The novel SARS-CoV-2 pandemic starting in 2019 profoundly changed the world, and thousands of residents of New York City were affected, leading to one of the most acute surges in regional hospital capacity. As the largest academic medical center in the Bronx, Montefiore Medical Center was immediately impacted, and the entire hospital was mobilized to address the needs of its community. In this article, we describe our experiences as a large academic anesthesiology department during this pandemic. Our goals were to maximize our staff's expertise, maintain our commitment to wellness and safety, and preserve the quality of patient care. Lessons learned include the importance of critical care training presence and leadership, the challenges of converting an ambulatory surgery center to an intensive care unit (ICU), and the management of effective communication. Lastly, we provide suggestions for institutions facing an acute surge, or subsequent waves of COVID-19, based on a single center's experiences.

[National organization of forensic medicine in France]. / Organisation nationale de la médecine légale en France.

Forensic medicine has long been characterized, in France, by diverse medical practices, which affected its recognition and development. A change was needed, Harmonization procedure includes the development of professional guidelines and allows forensic medicine to look at itself. However, the implementation of the recommendations is still far from complete. A national reform came into effect on 15 January 2011 and has defined a national reform of forensic medicine which includes funding by global budgets instead of fee-for-service. This reform allows easier organization and identification of forensic medicine units. One year later, tangible results are mixed. Forensic medicine is now more clearly identified but properly defined funding criteria are still lacking.

Deinstitutionalization in Europe: two recent examples from Germany and Hungary.

Deinstitutionalization has made possible the development of modern community psychiatric services, however radical decrease in the number of hospital beds may result in a reduction in the overall standard of psychiatric care and disruptions in service delivery. The authors present an example of deinstitutionalisation in Hungary, which led to serious difficulties in the provision of healthcare in the field of psychiatry, contrasted with a case from Germany serving as an example of an alternative solution.

The Concord Centre for Mental Health's new 'phase of illness' model of care: are we on the right track?

OBJECTIVE: The aim of this study was to provide an overview of a new 'phase of illness' model of care after relocation of Rozelle Hospital to the new purpose built Concord Centre for Mental Health and discuss its implementation and progress thus far. METHOD: One year after relocation, staff were asked to provide feedback of their views of the new model of care in order to identify implementation barriers and ways forward. RESULTS: The new model has clear benefits for the consumer, but there are a number of practical challenges and dilemmas emerging that necessitate some refinement and evaluation. Feedback from staff provided a wide range of opinions indicating that some were quite cynical of the new model while others were very supportive and thought that patient care was enhanced. CONCLUSIONS: Further development and consolidation of the model is required, including more education sessions and a clear mission statement at unit, hospital and community levels. Further research is also required to assess the impact and ability of the new model to deliver better patient outcomes, especially in regard to continuity of care.

Indicadores hospitalarios por Comunidades Autónomas, 1980-2004 (Análisis longitudinal de indicadores de morbilidad y dotación hospitalaria en salud mental) / Hospital indicators by Regional Communities, 1980-2004 (Longitudinal analysis of morbidity indicators and hospital staffing in mental health)

Introducción. Análisis comparativo entre Comunidades Autónomas (CCAA) de indicadores asistenciales relativos a la morbilidad y dotación hospitalaria en la atención psiquiátrica a lo largo de un período de tiempo (1980-2004) marcado por el inicio y desarrollo de políticas desinstitucionalizadoras y traspaso de competencias a las CCAA. Metodología. Estudio longitudinal. Análisis descriptivo de variables desagregadas por CCAA, relativas a la morbilidad hospitalaria por patología psiquiátrica (CIE-9, códigos 290-319) e indicadores de dotación hospitalaria a lo largo de un período de 25 años. Fuente de información: Encuesta de Morbilidad Hospitalaria, 1980-2004 y Estadística de Establecimientos Sanitarios en Régimen de Internado, 1980-2004. Resultados. Las diferencias entre CCAA son sustanciales en todas las variables analizadas: altas, estancia total y media, consultas totales y primeras consultas, tasa de psiquiatras en atención hospitalaria, número de hospitales psiquiátricos y camas en funcionamiento. Para el conjunto de las CCAA, cabe destacar un incremento en las altas, descenso de las estancias totales y medias, incremento notable de consultas, escaso incremento de psiquiatras en atención hospitalaria y estancamiento en la disminución de hospitales psiquiátricos y camas en funcionamiento en hospital psiquiátrico durante el último período de la serie temporal, así como el escaso aumento de camas en funcionamiento en los hospitales no clasificados como hospital psiquiátrico. Conclusiones. Encontramos indicios de modelos de atención cualitativamente diferentes entre CCAA y cambios sustanciales en los principales indicadores asistenciales a lo largo de la serie temporal (AU)

Introduction. Comparative analysis by Spanish Regional Communities (RC) of indicators related to morbidity and staffing in psychiatric care hospital over a period of time (1980-2004) marked by the initiation and development of deinstitutionalization policies and handover of powers to RC. Methodology. Longitudinal study. Descriptive analysis of variables, broken down by RC, related to psychiatric morbidity (ICD-9, codes 290-319) and indicators of hospital staffing over a 25-year period. Database source: Hospital Morbidity Survey, 1980-2004 and Statistics for care facilities providing in-patient care regime, 1980-2004. Results. Differences between Regional Communities are substantial in all the analyzed variables: discharges, total and average stay, total and initial consultations, rate of psychiatrists in hospital care, number of beds and psychiatric hospitals. For all the Regional Communities as a whole, an increase is observed in hospital discharges, decrease of total and mean stays, notable increase of consultations, little increase in psychiatric staff in hospital care and stagnation in the decline of psychiatric hospitals and beds in operation in psychiatric hospital during the last period of time series and low increase in beds for the hospitals that are not classified as a psychiatric hospital. Conclusions. We found evidence of qualitatively different care models between Regional Communities and substantial changes in major indicators over time series (AU)

A política de reestruturação dos hospitais de ensino: notas preliminares sobre os seus impactos na micropolítica da organização hospitalar / Teaching hospitals reorganization policy: preliminary notes about its impacts on the hospital organization micropolitics

Iniciado em 2004, o Programa de Reestruturação dos Hospitais de Ensino é uma das principais estratégias para o enfrentamento da crise generalizada do setor hospitalar no âmbito do Sistema Único de Saúde, concebido por iniciativa do governo federal com participação de segmentos da sociedade civil organizada. Este artigo apresenta resultados preliminares de investigação em andamento, que tem como objetivo analisar o impacto dessa política governamental no cotidiano de instituições hospitalares de ensino, utilizando se, como referencial teórico, elementos da micropolítica das organizações de saúde, em particular a tensão entre as determinações externas e o forte protagonismo dos trabalhadores de saúde na configuração da vida organizacional. (AU)

Restauración hospitalaria: el modelo de línea fría / Hospital catering: the cold line model

La alimentación demás de contribuir a mejorar el estado de salud de los pacientes, es un componente clave de la consideración del confort de la estancia en el hospital. Los hospitales precisan que el servicio de restauración garantice las condiciones higiénico-sanitarias de los alimentos, suministre una dieta adecuada a las necesidades nutricionales de cada paciente y respete en la medida de lo posible sus costumbres y preferencias alimentarias. Este artículo hace un repaso a todo ello con el ejemplo de la gestión de la restauración hospitalaria en el Hospital de Basurto (AU)

Food, as well as contributing to improving the health of patients, is a key component when considering the comfort of a stay in hospital. Hospitals need the catering service to ensure the hygienic and sanitary condition of the food, to provide a diet suited to the nutritional needs of each patient and as far as possible which respects their food customs and preferences. This article reviews all this, with the example of the hospital catering management in the Hospital de Basunto (AU)

Línea fría en el Hospital Centro Alexis Vautrin (CAV) de Nancy, Francia / The cold line in the Hospital Centro Alexis Vautrin (CAV) of Nancy, France

El presente artículo nos presenta un ejemplo de gestión del servicio de alimentación y restauración de un hospital más allá de nuestras fronteras. En este caso, el Centro Alexis de Nancy (Francia), propone un sistema de organización basado en la división línea caliente-línea fría: la primera para las comidas de pacientes y comedor de personal; la segunda para las cenas de pacientes y personal (AU)

This article presents us with an example of the management of the food and catering services of a hospital outside our borders. In this case, the Alexis Vautrin Centre of Nancy (France) proposes an organization system based on the hot line-cold line division: the former for the lunches of patients and the staff canteen; and the latter for the suppers of patients and staff (AU)

Hostelería hospitalaria del Complejo Hospitalario Universitario de Santiago (CHUS) / The hospital catering service of the Complejo Hospitalario Universitario de Santiago (CHUS)

Los requerimientos de eficiencia en la gestión hospitalaria se basan en las necesidades logísticas en función de las características estructurales del hospital, para concluir con éxito el servicio prestado a los pacientes. Este artículo resume la evaluación desarrollada en el CHUS del servicio prestado en función de la cantidad y calidad ofrecida, así como el grado de fiabilidad y compromiso de la sección de Hostelería Hospitalaria del centro (AU)

The efficiency requirements in hospital management are based on the logistics needs according to the structural characteristics of the hospital, in order to successfully perform the service given to patients. This article summarises the assessment, developed in the CHUS, of the service provided according to the quantity and quality offered, as well as the degree of reliability and commitment in the Hospital Catering section of the centre (AU)

Reestruturação e peparo dos kits cirúrgicos para a implantação de um programa informatizado / Surgical kits: reorganization and preparation for informatizated program

Este estudo foi realizado no Centro Cirúrgico do Hospital Universitário da Universidade de São Paulo (HU-USP) e teve, conmo objetivo, reestruturar os kits cirúrgicos para a implantação de um sistema informatizado de suprimento de materiais...