Aitor Alquézar-Arbé1, Pascual Piñera2, Javier Jacob3, Alfonso Martín4, Sònia Jiménez5, Pere Llorens6, Francisco Javier Martín-Sánchez7, Guillermo Burillo-Putze8, Eric Jorge García-Lamberechts7, Juan González Del Castillo7, Miguel Rizzi1, Teresa Agudo Villa4, Antoni Haro3, Natalia Martín Díaz2, Òscar Miró5. 1. Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España. 2. Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, España. 3. Servicio de Urgencias, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. 4. Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, España. 5. Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España. 6. Servicio de Urgencias, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Elche, Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), España. 7. Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España. 8. Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, España.
Abstract
OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.
OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.
Authors: Nikolaus Röthke; Daniel Wollschläger; Angela M Kunzler; Annika Rohde; Stefan Molter; Marc Bodenstein; Andreas Reif; Henrik Walter; Klaus Lieb; Oliver Tüscher Journal: Nervenarzt Date: 2021-05-19 Impact factor: 1.214
Authors: Òscar Miró; Pere Llorens; Sònia Jiménez; Pascual Piñera; Guillermo Burillo-Putze; Alfonso Martín; Francisco Javier Martín-Sánchez; Juan González Del Castillo Journal: Int J Cardiol Date: 2021-01-30 Impact factor: 4.164
Authors: Òscar Miró; Pere Llorens; Sònia Jiménez; Pascual Piñera; Guillermo Burillo-Putze; Alfonso Martín; Francisco J Martín-Sánchez; Jorge Lamberechts; Aitor Alquézar-Arbé; Javier Jacob; José Noceda; María J Cano Cano; María J Fortuny Bayarri; Juan M Marín Porrino; Napoleón Meléndez; Carles Pérez García; José V Brasó Aznar; María C Ponce; Elena Díaz Fernández; Laura Ejarque Martínez; Ana Peiró Gómez; Josep Tost; María J Domínguez; Francisco J Teigell Muñoz; Juan González Del Castillo Journal: J Hepatobiliary Pancreat Sci Date: 2021-01-07 Impact factor: 3.149
Authors: Aitor Alquézar-Arbé; Òscar Miró; Juan González Del Castillo; Sònia Jiménez; Pere Llorens; Alfonso Martín; Francisco Javier Martín-Sánchez; Eric Jorge García-Lamberechts; Pascual Piñera; Javier Jacob; Juan Miguel Marín Porrino; Blas Jiménez; Rigoberto Del Río; Carles Pérez García; José Vicente Brasó Aznar; María Carmen Ponce; Elena Díaz Fernández; Josep Tost; Enrique Martín Mojarro; Arturo Huerta García; Alejandro Martín Quirós; José Noceda; María José Cano Cano; Amparo Fernández de Simón Almela; María José Fortuny Bayarri; Matilde González Tejera; Alberto Domínguez Rodriguez; Guillermo Burillo-Putze Journal: J Emerg Med Date: 2021-11-03 Impact factor: 1.473