Kai Xuan Lim1, Yi-Tui Chen2, Kuan-Ming Chiu3, Fang Ming Hung4. 1. Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 2. Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan. 3. Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 4. Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address: philip@mail.femh.org.tw.
A novel coronavirus disease (COVID-19) was firstly reported in Wuhan, People's Republic of China at the end of 2019 and was spread globally in a short period of time. Taiwan, due to its geographic proximity to China, was expected be the one of the hardest-hit region but Taiwan successfully fight the pandemic initially. However, due to the outbreak of the highly contagious Alpha variants of COVID-19 in mid-May 2021, there was a sharp surge of confirmed cases in Taiwan.Far eastern memorial hospital (FEMH), the only tertiary center locates in New Taipei city facing the impact of the pandemic in the frontline. To maintain our hospital capacity and to provide early detection and response to patients’ clinical deterioration, several local modern hotels was transformed into care centers to expand the capacity of medical services. We are going to share the establishment experiences of the largest care center in Taiwan.Due to the tight schedule, our care center was set up within 80 h after first-time site survey. Zone and circuits restriction were implemented in the whole building under the infectious disease doctor's instruction for contamination prevention and all the staffs were recruited within 2 days. Initial triage was conducted at patient arrival and patients were relocated according to their clinical status. Cloud-base information system were widely used to assist daily operation. Daily ward round, medical consultation, measurement and recording of vital signs were all carried out on the social media platform to minimize the contact and the amount of time spent in close proximity between staffs and patients(Fig. 1
).
Figure 1
Information system and social medial platform were highly integrated in our daily operation.
Information system and social medial platform were highly integrated in our daily operation.Between 28 May and the 7 July 2021, a total of 679 patients were sent to our care center and 47 of them who need more intensive care were transferred to our hospital directly after initial triage. 632 patients were admitted to our care center. Throughout the isolation period, 74 of them with clinical deterioration were transferred back to FEMH and 20 patients was relocated to other care center. Finally, 538 patients was discharged smoothly from our care center. No patient died in our care center and no staff was infected during these 41-day of operation.During the COVID-19 pandemic, household isolation had become the common method to maintain medical capacity and hospital operation in many country but unexplained death and sudden hypoxic respiratory failure at home have been revealed in the literatures. Several quarantine methods and facilities had been designed and introduced to maintain health care capacity and provide appropriate care to patients included isolation hotel, medicalized hotels and makeshift Fangcang hospital. Our model provided a guidance about transformation process of a modern hotel into a cloud-based virtual ward care center fully integrated with cloud-base information system and social medial platform which delivered nearly hospital level medical services within an extremely short time. It give us another quarantine option for patient containment during such infectious disease.
Declaration of competing interest
The authors have no conflicts of interest relevant to this article.
Authors: Orla Torrallardona-Murphy; Juan M Pericàs; Neus Rabaneda-Lombarte; Marta Cubedo; David Cucchiari; Júlia Calvo; Júlia Serralabós; Elisenda Alvés; Aleix Agelet; Judit Hidalgo; Eduarda Alves; Laura García; Marta Sala; Irene Pereta; Eva Castells; Adolfo Suárez; Anna Carbonell; Nuria Seijas; Faust Feu; Antonio Alcaraz; Carme Hernández; Emmanuel Coloma; David Nicolás Journal: Ann Intern Med Date: 2021-06-15 Impact factor: 25.391