National Preventive Medicine Residency, Ministry of Health Holdings, Singapore (Dr Goei); and Medical Board (Surgical & Ambulatory Services), Woodlands Health Campus, National Healthcare Group Singapore (Dr Tiruchittampalam).
J Public Health Manag Pract. 2020 Nov/Dec;26(6):613-621. doi: 10.1097/PHH.0000000000001257.
The coronavirus disease 2019 (COVID-19) pandemic has placed a strain on health care systems worldwide. Many hospitals experienced severe bed shortages; some had to turn patients away. In Singapore, the widespread outbreak, especially among the dormitory-based population, created a pressing need for alternative care sites.
The first massive-scale community care facility (CCF) was started in Singapore to address the pandemic. It served as a low-acuity primary care center that could isolate and treat COVID-19-positive patients with mild disease. This allowed decompression of the patient load in hospitals, ensuring that those with more severe disease could receive timely medical attention.
Various groups from the private and public sectors, including health care, construction, security, hotel management, and project coordination, were involved in the setup and operations of the CCF. A large exhibition center was converted into the care facility and segregated into zones to reduce cross-contamination. State-of-the-art technological infrastructure for health management was used. Several paraclinical services were made available.
The CCF was a timely and robust response that fulfilled several crucial functions, including cohort isolation, triage, basic medical care, and timely reviews and escalation of patients. It placed a unique focus on promoting patient ownership, responsibility, and mental well-being. It was largely successful, with a low hospital transfer rate of 0.37%.
The success of the CCF could be attributed to the use of a facility of opportunity, strong interorganizational and cross-sector cooperation, an integrated and robust clinical system, and clear communication channels. It allows for efficient resource utilization and is valuable in future pandemics with similar disease characteristics.
2019 年冠状病毒病(COVID-19)大流行给全球卫生保健系统带来了压力。许多医院床位严重短缺;有些医院不得不拒收病人。在新加坡,广泛的疫情爆发,尤其是在宿舍居住人群中,迫切需要替代护理场所。
新加坡设立了第一个大规模社区护理设施(CCF)以应对疫情。它是一个低急症初级保健中心,可以隔离和治疗 COVID-19 轻症阳性患者。这有助于减轻医院的患者负担,确保那些病情更严重的患者能够及时得到医疗关注。
私营和公共部门的多个团体,包括医疗保健、建筑、安保、酒店管理和项目协调,参与了 CCF 的设立和运营。一个大型展览中心被改造成护理设施,并划分为不同区域,以减少交叉污染。采用了先进的医疗管理技术基础设施。提供了多项辅助临床服务。
CCF 是一种及时而有力的应对措施,履行了多项关键职能,包括群体隔离、分诊、基本医疗护理,以及对患者的及时审查和升级。它特别注重促进患者的自主权、责任感和心理健康。它取得了很大的成功,医院转院率仅为 0.37%。
CCF 的成功可以归因于对机会设施的利用、强大的组织间和跨部门合作、综合和强大的临床系统以及明确的沟通渠道。它允许有效利用资源,对于具有类似疾病特征的未来大流行具有重要价值。