Hospital Health Direction, Public Health Agency, Azienda AUSL Modena, Modena, Italy.
Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, United Kingdom.
Popul Health Manag. 2021 Apr;24(2):174-181. doi: 10.1089/pop.2020.0255. Epub 2020 Dec 30.
Italy was one of the countries most affected by the number of people infected and dead during the first COVID-19 wave. The authors describe the rapid rollout of a population health clinical and organizational response in preparedness and capabilities to support the first wave of the COVID-19 pandemic in the Italian province of Modena. The authors review the processes, the challenges faced, and describe how excess demand for hospital services was successfully mitigated and thus overwhelming the healthcare services avoided the collapse of the local health care system. An analysis of bed occupancy in the region predicted during the first weeks of the epidemic. The SEIR model estimated the number of infected people under different containment measures. Community resources were mobilized to reduce provincial hospitals' burden of care. A population health approach, based on a radical reorganization of the workflow and emergency patient management, was implemented. The bed saturation of the Modena Healthcare Agency was measured by an ad hoc, newly implemented intensive care unit (ICU) bed occupancy and COVID-19 centralized governance dashboard. ICU bed occupancy increased by 114%, avoiding saturation of the Modena Healthcare Agency system. The Emilia-Romagna region achieved a higher rate of ICU bed availability at 2.15 ICU beds per 10,000 inhabitants as compared with community 1 ICU bed availability prior to the pandemic. Rapid and radical local reorganization of regional efforts helped inform the successful development and implementation of strategic choices within the hospital and the community to prevent the saturation of key facilities.
意大利是受新冠病毒第一波疫情影响感染人数和死亡人数最多的国家之一。本文作者描述了意大利摩德纳省在应对新冠病毒第一波疫情时，如何迅速开展人群健康临床和组织应对准备工作，提高应对能力。本文回顾了应对过程中面临的挑战，并介绍了如何成功缓解医院服务的过度需求，从而避免医疗系统崩溃。对该地区疫情第一周的病床占用情况进行了预测分析。SEIR 模型估计了在不同防控措施下感染人数。社区资源被动员起来，以减轻省级医院的护理负担。实施了一种基于工作流程和急诊患者管理彻底重组的人群健康方法。摩德纳医疗保健机构的床位饱和度通过新实施的 ICU 床位占用和新冠疫情集中治理仪表板进行测量。摩德纳医疗保健机构的 ICU 床位占用增加了 114%，避免了系统饱和。艾米利亚-罗马涅地区在每 10000 名居民中有 2.15 张 ICU 床位，而在大流行前社区仅有 1 张 ICU 床位，实现了更高的 ICU 床位可用性。区域内迅速而彻底的重组有助于为医院和社区内部的战略选择提供信息，以防止关键设施饱和。
