Intensive Care Department, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
Medical Intensive Care Unit, Saint Louis University Hospital and Paris 7 University, 1 avenue Claude Vellefaux, 75010, Paris, France.
Intensive Care Med. 2021 Mar;47(3):282-291. doi: 10.1007/s00134-021-06352-y. Epub 2021 Feb 22.
Coronavirus disease 19 (COVID-19) has posed unprecedented healthcare system challenges, some of which will lead to transformative change. It is obvious to healthcare workers and policymakers alike that an effective critical care surge response must be nested within the overall care delivery model. The COVID-19 pandemic has highlighted key elements of emergency preparedness. These include having national or regional strategic reserves of personal protective equipment, intensive care unit (ICU) devices, consumables and pharmaceuticals, as well as effective supply chains and efficient utilization protocols. ICUs must also be prepared to accommodate surges of patients and ICU staffing models should allow for fluctuations in demand. Pre-existing ICU triage and end-of-life care principles should be established, implemented and updated. Daily workflow processes should be restructured to include remote connection with multidisciplinary healthcare workers and frequent communication with relatives. The pandemic has also demonstrated the benefits of digital transformation and the value of remote monitoring technologies, such as wireless monitoring. Finally, the pandemic has highlighted the value of pre-existing epidemiological registries and agile randomized controlled platform trials in generating fast, reliable data. The COVID-19 pandemic is a reminder that besides our duty to care, we are committed to improve. By meeting these challenges today, we will be able to provide better care to future patients.
新型冠状病毒病（COVID-19）给医疗保健系统带来了前所未有的挑战，其中一些挑战将带来变革性的改变。医疗保健工作者和政策制定者都清楚地认识到，有效的重症监护能力扩充应对措施必须嵌入整体护理提供模式之中。COVID-19 大流行突出了应急准备的一些关键要素。这些要素包括拥有国家或地区战略储备的个人防护设备、重症监护病房（ICU）设备、消耗品和药品，以及有效的供应链和高效的利用协议。重症监护病房还必须能够容纳患者人数的增加，重症监护人员配置模式应允许需求波动。应制定、实施和更新预先存在的 ICU 分诊和临终关怀原则。日常工作流程应进行重组，包括与多学科医疗保健工作者的远程连接以及与家属的频繁沟通。大流行还展示了数字化转型的好处和远程监测技术（如无线监测）的价值。最后，大流行突出了预先存在的流行病学登记处和灵活的随机对照平台试验在快速、可靠地生成数据方面的价值。COVID-19 大流行提醒我们，除了关爱患者的责任外，我们还致力于改进。通过应对今天的这些挑战，我们将能够为未来的患者提供更好的护理。
