Tsopra Rosy, Frappe Paul, Streit Sven, Neves Ana Luisa, Honkoop Persijn J, Espinosa-Gonzalez Ana Belen, Geroğlu Berk, Jahr Tobias, Lingner Heidrun, Nessler Katarzyna, Pesolillo Gabriella, Sivertsen Øyvind Stople, Thulesius Hans, Zoitanu Raluca, Burgun Anita, Kinouani Shérazade
INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France.
Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France.
BMC Fam Pract. 2021 May 17;22(1):96. doi: 10.1186/s12875-021-01413-z.
General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries.
A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results.
Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community).
We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics.
全科医生在管理新冠疫情中发挥着关键作用。然而，他们可能在使自身业务适应疫情方面遇到困难。我们在此对15个国家在疫情初期全科医生诊所重组指南进行分析。
一个全科医生网络通过三个步骤共同协作：（i）根据世界卫生组织、美国疾病控制与预防中心以及医疗机构的卫生专业资源，确定全科医生诊所重组的关键建议；（ii）收集15个国家发布的指南中包含的关键建议；（iii）对结果进行分析、比较和综合。
确定了四种类型的全科医生诊所重组建议：（i）全科医生诊疗的重组（取消非紧急诊疗，通过电子诊疗进行随访），（ii）全科医生诊所的重组（区域划分、视觉警示和标识、严格的卫生措施），（iii）全科医生医疗检查的重组（设备、卫生、部分临床检查、患者教育），（iv）全科医生工作人员的重组（设备、管理、会议、与当地社区的协作）。
我们在此对15个国家在新冠疫情初期全科医生诊所重组指南进行分析。这些指南主要侧重于临床护理，对工作人员管理关注较少，并且很大程度上忽视了流行病学监测和研究领域。各国指南的差异以及在常规护理中应用这些指南的困难，凸显了初级保健领域进行深入研究的必要性。从而，初级保健将能够提供适用于实际情况且有更强证据支持的建议，这在疫情期间尤为必要。
