AlShareef Yasir, AlShammary Sami Ayed, Abuzied Yacoub, AlAsseri Yahya, AlQumaizi Khalid I
Department of Surgery, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Ann Med Surg (Lond). 2022 Jan;73:103207. doi: 10.1016/j.amsu.2021.103207. Epub 2021 Dec 21.
Coronavirus 19 pandemic impacted the health system with more pressure on the critical areas, leading to direct manpower working in the Operating Room to help treat this new problem by postponing elective surgical cases and affecting some urgent ones. However, elective surgical services start to recover by establishing one or more hospitals that deal with COVID-19 free patients (green hospital) in each area with a dedicated one to treat COVID19 cases. Our research shows if this model's application assures safe and continued recovery of surgical services to reach the level before the pandemic. This study aimed to explore if assigning a green hospital to assure safe and continuous resumption of surgical services during a pandemic.
This study used a multicenter, national, quasi-experimental, post-test-only control group design. All hospitals assigned at least one hospital as a green hospital (COVID-19 free hospital) in the northern areas of Saudi Arabia were included in the study. We also included Riyadh's large tertiary care hospital as a control none green hospital. We reported the number of surgical backlog in each city, the number of surgical cases performed, the percentage of OR utilization in each city and the percentage of COVID-19 cases to the number of ICU bed cases in each city.
This study included green hospitals in five cities in the northern area of Saudi Arabia. Besides, we included one none large green hospital in Riyadh city as a control group. The median of weekly procedures in green hospitals was 101 (99, 109.5) in Alqurayat, 233 (194, 237) in Tabuk, 180 (162, 199) in Haill, 108 (90, 120) in Al Jawf and 257 (155, 313) in Northern Borders. The median of weekly procedures in the control hospital was 245 (215, 259). Green hospitals contributed to reducing the surgical backlog by a median percentage of 74% (38, 108) in Alqurayat, 25% (21, 26) in Tabuk, 8% (7, 9) in Haill, 81% (54, 91) in Al Jawf and 78% (72, 88) in Northern Borders. While in the control hospital was 8% (8, 9).
Implementing elective surgeries in green hospitals contributes to a continuous resumption of surgical services during the COVID-19 pandemic.
2019冠状病毒病疫情给卫生系统带来冲击，关键领域压力增大，导致手术室的直接人力通过推迟择期手术病例并影响一些急诊病例来帮助应对这一新问题。然而，通过在每个地区建立一家或多家收治非新冠患者的医院（绿色医院）以及一家专门收治新冠病例的医院，择期手术服务开始恢复。我们的研究表明，这种模式的应用能否确保手术服务安全且持续恢复到疫情前的水平。本研究旨在探讨指定一家绿色医院能否确保在疫情期间安全且持续地恢复手术服务。
本研究采用多中心、全国性、准实验、仅后测对照组设计。沙特阿拉伯北部地区所有指定至少一家医院作为绿色医院（非新冠医院）的医院均纳入研究。我们还纳入了利雅得的一家大型三级护理医院作为非绿色医院对照组。我们报告了每个城市的手术积压数量、实施的手术病例数量、每个城市手术室的使用率以及每个城市新冠病例数与重症监护病床病例数的百分比。
本研究纳入了沙特阿拉伯北部地区五个城市的绿色医院。此外，我们纳入了利雅得市一家非大型绿色医院作为对照组。绿色医院中，古拉亚特每周手术中位数为101（99，109.5），塔布克为233（194，237），哈伊勒为180（162，199），焦夫为108（90，120），北部边境为257（155，313）。对照医院每周手术中位数为245（215，259）。绿色医院使手术积压减少的中位数百分比在古拉亚特为74%（38，108），塔布克为25%（21，26），哈伊勒为8%（7，9），焦夫为81%（54，91），北部边境为78%（72，88）。而对照医院为8%（8，9）。
在绿色医院实施择期手术有助于在新冠疫情期间持续恢复手术服务。
