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美国学术眼科部门在 COVID-19 大流行期间的临床经验。

Clinical Experience of an American Academic Ophthalmology Department During the COVID-19 Pandemic.

机构信息

Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Qual Manag Health Care. 2022;31(4):267-273. doi: 10.1097/QMH.0000000000000358. Epub 2022 Feb 8.

Abstract

BACKGROUND AND OBJECTIVES

To describe the experience of a large American academic ophthalmology department from the start of the COVID-19 pandemic to the early recovery phase in Summer 2020.

METHODS

Retrospective review; description of approaches taken by our academic medical center and department regarding supply chain issues, protection of doctors and staff, elimination of nonurgent care, calls for staff and faculty deployment, and reopening. Comparison of surgical and clinic volumes in suburban locations versus the main campus; analysis of volumes compared with pre-pandemic periods.

RESULTS

At our medical center, screening and precautions (such as the mask policy) continued to evolve from March through August 2020. Ophthalmologists were not allowed to use N95 respirators except in rare circumstances. Surgical and clinic volume dropped at both urban and suburban locations, but surgery rebounded more quickly at suburban surgery centers once elective procedures resumed. Mandates from administration were not always attainable.

CONCLUSIONS

During respiratory pandemics such as COVID-19, medical centers should adopt protective measures that are consistent across inpatient and outpatient sectors and consistent with other institutions. Our department's large presence outside the urban center where the main hospital is located allowed faster return of clinical care overall. In the event of another pandemic, a central budget rather than individual divisional budgets should be used for purchase of protective equipment for health care workers of an academic center. Because outpatient care provides important continuity of care and keeps patients away from emergency departments and hospitals, perhaps outpatient care does not have to be curtailed to the extent it was in Spring-Summer 2020, provided that outpatient health care workers have sufficient staff and equipment and the above measures are in place.

摘要

背景与目的

描述 2020 年夏季美国一家大型学术眼科从 COVID-19 大流行开始到早期复苏阶段的经验。

方法

回顾性研究;描述我们的学术医疗中心和部门在供应链问题、保护医生和工作人员、消除非紧急护理、呼吁工作人员和教师部署以及重新开放方面所采取的方法。比较郊区和主校区的手术和诊所量;分析与大流行前时期相比的数量。

结果

在我们的医疗中心,从 2020 年 3 月到 8 月,筛查和预防措施(如口罩政策)不断发展。除了极少数情况外,眼科医生不允许使用 N95 呼吸器。城市和郊区的手术和诊所量都有所下降,但一旦恢复选择性手术,郊区手术中心的手术量反弹更快。管理层的命令并不总是能够实现。

结论

在 COVID-19 等呼吸道大流行期间,医疗中心应在住院和门诊部门采用一致的保护措施,并与其他机构保持一致。我们部门在城市中心以外的大型存在,该中心是主要医院所在地,这使得整体临床护理更快地恢复。在另一场大流行中,学术中心的医护人员防护设备的购买应使用中央预算而不是个别部门预算。由于门诊护理提供了重要的连续性护理,并使患者远离急诊部门和医院,因此只要门诊医护人员有足够的人员和设备,并且采取了上述措施,门诊护理可能不必像 2020 年春夏那样受到限制。

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