Anglès Acedo S, Escura Sancho S, Ros Cerro C, López Frias L, Benito García E, Carmona Guerrero C, Espuña Pons M
Unidad de Suelo Pélvico, ICGON, Hospital Clínic de Barcelona, Barcelona, España.
Clin Invest Ginecol Obstet. 2022 Jul-Sep;49(3):100752. doi: 10.1016/j.gine.2022.100752. Epub 2022 Feb 14.
The COVID-19 pandemic caused a sudden change in the usual care practice of our urogynaecology unit. Therefore, we designed a new healthcare model to adapt our practice to the epidemiological situation. The central axis of the new model was reduced hospital attendance, offering the same healthcare quality through the introduction of telemedicine.To achieve this aim, we made the following changes: a first telematic medical visit was the first step, telematic monitoring visits for conservative and pharmacological treatments and pack visit. We created the following packs: LUTS, postpartum and post-discharge pack. All packs included visits and diagnostic tests performed on the same day.The LUTS pack is indicated in patients with lower urinary tract symptoms, associated or not with pelvic organ prolapse. It includes two visits (nursing and medical) and two tests (urodynamics and pelvic floor ultrasound).The postpartum pack is indicated in women with symptoms of urinary incontinence, anal incontinence, pelvic organ prolapse and sexual disfunctions after delivery, as well as asymptomatic patients with a history of obstetric perineal trauma. It includes a medical visit, a pelvic floor ultrasound and a visit with the physiotherapist.The post-discharge pack is scheduled a month after the surgery and includes two tests (pelvic floor ultrasound and uroflowmetry) and a medical visit.Some face-to-face visits were maintained, as were physiotherapy treatments and other visits following medical criteria.
新冠疫情使我们泌尿妇科的常规护理实践发生了突然变化。因此,我们设计了一种新的医疗模式,以使我们的实践适应疫情形势。新模式的核心是减少患者到院就诊次数,通过引入远程医疗提供同等医疗质量。为实现这一目标,我们做出了以下改变:首次远程医疗问诊是第一步,对保守治疗和药物治疗进行远程监测问诊以及套餐问诊。我们创建了以下套餐:下尿路症状套餐、产后套餐和出院后套餐。所有套餐都包括在同一天进行的问诊和诊断检查。下尿路症状套餐适用于有或无盆腔器官脱垂的下尿路症状患者。它包括两次问诊(护理和医疗)和两项检查(尿动力学检查和盆底超声检查)。产后套餐适用于产后出现尿失禁、肛门失禁、盆腔器官脱垂和性功能障碍症状的女性,以及有产科会阴创伤史的无症状患者。它包括一次医疗问诊、一次盆底超声检查和一次物理治疗师问诊。出院后套餐安排在手术后一个月,包括两项检查(盆底超声检查和尿流率测定)和一次医疗问诊。一些面对面问诊、物理治疗以及其他符合医疗标准的问诊得以保留。