Regional Capacity and Patient Transfer Service (RCPS) West-Netherlands, Leiden, the Netherlands.
Leiden University Medical Center, Leiden, the Netherlands.
Prehosp Disaster Med. 2022 Oct;37(5):600-608. doi: 10.1017/S1049023X22001169. Epub 2022 Aug 11.
The coronavirus disease 2019 (COVID-19) pandemic challenged health care systems in an unprecedented way. Due to the enormous amount of hospital ward and intensive care unit (ICU) admissions, regular care came to a standstill, thereby overcrowding ICUs and endangering (regular and COVID-19-related) critical care. Acute care coordination centers were set up to safely manage the influx of COVID-19 patients. Furthermore, treatments requiring ICU surveillance were postponed leading to increased waiting lists.
A coordination center organizing patient transfers and admissions could reduce overcrowding and optimize in-hospital capacity.
The acute lack of hospital capacity urged the region West-Netherlands to form a new regional system for patient triage and transfer: the Regional Capacity and Patient Transfer Service (RCPS). By combining hospital capacity data and a new method of triage and transfer, the RCPS was able to effectively select patients for transfer to other hospitals within the region or, in close collaboration with the National Capacity and Patient Transfer Service (LCPS), transfer patients to hospitals in other regions within the Netherlands.
From March 2020 through December 2021 (22 months), the RCPS West-Netherlands was requested to transfer 2,434 COVID-19 patients. After adequate triage, 1,720 patients with a mean age of 62 (SD = 13) years were transferred with the help of the RCPS West-Netherlands. This concerned 1,166 ward patients (68%) and 554 ICU patients (32%). Overcrowded hospitals were relieved by transferring these patients to hospitals with higher capacity.
The health care system in the region West-Netherlands benefitted from the RCPS for both ward and ICU occupation. Due to the coordination by the RCPS, regional ICU occupation never exceeded the maximal ICU capacity, and therefore patients in need for acute direct care could always be admitted at the ICU. The presented method can be useful in reducing the waiting lists caused by the delayed care and for coordination and transfer of patients with new variants or other infectious diseases in the future.
2019 年冠状病毒病（COVID-19）大流行以前所未有的方式挑战了医疗体系。由于大量的医院病房和重症监护病房（ICU）入院，常规护理停止，从而导致 ICU 过度拥挤，危及（常规和 COVID-19 相关）重症护理。设立了急性护理协调中心，以安全管理 COVID-19 患者的涌入。此外，需要 ICU 监测的治疗被推迟，导致等待名单增加。
一个协调中心组织患者转移和入院可以减少过度拥挤并优化医院内的容量。
医院容量的急剧短缺促使荷兰西部地区建立了一个新的患者分诊和转移区域系统：区域容量和患者转移服务（RCPS）。通过结合医院容量数据和一种新的分诊和转移方法，RCPS 能够有效地选择患者转移到该地区的其他医院，或者，在与国家容量和患者转移服务（LCPS）密切合作的情况下，将患者转移到荷兰其他地区的医院。
从 2020 年 3 月到 2021 年 12 月（22 个月），RCPS 荷兰西部被要求转移 2434 名 COVID-19 患者。经过充分的分诊，RCPS 荷兰西部帮助转移了 1720 名平均年龄为 62 岁（标准差=13 岁）的患者。这涉及 1166 名病房患者（68%）和 554 名 ICU 患者（32%）。通过将这些患者转移到容量较高的医院，过度拥挤的医院得到了缓解。
荷兰西部地区的医疗系统从 RCPS 中受益于病房和 ICU 的占用。由于 RCPS 的协调，区域 ICU 占用从未超过最大 ICU 容量，因此需要急性直接护理的患者始终可以在 ICU 入院。所提出的方法可用于减少因延迟护理而导致的等待名单，并在未来协调和转移具有新变体或其他传染病的患者时使用。
