Enhancing intensive care capacity: COVID-19 experience from a Tertiary Center in Israel

Leshem, Eyal; Klein, Yoram; Haviv, Yael; Berkenstadt, Haim; Pessach, Itai M.

doi:10.1007/s00134-020-06097-0

Cited by 15 publications

(13 citation statements)

References 2 publications

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“…There was a substantial decrease in elective cases in particular between calendar Week 11 and 15 which can be clearly related to nationwide lockdown in most countries and a reduction in elective surgical procedures in order to be able to preserve intensive care capacity for potential COVID-19 patients [ 7 ]. As this expected increase in ICU admissions for COVID-19 patients did not occur in many settings, these measures were gradually eased, enabling the resumption of treatment for elective patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions

Czerny

Gottardi

Puiu

et al. 2021

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute and elective thoracic and abdominal aortic procedures. METHODS Forty departments shared their data on acute and elective thoracic and abdominal aortic procedures between January and May 2020 and January and May 2019 in Europe, Asia and the USA. Admission rates as well as delay from onset of symptoms to referral were compared. RESULTS No differences in the number of acute thoracic and abdominal aortic procedures were observed between 2020 and the reference period in 2019 [incidence rates ratio (IRR): 0.96, confidence interval (CI) 0.89–1.04; P = 0.39]. Also, no difference in the time interval from acute onset of symptoms to referral was recorded (<12 h 32% vs > 12 h 68% in 2020, < 12 h 34% vs > 12 h 66% in 2019 P = 0.29). Conversely, a decline of 35% in elective procedures was seen (IRR: 0.81, CI 0.76–0.87; P < 0.001) with substantial differences between countries and the most pronounced decline in Italy (−40%, P < 0.001). Interestingly, in Switzerland, an increase in the number of elective cases was observed (+35%, P = 0.02). CONCLUSIONS There was no change in the number of acute thoracic and abdominal aortic cases and procedures during the initial wave of the COVID-19 pandemic, whereas the case load of elective operations and procedures decreased significantly. Patients with acute aortic syndromes presented despite COVID-19 and were managed according to current guidelines. Further analysis is required to prove that deferral of elective cases had no impact on premature mortality.

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Section: Discussionmentioning

confidence: 99%

Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions

Czerny

Gottardi

Puiu

et al. 2021

European Journal of Cardio-Thoracic Surgery

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“…These included two intensive care units, a separate emergency department, five inpatient wards, and a psychiatry ward, totaling with almost 400 COVID‐19‐specialized beds. Organic teams composed of hospital personnel were nonvoluntarily allocated to the COVID‐19 wards, with minimal relocations of medical stuff between teams (Leshem et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

The association between witnessing patient death and mental health outcomes in frontline COVID‐19 healthcare workers

Mosheva

Gross

Hertz‐Palmor

et al. 2021

Depression and Anxiety

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Background Healthcare workers (HCW) treating coronavirus disease 2019 (COVID‐19) patients face high levels of psychological stress. We aimed to compare mental health outcomes, risk and protective factors for posttraumatic stress symptoms (PTSS), probable depression, and anxiety between HCW working in COVID‐19 and non‐COVID‐19 wards. Methods A self‐report survey, administered in a large tertiary hospital in Israel during the peak of the COVID‐19 outbreak was completed by 828 HCW (42.2% physicians, 57.8% nurses. Patient‐Reported Outcomes Measurement Information System; the Patient Health Questionnaire‐9; the Primary Care‐Post Traumatic Stress Disorder Screen for DSM‐5 (PC‐PTSD‐5) were used for assessing anxiety, depression, and PTSS, respectively. Pandemic‐related stress factors, negative experiences, and potential protective factors were also assessed. Results Median PC‐PTSD scores differed significantly between study teams ( χ 2 [5] = 17.24; p = .004). Prevalence of probable depression and anxiety were similar in both groups. Risk factors for mental health outcomes included mental exhaustion, anxiety about being infected and infecting family. Overall, higher proportion of the COVID‐19 team witnessed patient deaths as compared to the non‐COVID‐19 team (50.2% vs. 24.7%). Witnessing patient death at the COVID‐19 wards was associated with a four‐fold increased likelihood of PTSS (odds ratio [OR] = 3.97; 95% confidence interval [CI], 1.58–9.99; p = .0007), compared with the non‐COVID‐19 wards (OR 0.91; 95% CI, 0.51–1.61; p = .43). Conclusions Witnessing patient death appears to be a risk factor for PTSS unique to HCW directly engaged in treating patients with COVID‐19. Our findings suggest that helping HCW cope with COVID‐19 related deaths might reduce their risk of posttraumatic stress.

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“…In response to the COVID-19 crisis, Sheba MC constructed rapid design solutions to increase patient bed capacity and to maintain regular hospital operations. Sheba MC added 500 beds to its existing total of 1,900 beds in the hospital (+26%), including 97 ICU beds in two underground COVID-19 critical care units ( Leshem et al, 2020 ). The isolated COVID-19 ICUs were constructed in only a few days in an underground parking lot, originally designed to serve as a fortified emergency hospital for non-ICU-level patients in times of war ( Figure 1 ).…”

Section: The New Model Of Care At the Sheba MC In Israelmentioning

confidence: 99%

Telemedicine Implementation in COVID-19 ICU: Balancing Physical and Virtual Forms of Visibility

Pilosof

Barrett

Oborn

et al. 2021

HERD

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Objective: This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care. Background: The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies. Methods: The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March–August 2020. Results: The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users’ sense of control, orientation in space, teamwork, safety, quality of care, and well-being. Conclusions: The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.

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Enhancing intensive care capacity: COVID-19 experience from a Tertiary Center in Israel

Cited by 15 publications

References 2 publications

Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions

Impact of the coronavirus disease 2019 (COVID-19) pandemic on the care of patients with acute and chronic aortic conditions

The association between witnessing patient death and mental health outcomes in frontline COVID‐19 healthcare workers

Telemedicine Implementation in COVID-19 ICU: Balancing Physical and Virtual Forms of Visibility

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