Pandemic hospitals and reorganizing emergency departments

Abstract

Emergency departments have always been the first point of contact for hospitals in many situations, including man-made and natural disasters. The first places where patients with symptoms of COVID-19 were met in health institutions were also emergency departments. Emergency departments play an important role in diagnosing the disease and isolating patients (by hospitalization if necessary).The process, which starts with the triage of outpatients admitted to the emergency department and brought by ambulance, continues as isolation of the patients in appropriate areas including physical evaluation, management of laboratory and scanning processes and, if necessary, providing cardiopulmonary resuscitation with airway support. Afterwards, patients can be treated as an outpatient, or hospitalized, or treated at the intensive care unit in line with their preliminary diagnosis and clinical conditions.Disruptions that may occur in one or more of these stages can lead to crowds and lengthy queues in the emergency department by prolonging the follow-up period of the patients.One of the strengths of Turkey at this point is that emergency departments are accustomed to the heavy patient load. The experiences gained from these conditions have facilitated the organization of pre-hospital emergency medical services, pandemic hospitals, and their emergency departments. In this organization, the main goal should be to provide uninterrupted and high-quality patient care through personnel training, personal protection measures, and the creation of physical conditions. Turkey's emergency departments are accustomed to managing the intensive patient flow, as they work at full capacity during normal times. Thanks to the experiences of emergency healthcare workers, health service was provided without any patient being turned away from the door of the emergency departments during the COVID-19 pandemic.In this review, we aimed to present the organization of pandemic hospitals and emergency departments during the COVID-19 pandemic. We made a schematic representation of the architectural areas through the emergency department of Ankara City Hospital, which has a bed capacity of 3810 with 256 beds in emergency department.

Impact of an ICU bed capacity optimisation method on the average length of stay and average cost of hospitalisation following implementation of China’s open policy with respect to COVID-19: a difference-in-differences analysis based on information management system data from a tertiary hospital in southwest China

“…Furthermore, hospital management departments and decision-makers should actively implement prevention and control management strategies to minimise the impact on patients from different admission channels. Scientific and priority scheduling should be employed to address the admission issues faced by emergency patients and outpatients 36 37 42–44…”

Construction of a 5G-based, three-dimensional, and efficiently connected emergency medical management system

“…With an increasing number of emergencies, the efficiency of emergency medical services plays an instrumental role in rescuing lives [ 5 ]. In multiple contexts, the emergency department has been the center of emergency medical rescue as the first contact point of medical treatment hospitals upon the occurrence of emergencies [ 6 ]. It is the core of the emergency medical service system for the professional handling of critically ill patients, sudden public events, massively wounded events, natural disasters, and collective poisoning [ 1 ].…”

“…Owing to the accessibility of the Emergency Department [ 8 ], peoples' habit of using the emergency department 24/7 to treat simple and chronic health issues [ 6 ] and the growing trend of natural disasters in China [ 9 ], people’s demands for emergency medicine have demonstrated a constant increase. The question of how to raise the capacity and efficiency of emergency medical services in satisfying societal demand remains the hotspot of medical research.…”

“…The COVID-19 outbreak has reminded us of the importance of telemedicine in medical services provision, especially as a tool to reduce the risk of cross-infection caused by close contact [ 16 ]. Similar to most emergency departments, we are also facing the challenges of the pandemic [ 6 , 17 ]. Also, like the emergency departments in other hospitals, we have developed a stringent triage process to avoid nosocomial infections [ 18 , 19 ].…”

The Rescue of the Romanian Health System by the Emergency Departments during the Fourth Wave of COVID-19 Pandemic

“…The emergency department plays an important role in diagnostic and therapeutic management, as it is the first place where the patient comes in contact with the hospital [ 24 ]. In critical situations, when there is a significant increase in the number of patients who present themselves to the emergency room in a short time, the reorganization of emergency departments and an approach based on adaptive measures that allow the provision of medical care to as many patients as possible is required [ 25 , 26 ]. This kind of situation was seen during the COVID-19 pandemic which, through the epidemiological measures imposed, led to the reduction in the number of hospital beds available on the wards and the emergency departments facing a large number of patients.…”