Population Health Strategies to Support Hospital and Intensive Care Unit Resiliency During the COVID-19 Pandemic: The Italian Experience

Abstract

Italy was one of the countries most affected by the number of people infected and dead during the first COVID-19 wave. The authors describe the rapid rollout of a population health clinical and organizational response in preparedness and capabilities to support the first wave of the COVID-19 pandemic in the Italian province of Modena. The authors review the processes, the challenges faced, and describe how excess demand for hospital services was successfully mitigated and thus overwhelming the healthcare services avoided the collapse of the local health care system. An analysis of bed occupancy in the region predicted during the first weeks of the epidemic. The SEIR model estimated the number of infected people under different containment measures. Community resources were mobilized to reduce provincial hospitals' burden of care. A population health approach, based on a radical reorganization of the workflow and emergency patient management, was implemented. The bed saturation of the Modena Healthcare Agency was measured by an ad hoc, newly implemented intensive care unit (ICU) bed occupancy and COVID-19 centralized governance dashboard. ICU bed occupancy increased by 114%, avoiding saturation of the Modena Healthcare Agency system. The Emilia-Romagna region achieved a higher rate of ICU bed availability at 2.15 ICU beds per 10,000 inhabitants as compared with community 1 ICU bed availability prior to the pandemic. Rapid and radical local reorganization of regional efforts helped inform the successful development and implementation of strategic choices within the hospital and the community to prevent the saturation of key facilities.

Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation

“…A whole life-cycle approach to the healthcare facility operation is needed considering the rapid and constant alterations of healthcare environments resulting from transformations in medicine, technology and organizational changes [ 8 ]. Healthcare buildings must be planned and designed based on sound human factors principles and capable to accommodate current problems and needs, adapt to speedy transformations and respond to contemporary and future necessities, especially while facing emergency issues such as COVID-19 [ 9 , 10 , 11 ]. Modular and fast construction, repurposing of spaces and equipment of temporary settings have emerged as approaches to manage the urgent need for flexible and resilient solutions [ 12 , 13 , 14 ].…”

Analyzing Healthcare Facility Resilience: Scientometric Review and Knowledge Map

“…These may be the reasons why this domain has no large citation outbreak and high centrality nodes. In recent cited literature, COVID-19 is an unshirkable research content ( 18 , 90 ). They illustrate the impact of epidemics outbreaks on the use of technologies in healthcare facilities.…”

“…Clearly, the earlier that the disturbance is noticed, the faster and more effective the response actions can be. An effective surveillance and early warning system would be a powerful tool at both macro level and micro level ( 74 , 90 ). Take the epidemic threats as examples, surveillance applications include detecting the abnormal increase of the case, monitoring and describing the magnitude and patterns of infectious disease, predicting epidemic trends, and discovering the emerging infectious disease ( 118 ).…”

Effects of the COVID-19 outbreak on the use and perceptions of metropolitan agricultural parks. Evidence from Milan and Naples

“…Several studies have tried to motivate the fact that Italy was the rst and most affected country in Europe by the outbreak [42]. According to [18], the high level of similarity in terms of economic, geographical, climatic and environmental conditions between the most affected area in China (Wuhan) with the most Italian one (Po Valley) is a possible explanation.…”