Coordination of Hospitals in the Corona Pandemic

Abstract

BackgroundThe second wave of Corona-Pandemic posed the German Healthcare system to a major challenge. Due to the fast and wide spreading of SARS-CoV-2 in November 2020, the number of COVID-19-patients needing intensive care treatment was rapidly growing. Transferring patients between hospitals was necessary to prevent an overflow of treatment capacities within the ambulance district of Augsburg. This project aimed to create a coordination structure that ensures an efficient guiding of all hospitals within the ambulance district Augsburg.Material and methodsAn executive order of the Bavarian ministries of health and internal affairs1 lead to the appointment of a Medical Director of Hospital Coordination (MDHC) within each ambulance district. Each hospital had to nominate a pandemic officer (PO). Based on the executive order and the “disaster management manual 100”2 we established a hospital coordination structure for the ambulance district Augsburg.ResultsBetween October 18th 2020, and February 14th 2021, the staff of the MDHC coordinated 407 transfers of patients. 223 patients were treated on a general ward, 184 on intensive care units. The transfers prevented several impending triage situations. Using the coordination structure, the urgent reduction of a COVID-19 intensive care unit of a level 1 hospital from 7 to 2 beds was managed within 4 hours after alarm. ConclusionsBased on the “disaster management manual 100”2 we were able to establish a hospital coordination structure that can withstand high pressure and ensured that impending triage situations were prevented. Urgent shortages of treatment capacities were balanced through the transfer of patients. The major problem was the lack of intensive care personnel.