Experience of the Coronavirus Disease (COVID-19) Patient Care in the Amsterdam Region: Optimization of Acute Care Organization

Abstract

The Coronavirus (COVID-19) pandemic causes a large number of patients to simultaneously be in need of specialized care. In the Netherlands, hospitals scaled up their ICU and clinical admission capacity at an early stage of the pandemic. The importance of coordinating resources during a pandemic has already been emphasized in the literature. Therefore, in order to prevent hospitals from being overwhelmed by COVID-19 admissions, national and regional task forces were established for the purpose of coordinating patient transfers. This review describes the experience of ROAZ region Noord-Holland Flevoland, in coordinating patient transfers in the Amsterdam region. In total, 130 patient transfers were coordinated by our region, of which 73% patients were transferred to a hospital within the region. Over a two-month period, similarities regarding days with increased patient transfers were seen between our region and the national task force. In parallel, an increased incidence in hospital admissions in the Netherlands was observed. During a pandemic, an early upscale (an increase in surge spaces) of hospital admission capacity is imperative. Furthermore, it is preferred to establish national and regional task forces, coordinated by physicians experienced and trained in handling crisis situations, adhering full transparency regarding hospital admission capacity.

Preparations of Dutch emergency departments for the COVID-19 pandemic: A questionnaire-based study

“…guidance on clinical and ICU capacity [6]. Remarkably, however there was then no consensus or general advice on ED capacity.…”

“…The current COVID-19 pandemic was initially characterized by rapidly increasing patient hospital contacts. A swift overhaul of several aspects of ED preparations in Dutch hospitals was imperative [6,7]. Challenges mainly concerned surge capacity, frontline staff (staff at high risk of infection during initial contact with patients) protection and the segregation of suspect-COVID-19 patients [8][9][10][11].…”

“…Whilst clinical and intensive care unit (ICU) capacity for COVID-19 in Dutch hospitals were closely monitored and controlled through a national body (Landelijk Coördinatiecentrum Patiënten Spreiding), there was no guidance on the surge capacity management of EDs [6]. Consequently, hospitals largely restructured the organization of their EDs on an individual basis.…”

Preparations of Dutch emergency departments for the COVID-19 pandemic: a questionnaire-based study

“…4,5 Since its commencement, the current COVID-19 pandemic was characterized by rapidly increasing patient volumes, which necessitated a swift overhaul of several aspects of ED preparations in Dutch hospitals. 6,7 Challenges mainly concerned surge capacity, frontline staff protection and the segregation of patients with suspected COVID-19. 8-11…”

“…Whilst clinical and intensive care unit (ICU) capacity for COVID-19 in Dutch hospitals were closely monitored and controlled through a national body, there was no guidance on the surge capacity management of EDs. 6 Consequently, hospitals largely restructured the organization of their EDs on a solitary basis. This study aimed to form an overview of preparations that were taken in Dutch EDs during the initial phase of the COVID-19 pandemic.…”