Hospitals & COVID-19: Where are we succeeding and failing?

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Keynote at the European Health Management Association Webinar: Hospitals & COVID-19: Where are we succeeding and failing? - 6th May 2020.

Health & Medicine

alexandre_lourenco@outlook.pt
Alexandre Lourenço, 6th May 2020
Hospitals & COVID-19
where are we succeeding and failing?

6th May 2020

alexandre_lourenco@outlook.pt
Uncertainty and need to continues improvement

6th May 2020

alexandre_lourenco@outlook.pt
Hospitals are not the center of the health system
Our capacity is dependant on individual and community behaviours

6th May 2020

alexandre_lourenco@outlook.pt
Hospital related measures put in place
• Clarify first-point-of-contact strategy for possible COVID19 cases: phone, online, physical.

• Protect other potential first-contact health system entry point

• Designate hospitals to receive COVID19 patients and prepare to mobilize surge acute and
ICU capacity.
• Organize and expand services close to home for COVID19 response.

• Maintain continuity of essential services while freeing up capacity for COVID19 response.

• Train, repurpose and mobilize the health workforce according to priority services.

• Protect the physical health of frontline health workers.

• Anticipate and address the mental health needs of the health workforce.
Source: adapted from WHO, 2020

6th May 2020

alexandre_lourenco@outlook.pt
Flexibility and preparedness
ER
Source: DN, CHU São João, 2020

6th May 2020

alexandre_lourenco@outlook.pt
Hospital role on Covid-19
Asymptomatic
Mild cases
Moderate cases
Severe cases
Critical cases

6th May 2020

alexandre_lourenco@outlook.pt
Adaptt - surge planning tool
Source: tool develop for WHO, 2020 available: bit.ly/2YJtxnE

6th May 2020

alexandre_lourenco@outlook.pt
Issues
HR capacity - frontlines healthcare workers need to be replaced

Mental health disorders due to confinement and HR burnout
Higher health needs:

• The cancelation of elective activity led to yet uncertain consequences

• Increase of unemployment and poverty will be have consequences in health needs
Higher operational costs:

• PPE, regular testing, cleaning routines

• Reduce productivity

6th May 2020

alexandre_lourenco@outlook.pt
NHS activity, march
monthly surgeries in March
First
secondary
care

medical
appointments
Primary
care

medical
appointments

6th May 2020

alexandre_lourenco@outlook.pt
Excess Mortality Estimation During the COVID-19 Pandemic: Preliminary Data
from Portugal
Source: Nogueira et al Acta Med Port 2020

6th May 2020

alexandre_lourenco@outlook.pt
Current steps
Manage a dual system of service delivery balancing service capacity for COVID-19
Catch up canceled activity
Maintain flexibility to second waves
increased utilisation of eHealth

6th May 2020

alexandre_lourenco@outlook.pt

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