How covid has transformed hospitals: more acute care beds and more network with primary care

The covid-19 pandemic, which for almost two years has monopolized hospital resources and space, has meant a transformation of healthcare facilities. For example, the home hospitalization (a mode of entry in which the patient, clinically stable, remains at home instead of in the hospital, while receiving a medical visit each day) has increased 42% in Catalonia as a whole in recent years, as shown in this multimedia report from EL PERIÓDICO. In hospitals such as the Clínic of Barcelona, the percentage rises to 50%. But home hospitalization is not the only thing that has boosted the virus.

“The hospital has become much more versatile. Before, each service had its own beds: they were like small impassable hospitals. Now the beds are much more versatile and we take out more performance.” explains Antoni Castells, medical director of the Clínic. Thus, if any service is not occupying all the beds, they are used by emergency patients. “It has greatly reduced the time that a patient waits for a bed in the emergency room,” Castells says.

In addition, he explains, covid-19 taught professionals to be. “much more agile.” in decision making. Given that the impact of the virus was so high in the first wave, health teams made decisions “very quickly.” “Now the decision making is much more decentralized than before. It used to have to go through a committee decision committee,” says the medical director.

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The virus has also led to an increase in the number of beds in the intensive and semi-intensive units. “In the first wave we did this by force, but now we have consolidated an important number of beds: some 30 or 40 beds for critical and semi-critical patients. It was a shortage that the hospital had,” Castells continues. General hospitals are more and more acute care centers and the most seriously ill patients need procedures, surgical or otherwise, more invasive. This increase in the “complexity” makes the hospital need intensive care beds to care for them. Many conventional beds have thus been converted into spaces for seriously ill patients.

Reference hospital

With covid-19 hospitals have learned to work “more networked” with each other. El Clínic, for example, has a reference area, that of the C-17 highway, which connects Barcelona with Granollers, Mollet, Sant Celoni and Vic.. “With covid we have boosted this network. When one of these hospitals did not have beds, we took over. This has helped a lot because the capacity of these centers is less,” Castells points out. Once the strongest waves of the pandemic, these hospitals followed this policy, which has been consolidated. The Clínic is the benchmark in that area. “We may be under more pressure, but fortunately the commitment to these hospitals is favoring the return: the patient comes here for a more complex procedure, but then returns to his center,” he adds.

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He says the same thing Cristina Casanova, jefa de Divisió de Projectes i Qualitat Assistencial de la Consellera de Salut. “Although covid was a attrition very great, it has also brought opportunities to the system. For example, it has brought us more links with other care services: the hospitals have moved closer to the primary care and to the mental health centers.” Casanova points out. It has also boosted teleworking and reinforced certain “professional roles” such as the nurses.

Finally, the pandemic has incentivized something as simple but as important as the hand hygiene. Now compliance “is much higher,” according to Castells. “This gives us advantages vs. hospital-acquired infections. We are very concerned about them because more and more hospitals are suffering from the multidrug-resistant germs to all types of antibiotics,” he explains. According to him, the hygiene measures that have been taken “help” to decrease infections. However, it still there are no definitive studies to confirm this.

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