A feasibility study about covid-19 patients management in general hospital wards in italy: an organizational assessment approach
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University of Turin, Department of Public Health Sciences, Italy
Health Local Unit ASL TO3 Italy
University of Turin, Department of Public Health Sciences; AOU City of Health and Sciences of Turin, Italy
University of Turin, Department of Public Health Sciences; Health Local Unit ASL TO3, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A388
Background and objectives:
In the COVID-19 pandemic, healthcare-associated transmission has been a major concern and hospitals had to implement ways of isolating COVID-19 patients. Our study aimed to identify public health variables affecting the organizational approach of managing COVID-19 positive patients in hospital wards and describe our experience in three hospitals of Northern Italy.

We searched in the scientific literature organizational models for cohorting patients with COVID-19. We created a focus group and a SWOT analysis in order to define the best organizational assessment for each hospital. Results: There is poor literature about organizational assessment for cohorting COVID-19 patients. We analyzed the floor plans, the hospital ventilation system, the personal protective equipment (PPE) use during a shift, workload for healthcare workers (HCW) and patient safety. The variables that we identified were: 1) structural variables: presence or absence of single rooms with dedicated bathroom in hospital wards, presence or absence of an anteroom for donning and doffing, ventilation system; 2) patient care variables: safe patient care, patient well-being, necessity to move patient for diagnostic tests; 3) HCW variables: use of PPE, HCW workload; 4) Economic variables: costs for PPE supply, additional personnel costs, loss of COVID-free beds lIn particular, we focused our attention on structural variables, patient care variables, HCW variables and economic variables.

The analysis of variables led us to define different organizational assessments for the three hospitals. Our evaluation showed that Hospital structure is the most important variable to evaluate. If there are no single rooms and no dedicated bathroom, it is impossible to guarantee isolation of patients. The cost in PPE use and for additional personnel may be higher with the single room isolation system than with the ward isolation system. Feasibility studies are needed to define which organizational model best suits the hospital setting.

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