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Planning phase-2 for the endoscopic units in Northern Italy after COVID-19 lockdown: an exit strategy with a lot of critical issues and a few opportunities.
medRxiv - Gastroenterology Pub Date : 2020-05-13 , DOI: 10.1101/2020.05.12.20092270
Gianpiero Manes , alessandro Repici , Franco Radaelli , Simone Saibeni , Cristina Bezzio , Matteo Colombo , Fabio Pace

Background and aims: Restarting activity in Endoscopic Departments (ED) after COVID-19 lockdown raises critical issues. This survey investigates strategies and uncertainties on resumption of elective activity. Methods: Directors of 55 EDs in Northern Italy received a questionnaire focusing on the impact of pandemic on activity and organization and on the resources available at re-opening. A section was devoted to gather forecasts and proposals on the return path to normality. Results: All centres had reduced their activities of at least 50% of the pre-COVID-19 period. A rate of endoscopists (13.6%), nurses (25.2%), and health assistants (14%) were not available since infected, or relocated to other departments. One third of endoscopic rooms were converted to COVID-19 care. Two third had the waiting or the recovery areas too small for distancing. A dedicated pathway for infected patients could not be guaranteed in 20% of EDs. Only one third of EDs judged realistic to completely restore a pre-crisis workload by the next months. Optimizing appropriateness of procedures, closer interaction with GPs and triaging patients with telemedicine were the proposals to re-open EDs. Conclusions: The critical issues while re-opening EDs calls for reducing the workload in the endoscopy units through appropriate rescheduling of procedures.

中文翻译:

在COVID-19锁定之后,为意大利北部的内窥镜单元计划第二阶段:这是一个退出战略,有很多关键问题,也有一些机会。

背景和目的:在COVID-19锁定后引发内窥镜科(ED)的活动重新开始,从而引发严重问题。这项调查调查了恢复选修活动的策略和不确定性。方法:意大利北部55个ED的主管收到了一份调查表,重点关注大流行对活动和组织的影响以及重新开放时可用的资源。有一部分专门收集有关回归正常状态的预测和建议。结果:所有中心的活动减少了至少COVID-19之前时期的50%。由于感染或无法转移到其他部门,无法使用内镜医师(13.6%),护士(25.2%)和卫生助手(14%)。三分之一的内窥镜室转为COVID-19护理。三分之二的等候区或恢复区太小,无法隔开。在20%的ED中不能保证为感染患者提供专门的途径。只有三分之一的教育署认为在接下来的几个月内完全恢复危机前的工作量是现实的。重新开放急诊室的建议是优化程序的适当性,与全科医生的密切联系以及对远程医疗患者进行分类。结论:重新开放急诊室时的关键问题要求通过适当地重新安排程序来减少内窥镜检查单元的工作量。
更新日期:2020-05-13
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