新型冠状病毒感染疫情应急状态下急诊管理策略与实践

Management Strategy and Practice of Emergency District in General Hospital under the Emergency Situation of COVID-19 Infection

目的探讨新型冠状病毒感染疫情期间,综合性医院急诊区域防控管理策略。方法回顾性分析2022年4月至5月新冠病毒流行期间,某上海三级甲等综合性医院成立急诊工作专班,采用纵向实施层级管理,横向实行多学科协作的管理模式,结合急诊工作特点和医院实际情况,从政策导向、流程再造、“平疫”功能结合与转换、院前急救与联动、加强院感管理与个人防护等方面,针对性开展了一系列应急管理措施。结果医院在疫情高位流行期间,急诊救治能力和容纳患者数量较以往提升了3倍以上。在区域内多数医院急诊无法正常运行的情况下,该院承担了该区域内80%以上的院前急救任务,到院急危重症患者均得到妥善救治,实现了急诊新冠肺炎感染者0漏诊,保证急诊24h开放和急救绿色通道畅通,满足了患者的就医需求。结论新冠病毒流行期间,急诊科作为疫情防控的首道防线,通过精准管理、合理布局可以有效防止医院疫情的扩散传播,在医院应对突发卫生事件中发挥重要作用。

Objective To explore the prevention and control management strategies of emergency areas in general hospitals during the epidemic period of COVID-19 infection.Methods A special class of emergency work was set up in a third-level first-class general hospital in Shanghai during the epidemic of COVID-19 from April to May 2022,which adopted the management mode of vertical hierarchical management and horizontal multidisciplinary collaboration,combined with the characteristics of emergency work and the actual situation of the hospital.A series of emergency management measures have been carried out from the aspects of policy guidance,process reengineering,combination and transformation of“epidemic control”function,pre-hospital first aid and linkage,strengthening hospital infection management and personal protection.Results During the period of high prevalence,the capacity of emergency treatment and the number of patients were increased by more than three times.Under the circumstance that the emergency department of most hospitals in the region could not operate normally,and the hospital undertook more than 80%of the prehospital first aid tasks in the region.The critically ill patients in the hospital were properly treated,which realized zero missed diagnosis of COVID-19 infection in the emergency department,ensured 24-hour opening of the emergency department and unobstructed green channel for first aid,and met the medical needs of patients.Conclusion During the epidemic of COVID-19,the emergency department,as the first line of defense for epidemic prevention and control,can effectively prevent the spread of the epidemic in hospitals through precise management and rational layout,which is of great significance in dealing with health emergencies in hospitals.