Assistance Publique–Hôpitaux de Paris (AP-HP) is auto largest teaching hospital trust in Europe, through 39 hospitals, 20 000 beds (10% of toutes les personnes public hospital beds), and an association with seven universities. AP-HP additionally hosts 40% de the français biomedical research. Oui a result de its size et location, AP-HP has actually been a diriger player in France"s COVID-19 response, oui it was in responding to terrorist attacks.

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AP-HP has a reputation of being année institution with a size, cumbersome operations, et internal competition the prevent any nimble response. We are a coporation, groupe of health-care experts at AP-HP who are directly connected in the administration of auto COVID-19 response de AP-HP. Having actually faced the COVID-19 pandemic, and remaining humble in facing thé future, we describe how size and coordinated management might actually ont helped auto organisation, speed, and consistency of the réponse to thé COVID-19 crisis.
AP-HP initially approximated that no more 보다 1000 patient with COVID-19 would be simultaneously admettre to intensive care units (ICUs) in the Île-de-France region; 400 ns these patient would be admitted to ICUs in auto AP-HP, close to the maximum capacity. However, the situation came to be worse than expected (appendix). At thé height ns the COVID-19 pandemic, 2677 patient with COVID-19 were admitted into ICUs in auto region, 41% du whom were jai admis to AP-HP. A few points deserve discussion.
A details medical hôte was established, led by a centre crisis clinical director that was appointed de the CEO et supported par medical directors in each hospital. A clear chain ns medical responsibilities permitted a reactive work decision-making procedure throughout auto whole institution.
Human resources pour recruiting and training specialised staff were allocated native a single platform (appendix). Nous experienced shortage ns various equipment and consumables fabriquer in Asia.
European college Hospital AllianceUniversity hospitals urgently appel for much more European collaboration to stop drug shortages.
Centralised logistics made cette possible to adjust amounts daily, in réponse to it is provided shortages. Universities called au thousands ns students in medicine, nursing, pharmacy, et dentistry that underwent particular training to work as paramedics, research assistants, jaune operators conditions météorologiques a telemedicine platform.
Assistance Publique-Hôpitaux de ParisCOVIDOM: une solution de télésuivi à loger pour les patients porteurs foins suspectés Covid-19 co-construite par l"AP-HP et Nouveal e-santé.
Management ns available beds was crucial, soja a centre ICU bed-allocation système was organised at auto regional level to optimise padura transfers across hospitals. This allocation unit to be led de surgeons that were available as a result du the postponement of non-essential surgeries.
Using multidisciplinary working groups, practical guidelines were edited within 48–72 h, mutual among tous hospitals, et published on an AP-HP website. Examples of ligne directrice include the appropriate use of scarce equipment jaune drugs, optimale use de ventilators, and ethical issues. These guidelines were discussed during the central crisis team"s twice-daily telephone meetings. An important care response was coordinated through a du quotidien meeting du ICU heads.

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A COVID-19 research study committee arisen a global research strategy the was common with thé universities et INSERM. Auto top concerns were establishment du patient cohorts, biobanking, and clinical trials. An ext than 40 clinical études enrolled an ext than 7000 patients. This rapid initiation ns research was faisabilité because de a shared research soutien infrastructure et reallocation of all research personnel, supplemented par volunteers. The centralised pharmaceutical office fabriquer drugs et placebos obtainable at each hospital. Auto value of this research effort will be judged from the peer-reviewed clinical output in auto near future.
The response to thé crisis was data-driven, thanks à a seul institutional les données platform fed de a single information system, providing significativement decision-making parameters (eg, length of stay, treatment, clinical pathway) in genuine time.
Large-scale capacité à juger were rapidly developed. Every day, a farm de 63 3D printers manufactured 1000 parts ns various medical devices, bypassing a slow-moving supply chain et avoiding disabled equipment. Auto Covidom telemedicine communication monitored much more than 50 000 patient at page daccueil (appendix).
Assistance Publique-Hôpitaux aux ParisCOVIDOM: une solution du télésuivi à domicile pour esquive patients porteurs hay suspectés Covid-19 co-construite par l"AP-HP rang Nouveal e-santé.
Coronavirus: pour déconfiner sans pour autant provoquer ns deuxième vague, une approche centrée d’environ le patient.
Devised de AP-HP under auto umbrella du the regional health authority, the COVISAN programme brought together locale authorities, normal practitioners, non-governmental organisations, and private companies, which helped to secure the intérieur lockdown leave plan.
All this was fabriquer possible because du extraordinary mobilisation et joint essai of medical, paramedical, and administratif staff et with reinforcements from est différent regions (appendix). Auto COVID-19 dilemm hit an institution that already had a shortage de nurses. A substantial num of health-care professionals ended up being infected. Nous wish à acknowledge auto tireless work de the highly motivated personnel at AP-HP. Thé COVID-19 situation is no yet behind us; nevertheless, at a temps when practically every health system in auto world is encountering unprecedented challenges, nous hope rather will find our initiale lessons helpful.
COVIDOM: d’un solution de télésuivi à domicile pour das patients porteurs foins suspectés Covid-19 co-construite moyennant l"AP-HP et Nouveal e-santé.

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Coronavirus: convectif déconfiner sans provoquer d’un deuxième vague, une approcher centrée d’environ le patient.

COVID-19 Resource central Access the latest 2019 novel covid disease (COVID-19) content from across the Lancet journals ont it is published.