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How a Madrid hospital modified management in COVID-19 crisis

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Read how a public institution, Rey Juan Carlos University Hospital, in Madrid, acted swiftly to modify spaces, staffing and responsibilities to treat both COVID-19 patients and those without the disease to provide the critical staffing and material resources, and information, that hospital leaders have needed to manage during the COVID-19 crisis in Spain, among the world’s worst.

In an article in NEJM Catalyst, four physician leaders at the hospital say:

“During the Covid-19 pandemic, we have continuously evaluated and adapted to our circumstances. This was initially done on a daily basis, enabling us to quickly adjust staff roles as of the fourth day of the state of alarm declared in Spain. For example, we managed our physician corps by adding or transforming roles, including the addition of reserve personnel, while respecting rest times.”


“To most effectively organize these changes in physician roles, we defined needs (‘COVID-19 shifts’), the daily tasks to be carried out under each position, and the person assigned to that activity. This information is contained in a document available to all physicians via the hospital intranet. Updated in real time, it sets out the plan for the following week.”

“Members of our Covid teams have gradually become opinion leaders and role models of best practices.”

“Every day, a multidisciplinary crisis management team made up of hospital managers, the office of the medical director, the nursing director, preventive medicine, microbiology, and leaders in internal medicine, the ICU, and critical care gather to discuss problems and solutions around spaces and staffing. Meetings like these have helped to build the ONE TEAM concept, reminding us that we depend on each other to deliver the best possible care.”

They conclude:

“Looking back over the past two months, we have met the challenges posed by this pandemic thanks to the great capacity for coordination and plasticity shown by our health care professionals and to the leadership of our centralized hospital management team. We are now working to update all the resources we have been using in case there is a new curve.”

To read the article, please hit this link.

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