The Exponential Phase of the Covid-19 Pandemic in Central Italy: An Integrated Care Pathway

Carlo Capalbo, Antonio Aceti, Maurizio Simmaco, Rita Bonfini, Monica Rocco, Alberto Ricci, Christian Napoli, Matteo Rocco, Valeria Alfonsi, Antonella Teggi, Giovanni Battista Orsi, Marina Borro, Iolanda Santino, Robert Preissner, Paolo Marchetti, Adriano Marcolongo and Paolo Anibaldi
Additional contact information
Carlo Capalbo: Medical Oncology Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Antonio Aceti: Infectious Diseases Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Maurizio Simmaco: Laboratory Analysis and Advanced Molecular Diagnostics Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Rita Bonfini: Emergency Department Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Monica Rocco: Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Alberto Ricci: Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant’Andrea, 00189 Rome, Italy
Christian Napoli: Medical Direction Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Matteo Rocco: Medical Direction Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Valeria Alfonsi: Medical Direction Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Antonella Teggi: Infectious Diseases Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Giovanni Battista Orsi: Department of Public Health and Infectious Diseases, University La Sapienza, 00189 Rome, Italy
Marina Borro: Laboratory Analysis and Advanced Molecular Diagnostics Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Iolanda Santino: Microbiology Unitand Advanced Molecular Diagnostics Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
Robert Preissner: Department of Physiology, CharitéUniversitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany
Paolo Marchetti: Medical Oncology Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Adriano Marcolongo: General Direction Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
Paolo Anibaldi: Medical Direction Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy

IJERPH, 2020, vol. 17, issue 11, 1-10

Abstract: The Coronavirus Disease (Covid-19) pandemic is rapidly spreading across the world, representing an unparalleled challenge for health care systems. There are differences in the estimated fatality rates, which cannot be explained easily. In Italy, the estimated case fatality rate was 12.7% in mid-April, while Germany remained at 1.8%. Moreover, it is to be noted that different areas of Italy have very different lethality rates. Due to the complexity of Covid-19 patient management, it is of paramount importance to develop a well-defined clinical workflow in order to avoid the inconsistent management of patients. The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care to support patient management in the Sant’Andrea Hospital, Rome. The main objective of this pilot study was to develop a new ICP evaluated by care indicators, in order to improve the COVID-19 patient management. The suggested ICP was developed by a multi-professional team composed of different specialists and administrators already involved in clinical and management processes. After a review of current internal practices and published evidences, we identified (1) the activities performed during care delivery, (2) the responsibilities for these activities, (3) hospital structural adaptation needs and potential improvements, and (4) ICP indicators. The process map formed the basis of the final ICP document; 160 COVID-19 inpatients were considered, and the effect of the ICP implementation was evaluated over time during the exponential phase of the COVID-19 pandemic. In conclusion, a rapid adoption of ICP and regular audits of quality indicators for the management of COVID-19 patients might be important tools to improve the quality of care and outcomes.

Keywords: coronavirus; COVID-19; clinical pathway; Italy; pandemic; SARS-Cov-2; risk management (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (7)

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