Urgent patients; Hubs for time dependent diseases
About this good practice
The practice described below concerns the coordination of hubs for time-dependent cardiovascular diseases.
Hub system. The Hub system was introduced by Lombardy Region to deal with the pandemic. This reorganisation involved the conversion of some Lombardy hospitals into Hubs dedicated exclusively to Time Dependent Diseases, while other hospitals on the territory to treat Covid patients (non-Hubs).
Characteristics. 4 Hub centres for cardiac surgery in Lombardy had to provide for the activation of preferential paths for non-Covid emergencies. Monzino Centre acted as the coordinator of the 4 Cardiac Surgery Hub.
Taking charge of patients. Decisions on which patient to transport and operate at the Hub were quickly taken and in compliance with a protocol. The hospital transmitted data via a telematic system. In case of acceptance, the patient was transferred to the Hub.
Collaboration with other Hubs. The cardiac surgeons of the Cardiology Centre created a shared priority list of emergencies to be attended.
Transfer of medical/nursing teams. Hub Centres were faced with the problem of non-sufficient staff. To deal with this, it was decided that Hospital teams (including those of non-hubs) would follow the patients admitted to the hub.
Access Rules. All patients had to be Covid negative.
Evidence of success
The Procedures described, adopted in a timely manner, enabled coordinated and effective management of transfer from other hospitals and admissions of patients to a dedicated Hub.
Potential for learning or transfer
The lesson learned could be identified as follows:
- Rapid conversion of hospitals into exclusive hubs for certain diseases, creating a protective shield for specific categories of patients.
- Strong collaboration and coordination between hub and non-hubs, creating a patient data sharing network and rapid transfer system.
- Solutions to medical staff shortages through the transfer of physicians and nurses between hubs for the same types of pathology.