[Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department].
Identifieur interne : 001537 ( Main/Corpus ); précédent : 001536; suivant : 001538[Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department].
Auteurs : Antoine Garnier ; Julien Vaucher ; Christophe Bianchi ; Vanessa Kraege ; Marie Méan ; Julien Castioni ; Pierre-Alexandre Bart ; Valérie Champier ; Philippe Eggimann ; David Gachoud ; Milica Jovanovic ; Olivier Lamy ; Pedro Marques-Vidal ; Matteo Monti ; Anne Perier ; Sylvie Robert ; Guillaume Roulet ; Claudio Sartori ; Gérard Waeber ; Peter VollenweiderSource :
- Revue medicale suisse [ 1660-9379 ] ; 2020.
English descriptors
- KwdEn :
- MESH :
- geographic : France.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- organization & administration : Tertiary Care Centers.
- Betacoronavirus, Crew Resource Management, Healthcare, Humans, Pandemics.
Abstract
The rapid progression of COVID-19 is an organizational challenge for all hospitals. To secure the patient overflow, the Department internal medicine of the University Hospital of Lausanne increased nurse and medical workforces as well as bed capacity by 65 %, with extraordinary help from other departments. The implemented crisis management stood upon three pillars : a crisis management team, steering documents and internal communication. In this new form, the Department had already taken care of 442 COVID-19 admissions by April 16, 2020. Alongside organizational challenges, clinical issues such as rapid respiratory distress, clinical suspicions with negative PCR and treatment uncertainties in the absence of sufficient evidence were overcome. Despite the peak of the pandemic appearing to have passed, the next phase could be just as complicated.
La progression rapide du COVID-19 constitue un défi organisationnel pour tous les hôpitaux. Pour anticiper un afflux important de patients, le service de médecine interne du CHUV a ainsi augmenté ses forces de travail médico-soignantes et son nombre de lits de 65 % avec un soutien extraordinaire de toute l’institution. Pour opérer ces changements majeurs, l’organisation de crise mise en place s’est appuyée sur trois piliers : une cellule de conduite, des documents de pilotage et une communication interne. Sous cette nouvelle forme, le service a pris en charge 442 hospitalisations COVID-19 jusqu’au 16 avril 2020. Si les enjeux organisationnels ont été majeurs, la gestion des situations complexes, comme les manifestations respiratoires et les multiples incertitudes cliniques diagnostiques et thérapeutiques, ont été également une gageure. Le pic de la pandémie semble passé, mais la prochaine phase pourrait constituer un nouveau défi organisationnel.
PubMed: 32348056
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">[Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department].</title><author><name sortKey="Garnier, Antoine" sort="Garnier, Antoine" uniqKey="Garnier A" first="Antoine" last="Garnier">Antoine Garnier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Direction médicale, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Vaucher, Julien" sort="Vaucher, Julien" uniqKey="Vaucher J" first="Julien" last="Vaucher">Julien Vaucher</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Bianchi, Christophe" sort="Bianchi, Christophe" uniqKey="Bianchi C" first="Christophe" last="Bianchi">Christophe Bianchi</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Kraege, Vanessa" sort="Kraege, Vanessa" uniqKey="Kraege V" first="Vanessa" last="Kraege">Vanessa Kraege</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Mean, Marie" sort="Mean, Marie" uniqKey="Mean M" first="Marie" last="Méan">Marie Méan</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Castioni, Julien" sort="Castioni, Julien" uniqKey="Castioni J" first="Julien" last="Castioni">Julien Castioni</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Direction des ressources humaines, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Bart, Pierre Alexandre" sort="Bart, Pierre Alexandre" uniqKey="Bart P" first="Pierre-Alexandre" last="Bart">Pierre-Alexandre Bart</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Champier, Valerie" sort="Champier, Valerie" uniqKey="Champier V" first="Valérie" last="Champier">Valérie Champier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Eggimann, Philippe" sort="Eggimann, Philippe" uniqKey="Eggimann P" first="Philippe" last="Eggimann">Philippe Eggimann</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Gachoud, David" sort="Gachoud, David" uniqKey="Gachoud D" first="David" last="Gachoud">David Gachoud</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Jovanovic, Milica" sort="Jovanovic, Milica" uniqKey="Jovanovic M" first="Milica" last="Jovanovic">Milica Jovanovic</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Lamy, Olivier" sort="Lamy, Olivier" uniqKey="Lamy O" first="Olivier" last="Lamy">Olivier Lamy</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Marques Vidal, Pedro" sort="Marques Vidal, Pedro" uniqKey="Marques Vidal P" first="Pedro" last="Marques-Vidal">Pedro Marques-Vidal</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Monti, Matteo" sort="Monti, Matteo" uniqKey="Monti M" first="Matteo" last="Monti">Matteo Monti</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Perier, Anne" sort="Perier, Anne" uniqKey="Perier A" first="Anne" last="Perier">Anne Perier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Robert, Sylvie" sort="Robert, Sylvie" uniqKey="Robert S" first="Sylvie" last="Robert">Sylvie Robert</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Roulet, Guillaume" sort="Roulet, Guillaume" uniqKey="Roulet G" first="Guillaume" last="Roulet">Guillaume Roulet</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Sartori, Claudio" sort="Sartori, Claudio" uniqKey="Sartori C" first="Claudio" last="Sartori">Claudio Sartori</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Waeber, Gerard" sort="Waeber, Gerard" uniqKey="Waeber G" first="Gérard" last="Waeber">Gérard Waeber</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de médecine, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Vollenweider, Peter" sort="Vollenweider, Peter" uniqKey="Vollenweider P" first="Peter" last="Vollenweider">Peter Vollenweider</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32348056</idno><idno type="pmid">32348056</idno><idno type="wicri:Area/Main/Corpus">001537</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001537</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department].</title><author><name sortKey="Garnier, Antoine" sort="Garnier, Antoine" uniqKey="Garnier A" first="Antoine" last="Garnier">Antoine Garnier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Direction médicale, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Vaucher, Julien" sort="Vaucher, Julien" uniqKey="Vaucher J" first="Julien" last="Vaucher">Julien Vaucher</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Bianchi, Christophe" sort="Bianchi, Christophe" uniqKey="Bianchi C" first="Christophe" last="Bianchi">Christophe Bianchi</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Kraege, Vanessa" sort="Kraege, Vanessa" uniqKey="Kraege V" first="Vanessa" last="Kraege">Vanessa Kraege</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Mean, Marie" sort="Mean, Marie" uniqKey="Mean M" first="Marie" last="Méan">Marie Méan</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Castioni, Julien" sort="Castioni, Julien" uniqKey="Castioni J" first="Julien" last="Castioni">Julien Castioni</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Direction des ressources humaines, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Bart, Pierre Alexandre" sort="Bart, Pierre Alexandre" uniqKey="Bart P" first="Pierre-Alexandre" last="Bart">Pierre-Alexandre Bart</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Champier, Valerie" sort="Champier, Valerie" uniqKey="Champier V" first="Valérie" last="Champier">Valérie Champier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Eggimann, Philippe" sort="Eggimann, Philippe" uniqKey="Eggimann P" first="Philippe" last="Eggimann">Philippe Eggimann</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Gachoud, David" sort="Gachoud, David" uniqKey="Gachoud D" first="David" last="Gachoud">David Gachoud</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Jovanovic, Milica" sort="Jovanovic, Milica" uniqKey="Jovanovic M" first="Milica" last="Jovanovic">Milica Jovanovic</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Lamy, Olivier" sort="Lamy, Olivier" uniqKey="Lamy O" first="Olivier" last="Lamy">Olivier Lamy</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Marques Vidal, Pedro" sort="Marques Vidal, Pedro" uniqKey="Marques Vidal P" first="Pedro" last="Marques-Vidal">Pedro Marques-Vidal</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Monti, Matteo" sort="Monti, Matteo" uniqKey="Monti M" first="Matteo" last="Monti">Matteo Monti</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Perier, Anne" sort="Perier, Anne" uniqKey="Perier A" first="Anne" last="Perier">Anne Perier</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Robert, Sylvie" sort="Robert, Sylvie" uniqKey="Robert S" first="Sylvie" last="Robert">Sylvie Robert</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Roulet, Guillaume" sort="Roulet, Guillaume" uniqKey="Roulet G" first="Guillaume" last="Roulet">Guillaume Roulet</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Sartori, Claudio" sort="Sartori, Claudio" uniqKey="Sartori C" first="Claudio" last="Sartori">Claudio Sartori</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Waeber, Gerard" sort="Waeber, Gerard" uniqKey="Waeber G" first="Gérard" last="Waeber">Gérard Waeber</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de médecine, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation></author><author><name sortKey="Vollenweider, Peter" sort="Vollenweider, Peter" uniqKey="Vollenweider P" first="Peter" last="Vollenweider">Peter Vollenweider</name><affiliation><nlm:affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Revue medicale suisse</title><idno type="ISSN">1660-9379</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Crew Resource Management, Healthcare (MeSH)</term><term>France (MeSH)</term><term>Humans (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (epidemiology)</term><term>Tertiary Care Centers (organization & administration)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>France</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Tertiary Care Centers</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>Crew Resource Management, Healthcare</term><term>Humans</term><term>Pandemics</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The rapid progression of COVID-19 is an organizational challenge for all hospitals. To secure the patient overflow, the Department internal medicine of the University Hospital of Lausanne increased nurse and medical workforces as well as bed capacity by 65 %, with extraordinary help from other departments. The implemented crisis management stood upon three pillars : a crisis management team, steering documents and internal communication. In this new form, the Department had already taken care of 442 COVID-19 admissions by April 16, 2020. Alongside organizational challenges, clinical issues such as rapid respiratory distress, clinical suspicions with negative PCR and treatment uncertainties in the absence of sufficient evidence were overcome. Despite the peak of the pandemic appearing to have passed, the next phase could be just as complicated.</div><div type="abstract" xml:lang="fr">La progression rapide du COVID-19 constitue un défi organisationnel pour tous les hôpitaux. Pour anticiper un afflux important de patients, le service de médecine interne du CHUV a ainsi augmenté ses forces de travail médico-soignantes et son nombre de lits de 65 % avec un soutien extraordinaire de toute l’institution. Pour opérer ces changements majeurs, l’organisation de crise mise en place s’est appuyée sur trois piliers : une cellule de conduite, des documents de pilotage et une communication interne. Sous cette nouvelle forme, le service a pris en charge 442 hospitalisations COVID-19 jusqu’au 16 avril 2020. Si les enjeux organisationnels ont été majeurs, la gestion des situations complexes, comme les manifestations respiratoires et les multiples incertitudes cliniques diagnostiques et thérapeutiques, ont été également une gageure. Le pic de la pandémie semble passé, mais la prochaine phase pourrait constituer un nouveau défi organisationnel.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32348056</PMID><DateCompleted><Year>2020</Year><Month>05</Month><Day>01</Day></DateCompleted><DateRevised><Year>2020</Year><Month>05</Month><Day>01</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1660-9379</ISSN><JournalIssue CitedMedium="Print"><Volume>16</Volume><Issue>N° 691-2</Issue><PubDate><Year>2020</Year><Month>Apr</Month><Day>29</Day></PubDate></JournalIssue><Title>Revue medicale suisse</Title><ISOAbbreviation>Rev Med Suisse</ISOAbbreviation></Journal><ArticleTitle>[Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department].</ArticleTitle><Pagination><MedlinePgn>869-874</MedlinePgn></Pagination><Abstract><AbstractText>The rapid progression of COVID-19 is an organizational challenge for all hospitals. To secure the patient overflow, the Department internal medicine of the University Hospital of Lausanne increased nurse and medical workforces as well as bed capacity by 65 %, with extraordinary help from other departments. The implemented crisis management stood upon three pillars : a crisis management team, steering documents and internal communication. In this new form, the Department had already taken care of 442 COVID-19 admissions by April 16, 2020. Alongside organizational challenges, clinical issues such as rapid respiratory distress, clinical suspicions with negative PCR and treatment uncertainties in the absence of sufficient evidence were overcome. Despite the peak of the pandemic appearing to have passed, the next phase could be just as complicated.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Garnier</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Direction médicale, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vaucher</LastName><ForeName>Julien</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bianchi</LastName><ForeName>Christophe</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kraege</LastName><ForeName>Vanessa</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Méan</LastName><ForeName>Marie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Castioni</LastName><ForeName>Julien</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Direction des ressources humaines, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bart</LastName><ForeName>Pierre-Alexandre</ForeName><Initials>PA</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Champier</LastName><ForeName>Valérie</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eggimann</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gachoud</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jovanovic</LastName><ForeName>Milica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lamy</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Département de l'appareil locomoteur, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marques-Vidal</LastName><ForeName>Pedro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Monti</LastName><ForeName>Matteo</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Perier</LastName><ForeName>Anne</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Robert</LastName><ForeName>Sylvie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roulet</LastName><ForeName>Guillaume</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sartori</LastName><ForeName>Claudio</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Waeber</LastName><ForeName>Gérard</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Département de médecine, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vollenweider</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de médecine interne, CHUV, 1011 Lausanne.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne.</Affiliation></AffiliationInfo></Author></AuthorList><Language>fre</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Impacts organisationnels et défis cliniques de la pandémie COVID-19 pour un service hospitalier de médecine interne universitaire.</VernacularTitle></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Rev Med Suisse</MedlineTA><NlmUniqueID>101219148</NlmUniqueID><ISSNLinking>1660-9379</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000067498" MajorTopicYN="Y">Crew Resource Management, Healthcare</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D062606" MajorTopicYN="N">Tertiary Care Centers</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="fre"><AbstractText>La progression rapide du COVID-19 constitue un défi organisationnel pour tous les hôpitaux. Pour anticiper un afflux important de patients, le service de médecine interne du CHUV a ainsi augmenté ses forces de travail médico-soignantes et son nombre de lits de 65 % avec un soutien extraordinaire de toute l’institution. Pour opérer ces changements majeurs, l’organisation de crise mise en place s’est appuyée sur trois piliers : une cellule de conduite, des documents de pilotage et une communication interne. Sous cette nouvelle forme, le service a pris en charge 442 hospitalisations COVID-19 jusqu’au 16 avril 2020. Si les enjeux organisationnels ont été majeurs, la gestion des situations complexes, comme les manifestations respiratoires et les multiples incertitudes cliniques diagnostiques et thérapeutiques, ont été également une gageure. Le pic de la pandémie semble passé, mais la prochaine phase pourrait constituer un nouveau défi organisationnel.</AbstractText></OtherAbstract><CoiStatement>Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32348056</ArticleId><ArticleId IdType="pii">RMS0691-2-017</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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