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

Author

Listed:
  • Carlo Capalbo

    (Medical Oncology Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
    Department of Molecular Medicine, University La Sapienza, 00189 Rome, Italy
    These authors contributed equally to the research.)

  • Antonio Aceti

    (Infectious Diseases Unit Sant’Andrea Hospital, University La Sapienza, 00189 Rome, Italy
    These authors contributed equally to the research.)

  • 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)

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.

Suggested Citation

  • Carlo Capalbo & Antonio Aceti & Maurizio Simmaco & Rita Bonfini & Monica Rocco & Alberto Ricci & Christian Napoli & Matteo Rocco & Valeria Alfonsi & Antonella Teggi & Giovanni Battista Orsi & Marina B, 2020. "The Exponential Phase of the Covid-19 Pandemic in Central Italy: An Integrated Care Pathway," IJERPH, MDPI, vol. 17(11), pages 1-10, May.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:11:p:3792-:d:363467
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    Citations

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    Cited by:

    1. Marina Borro & Paolo Di Girolamo & Giovanna Gentile & Ottavia De Luca & Robert Preissner & Adriano Marcolongo & Stefano Ferracuti & Maurizio Simmaco, 2020. "Evidence-Based Considerations Exploring Relations between SARS-CoV-2 Pandemic and Air Pollution: Involvement of PM2.5-Mediated Up-Regulation of the Viral Receptor ACE-2," IJERPH, MDPI, vol. 17(15), pages 1-13, August.
    2. Noraziani Khamis & Intan Syafinaz Saimy & Nor Hayati Ibrahim & Nur Khairah Badaruddin & Nor Zam Azihan Mohd Hassan & Faridah Kusnin & Sukhvinder Singh Sandhu & Masitah Mohamed, 2021. "Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office," IJERPH, MDPI, vol. 18(19), pages 1-18, October.
    3. Carlo Capalbo & Enrico Bertamino & Alessandro Zerbetto & Iolanda Santino & Andrea Petrucca & Rita Mancini & Rita Bonfini & Valeria Alfonsi & Stefano Ferracuti & Paolo Marchetti & Maurizio Simmaco & Gi, 2020. "No Evidence of SARS-CoV-2 Circulation in Rome (Italy) during the Pre-Pandemic Period: Results of a Retrospective Surveillance," IJERPH, MDPI, vol. 17(22), pages 1-8, November.
    4. Hani Amir Aouissi & Ahmed Hamimes & Mostefa Ababsa & Lavinia Bianco & Christian Napoli & Feriel Kheira Kebaili & Andrey E. Krauklis & Hafid Bouzekri & Kuldeep Dhama, 2022. "Bayesian Modeling of COVID-19 to Classify the Infection and Death Rates in a Specific Duration: The Case of Algerian Provinces," IJERPH, MDPI, vol. 19(15), pages 1-18, August.
    5. Ștefan Cristian Gherghina & Daniel Ștefan Armeanu & Camelia Cătălina Joldeș, 2020. "Stock Market Reactions to COVID-19 Pandemic Outbreak: Quantitative Evidence from ARDL Bounds Tests and Granger Causality Analysis," IJERPH, MDPI, vol. 17(18), pages 1-35, September.
    6. Maria Piane & Lavinia Bianco & Rita Mancini & Paolo Fornelli & Angela Gabriele & Francesco Medici & Claudia Battista & Stefania Greco & Giuseppe Croce & Laura Franceschetti & Christian Napoli & Mario , 2022. "Impact of the COVID-19 Pandemic on Clinical Pathways for Non-SARS-CoV-2 Related Diseases in the Lazio Region, Italy," IJERPH, MDPI, vol. 19(2), pages 1-16, January.
    7. Kurubaran Ganasegeran & Mohd Fadzly Amar Jamil & Alan Swee Hock Ch’ng & Irene Looi & Kalaiarasu M. Peariasamy, 2021. "Influence of Population Density for COVID-19 Spread in Malaysia: An Ecological Study," IJERPH, MDPI, vol. 18(18), pages 1-12, September.

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