The place of Emergency Departments in unscheduled care: what to learn from the organizations set up during the COVID-19 epidemic?[Quelle place pour les Services d'Accueil des Urgences dans l'offre de soins non programmés : comment capitaliser sur l'expérience de la gestion de l'épidémie de COVID-19 dans la crise actuelle ?]

The place of Emergency Departments in unscheduled care: what to learn from the organizations set up during the COVID-19 epidemic? The closure of emergency departments (ED) during spring 2022 ask questions about unscheduled care organization in France, and notably about the place of ED in unscheduled care. The ED saturation is an historical matter, leading to poor quality of care and suffering for the professionals who work there. Paradoxically, the period of the 1st wave of the COVID-19 epidemic saw this saturation improve. This finding seemed interesting to enlighten the actual crisis and trying to find organizational innovations. A comprehensive qualitative approach carried out on the territory of South Isère in the fall of 2020 has shown that the unscheduled care refer to a vague concept and to unstructured organizations, resulting in recourse to ED by default. The response to the COVID-19 crisis was based on a new territorial collaboration, made possible by the solidarity. On the same time, massive deprogramming has left an unprecedented place for unscheduled care. These two elements made it possible to test organizational innovations for the benefit of a unscheduled care. The sustainability or adaptation of some of the innovations would make it possible, within a territorial collaboration affirmed by a shared populational responsibility, to think of the unscheduled episode as a step in a coordinated health journey. A gradation of the unscheduled care offer including private and public, outpatient and hospital structures, primary care and expertise would refocus ED around the management of urgent care.