in a Parisian hospital, the “impossible mission” of a dedicated team to free up beds

How to make room for Covid-19 patients who flock when the hospital is full ? This question has been a recurring one in hospitals for two years now and the start of the pandemic. There are only two solutions: open additional beds as soon as the epidemic resumes, or free up occupied beds for patients who no longer need to be hospitalized but have no drop-off point.

At the Saint-Antoine hospital in Paris, the management decided to create a little more than a year ago, during the second wave of Covid-19, a team responsible for finding places elsewhere for these patients without solution. “The reasoning was to say: perhaps within the hospital we have patients who are still hospitalized but medically discharged and in difficulty to access a care pathway”, says Dr. Jennifer Sobotka, the hospital’s crisis medical director.

She then identifies 100 beds occupied by patients, sometimes for months or even a year. These patients have nothing more to do in the hospital but impossible to send them home. “There are patients who do not have a home, others who are in precarious or unsanitary housing. There are also patients who were autonomous, came to the hospital for a pathology and are no longer so. They can’t go home that easy.”, she lists.

“At first, I thought it was an impossible mission”, recognizes Doctor Adrienne Reix, who is part of the team. “Approaches social assistance, such as entering an Ehpad, can take several months. At the same time, the social workers are overwhelmed. PPatiently, the team is therefore contacting all the structures that could accommodate these patients – in agreement with them: Ehpad, convalescent home, rehabilitation service… “There is a multiplication and a really very large number of devices on the territory”, explains P.auline Novis, who manages the beds at the hospital. “The subject is to succeed in identifying the right interlocutors.”

In the end, the team managed to create a solid file. “Over time, I built a directory of the different sectors and the different partners who made it easier for us to take care of patients”, welcomes Dr. Adrienne Reix. This file is contained in a computer file, classified “depending on specialty” : respiratory convalescence, obesity, healing… “As soon as I have a new contact, someone with whom I could exchange, I add it”, explains Adrienne Reix. The numbers of the structures and interlocutors with whom the contact goes well are carefully noted.

Thus, the hospital succeeded in freeing up the 100 beds occupied by patients without a reception solution. This represented between 5 and 10% of its capacity. Sometimes the team even manages to find a place in an nursing home within 24 hours. The system is therefore called upon to remain, to allow beds to be freed up continuously, immediately reallocated to a new patient with the Covid-19 epidemic.