in the Strasbourg emergency room, the mobile reception unit facilitates arrivals but does not solve the lack of beds

Two months after its installation, the prefabricated emergency car park in Strasbourg streamlines the circulation of emergency vehicles but does not allow for faster medical care.



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The prefab is installed in the hospital emergency parking lot.  (SOLENNE LE HEN / RADIOFRANCE)

A prefabricated facility to accommodate patients in the Strasbourg emergency parking lot: the image stood out as a symbol of the emergency crisis in France. The structure was installed at the end of December by the hospital management, to put an end to the traffic jams of ambulances and fire trucks. Two months later, franceinfo takes stock of the operation.

In the prefab, Édouard, 93, arrived by ambulance with foot pain. He takes his pain patiently, half lying on a stretcher: “It’s definitely not comfortable.” The man waits “since three hours” and has not yet seen a doctor: “It must be said that this is a waiting room.” This prefab which can accommodate eight patients is not yet really a hospital. It is under the supervision of paramedics and Professor Ferhat Meziani, head of the emergency department, is not satisfied with the system: “It’s the quality of patient care that is in question. The care is completely degraded. It’s a patch.”

“We are between a rock and a hard place”

A patch, which in any case fulfilled its objective: to relieve the ambulance drivers and firefighters, who could no longer bear being stuck in the parking lot for hours with their vehicles and their patients inside, while waiting for a place in the emergency room. The system works, the parking lot is now empty but not the prefab, nor the emergency rooms, however. “It does not advance medical and paramedical care in any wayexplains Stéphanie Rempp, emergency health manager. It’s a problem because in an emergency department you have to take everyone, whether there’s room or not. There are always a lot of people in the emergency room.”

As in all hospitals in France, the emergency rooms are jammed: patients on stretchers in every corner of the department. Professor Meziani summarizes as follows: “We are between a rock and a hard place. And often, unfortunately, it is the patient who suffers. That is what is difficult to bear.” The hammer is the continuous influx of patients. Patients who arrive at the emergency room often because they have not been able to see a doctor in town. And the anvil, the exit of patients from the service.

In Strasbourg, it’s enormous: one in three patients in the emergency room then requires hospitalization. Between 60 and 90 patients every day. Except that there are not enough beds available. Patients therefore wait more than 12 hours on stretchers in the emergency room. And the caregivers are breaking down. Professor Meziani talks about profession “life burner” : “Many professionals who were motivated, who were committed, got burned and therefore changed professions, countries, regions and even resigned.”

The gradual reopening of hospital beds

So the solution is to reopen hospital beds. 20% have closed over the last ten years at Strasbourg University Hospital. We are in the opposite movement but it is happening little by little, explains Céline Dugast, deputy general director of the hospital. “We moved a geriatrics unit which allowed us to open four additional bedsshe indicates. We have reopened continuing care beds with eight beds, thoracic pathology with two beds and we are preparing the opening of a digestive surgery unit. So as soon as we have the possibility of reopening beds, we do so.”

“We’re in bed nearby.”

Céline Dugast, deputy general director of the hospital

at franceinfo

“Today the nursing recruitment situation does not allow us to make commitments with openings of 24 beds, full nights, etc. We must be reasonable, each additional bed opened is relevant because it will make the arrival of new patients more fluid”, continues the general director.

The shortage of nurses does not allow as many beds to be reopened as the CHU would like. Emergency caregivers feel lonely. They would like private clinics and nursing homes in the region to give them an extra helping hand. In the meantime, the prefab in the parking lot will soon disappear. It will be replaced by a semi-permanent structure.

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