Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic

ABSTRACT Purpose: to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. Materials and Methods: In May the 6th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents' activity. A narrative summary of guidelines and current literature for each point of interest was performed. Conclusion: In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.摘要 目的：旨在更新新冠疫情期间泌尿外科的诊疗管理方案，提出优化患者诊疗服务、推行远程医疗与分诊流程、明确住院收治路径、降低院内感染风险以及确定住院医师在疫情期间职责的相关策略。材料与方法：2020年5月6日，我们通过PubMed、Web of Science及Science Direct等在线搜索引擎开展文献综述。我们梳理了欧洲泌尿外科学会(European Association of Urology, EAU)与欧洲泌尿放射学学会(European Society of Uroradiology, ERUS)针对新冠疫情期间泌尿外科患者管理所发布的指南建议。本次研究关注的核心要点包括：可暂缓与不可暂缓手术的界定、医护人员个人防护装备(Personal Protective Equipment, PPE)及医院防控方案、分诊、住院与手术管理、术后护理培训以及住院医师工作安排。我们针对各关注要点对相关指南与现有文献进行了叙述性总结。结论：在当前新冠疫情形势下，全球阳性病例数持续攀升，采用全新的医疗服务交付模式以应对物理隔离与自我隔离带来的挑战至关重要。合理使用个人防护装备、明确的医院入院路径以及推行远程医疗方案，均可作为持续开展医疗服务的有效策略。