“A true full hospital.” COVID-19 treatment in Krylatskoye

November 14
Healthcare

There are no dramatic sports events being fought at the ice palace in Krylatskoye. The only team to support from the commentary box with a panoramic view of the ice rink is a team of doctors and nurses.

Today the ice palace’s main arena has been given over to accommodate medical beds and advanced equipment and the stadium is run by people in coloured scrubs instead of skaters: yellow for cleaners, red for administrators responsible for maintenance and organisation, and purple for the disinfectors who control the red zone exits and entrances. Anybody wearing white alone is a doctor.

Huge words “Bon appétit” on the big screen can be seen from every corner of the arena: this means it’s time for breakfast. This screen also regularly shows classical silent and Russian films. There are recreation zones around the perimeter, where people can watch television or read books and newspapers.

In early October, a temporary hospital for COVID-19 patients opened in Krylatskoye. However, Andrei Shkoda, chief medical officer at Vorokhobov City Clinical Hospital No. 67, which is responsible for the facility, is against calling it temporary.

Mos.ru reveals why the temporary hospital is no different from a regular one and what condition the patients are in.

Andrei Shkoda, Chief Physician of Vorokhobov City Hospital No. 67. Photo: M. Denisov. Mos.ru

High-class training

Question: Usually when hearing the word ‘temporary’ people think it is literarily that. Can you dispel this stereotype?

Andrei Shkoda: We should not even say “temporary” in this case: this is a real hospital that operates according to all the rules set by the Moscow Healthcare Department. We have a reception department, labs and diagnostic services as well as linear departments and intensive care.

We have a full staff of doctors, nurses and maintenance workers such as cleaners, wardens and catering staff. This is why there is no way the hospital should be called temporary: it is a proper hospital with over 1,300 beds. There is only one difference: we are located on an ice rink.

Question: What makes this hospital more comfortable than a usual one?

Andrei Shkoda: First of all, rounds the doctors make. They go around all the sections in one go. Every bed has oxygen and a call button. We have psychologists who also are also trying to help the patients. Everything is transparent and can be seen. This means logistics is a big advantage.

Second, comfort for patients. There are things that usual hospitals simply do not have, for example, a huge screen where we show silent films such as those of Charlie Chaplin, as well as Russian films. There also are recreation zones: we have established them together with the Social Protection Department.

Moreover, we have 500 tablet PCs for patients. They can be used to watch television or a series or navigate the internet: we have free Wi-Fi that works excellently.

Question: So you had no difficulties with getting used to the new hospital format?

Andrei Shkoda: No, I can really say it was the other way around: we have quickly got used to all the good things.

Question: How many patients do you take in?

Andrei Shkoda: Our hospital is filling up gradually. Moreover, we have doctors and nurses and are ready to use our full potential if necessary.

We have intensive care units for patients in need of more complicated medical aid, with special temperature and additional disinfection inside. There is special monitoring equipment, high-flow oxygen supply for non-invasive therapy and all medicine needed. Seven such rooms have been built, each with six beds: 42 in total.

Safety and staff

Question: What has been the main challenge in managing the hospital?

Andrei Shkoda: Forming a team, because people come from different places: some from other regions and some from other city hospitals. I believe we have managed: we have a good friendly atmosphere here. Work is underway, the backbone team is full, and we will continue to build our personnel around it.

Moreover, the Moscow Healthcare Department consolidates the work of several other departments that help us. For example, the Department of Information Technology is responsible for the digital hospital, and the Department for Major Housing Repairs steps in if it’s necessary to do or fix something.

Question: Are there training sessions for personnel?

Andrei Shkoda: Yes. Together with the Healthcare Department we have organised simulation courses for all the doctors and nurses to prepare for various states of disease. For example, situations when a patient is brought in with 50 percent of their lung tissue damaged and they suddenly develop other symptoms. Then all the services here respond quickly and provide the patient with the necessary assistance.

Question: What safety measures are being observed by hospital workers?

Andrei Shkoda: Safety is always the top priority. We have a special entrance for personnel, as well as showers and places where PPE can be put on. Our personnel is instructed on how to do it the correct way; there are mirrors to control the process. There are experts who watch that doctors and nurses entering the red zones follow the instructions. Moreover, everyone’s temperature is taken at the entrance.

Leaving the red zone is even more important. It is necessary to deal with the scrubs and get out of them the proper way. The procedure is also monitored by special personnel. Our attention does not relax for even  an hour. I would like to note that we do have enough disinfectant and PPE.

Digital hospital

Question: Are there any unique practices you’ve developed that can be used in general medicine in the future?

Andrei Shkoda: Yes. First of all, the concept of a digital hospital: a practice that can be spread in the future, logistics of managing a large team of workers. This, of course, means new approaches to organising patients’ treatment that we have developed, such as fulfilling recommendations from the clinical committee: a huge job but it helps solve many serious problems.

Question: How does the digital hospital system you’ve mentioned work?

Andrei Shkoda: Right in the admissions department, while the patient changes out of their clothes, a nurse fills out a medical chart on a computer tablet. This means that upon admission, the administrative part is already done and medical workers can quickly look through the chart. If an ECG has been carried out, there is no need to decipher it: it happens automatically and everything is immediately included on the chart. Online lab tests are also transferred to the chart. We exclude routine work. We see all the deciphered tests online on computers in one large database.

This way, we can also see the CT of a patient that has not been brought in yet. We can look through the scans to determine the degree of damage and see how people felt before being brought to hospital.

Expert recommendations

Question: How to you assess the current situation regarding COVID-19?

Andrei Shkoda: I know exactly that there is no need for what we call, big talk. Time is required for recess to begin. I think that, as of today, the situation is not very stable. It is important to comply with safety rules.

We badly needed hospitals of this type for other medical institutions to continue working. Our hospital, for example, continues to operate as usual and provides scheduled and emergency assistance. These hospitals are very useful for the rest of the healthcare system.

Question: Are there situations when patients can stay at home?

Andrei Shkoda: It’s up to the doctors. There are no ready procedures. Only experts can decide if somebody should get treatment at home or in a hospital.

I would like to recommend that people take good care of themselves and their loved ones: do not attend public events, wear masks, observe social distancing, wash your hands frequently, and if you can wear glasses.

If you fall ill there is no need to rush off to work. The most important thing is not to diagnose yourself if you don’t feel well. Tell this to medical workers and they will try and help you.

Source: mos.ru

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