Pierre Appert

General Manager, Member of the Board GSD Healthcare, a part of Gruppo Ospedaliero San Donat

 Pierre Appert

“GSD has demonstrated full cooperation with regional health system to fight Covid 19”

Since the beginning of the Covid19 outbreak, San Donato Hospital group took some important measures in its 18 hospitals and outpatients’ clinics to prevent and contain the spread of the virusHospitals” magazine met with Pierre Appert General Manager, Member of the Board GSD Healthcare, a part of Gruppo Ospedaliero San Donato. Below is the full interview:

How are you responding to the Covid 19 crisis? and what are the steps you are taking to limit its spread? 

Since the beginning of the Covid19 outbreak, San Donato Hospital group took some important measures in its 18 hospitals and outpatients’ clinics to prevent and contain the spread of the virus. In fact, some services and related ways of accessing the facilities undergo major changes and reorganization regarding the timing, number of patients, family members present with the patient, surgical procedures, monitoring of the temperature…

For the time being, only people who need urgent or planned health care can go to the hospital. For greater protection, escorts are not allowed, unless the patient is a minor, a disabled person, not self-sufficient or a person with language-cultural difficulties. Entry to the hospital is prohibited for individuals subject to the quarantine measure provided by the legal provisions; in the case of respiratory infection symptoms and fever greater than or equal to 37.5 degrees Celsius; in case of a positive test to the coronavirus; if in the last 14 days there has been close contact with coronavirus positives. In addition of wearing masks, use of gels and social distancing.

In mid-March, the group was treating 1,023 Covid-19 patients in Lombardy and has been in the front line on the fight against Coronavirus. It is a mission that requires a great deal of effort in terms of medical and  personnel logistics. A commitment of incalculable importance, but quantifiable in numbers.  

Since February 21, the day where the emergency began, the San Donato Group first made its hospitals fully available to the regional health system.  The collaboration began with the identification of inpatient and intensive care beds dedicated to Covid-19 patients at the San Raffaele Research Hospital.  

The clinical activity in election within our hospitals, in accordance with Lombardy Region, was first reduced and then totally suspended to provide spaces and staff to the emergency.  

1,125 beds (including 102 in intensive care and 131 in the ordinary inpatient ward) 1,023 hospitalized patients (94 of whom were in intensive care).

At San Raffaele Research Hospital were dedicated:

  • 24 beds in intensive care.
  • 150 beds with non-invasive respiratory care.
  • 14 beds for resuscitation.

The entire interior area of the emergency ward was also dedicated to patients who need oxygen therapy and observation. 

In addition, the Hospital has a role of a regional hub for cardiovascular diseases, conferred by Lombardy Region.

The team of anesthesiologists-reanimation doctors of San Raffaele continues to be a reference center for cases of more serious respiratory failure: doctors and nurses also are taking care of critical cases of patients coming from other hospitals undergoing ECMO therapy.

At San Marco and San Pietro Hospitals where the serious situation in the province of Bergamo, involved our Hospitals there, which received about 300 Covid 19 patients.  We made available:  110 additional ordinary hospital places; 10 places in intensive care to prepare for a possible spike in patients in the Milan area.

The coronavirus is placing a huge strain on the healthcare system worldwide, how are you coping with this? and what lessons can we learn for the future?

The San Donato Group has demonstrated full cooperation with the regional health system to address this serious problem. From sending a task force of 20 intensive doctors in the first red zone at the beginning of the pandemic to the allocation of beds at our hospitals for the treatment of the Covid19 patients, to the 24-hour installation of a dedicated intensive care unit at the San Donato University Hospital.

In support of the Coronavirus emergency that is putting several hospitals in Lombardy under pressure, the San Donato Group put in place its know-how and a task force of specialists ready to support colleagues both in the red zone and in other hospitals in Lombardy that needed it.

In addition, at San Raffaele Medical University Hospital it was built in just 8 days, thanks to the incessant work of the workers who dedicated themselves day and night, a new intensive care unit which was carried out in the sports fields of our Medical University Vita -Salute. 

The department has been equipped with the medical equipment and devices necessary to treat serious patients who have contracted coronavirus and need respiratory assistance. 

This pandemic from the hospital perspective showed us a high necessity to build a strong alliance between high-specialization hospitals and the healthcare services in the territory like ambulatory services, home care services, and primary care centre. This alliance will permit a conscious restart that leaves no one behind, indeed, that protects the weakest and that allows other sections of the population a quick return to normality.

We are starting to hear about healthcare lessons for the post corona world, what is your vision and the policies you will be adopting for the coming period?

Safe start: Here is the priority in Phase 2 of the fight against coronavirus. The San Donato Group is also committed to ensuring safe hospitals for users and the gradual reopening to a new normal.  Can I go to the hospital? What are the rules to be met? How can I book medical visits? Here are some of the most frequently asked questions of those who need to go to the hospital for medical examinations, treatments or follow-ups, examinations.   To protect the health of the patients, our hospitals have reviewed entry, access to visits, bookings, payment of tickets and more.

The San Donato Hospital Group have provided different paths and areas: COVID spaces: isolated and dedicated to the care of COVID-19 patients; non-COVID spaces; where the usual inpatient and outpatient activity takes place.

At the height of phase 2, where we can think of starting elective surgery again, we must be sure that we can assure the patient that a clean and sanitized hospital will come to us, articulated by efficient pathways, and able to offer the best possible treatment.

Indeed we are calling it “POST”, the protocol that summarizes four fundamental principles to safely guide Phase 2: Prudence, Organization, Surveillance, Timeliness. To support this definition, there is the valuable clinical experience and scientific evidence collected by our doctors and researchers of the Raffaele Hospital who, led by Prof Alberto Zangrillo, Head of General and Cardiovascular Intensive Therapy, and Prof Fabio Ciceri, Deputy Scientific Director for Clinical Research, in these three months have hospitalized, observed and treated more than 1,000 patients suffering from coronavirus. This is the scientific contribution that the San Raffaele Hospital and the entire San Donato Group make available to Lombardy Region, to support health policy choices that take into account the wealth of scientific and clinical knowledge gained in the fight against the epidemic.

How do you rate your preparedness during the pandemic? and what are the difficulties you faced during this time? what about shortage in the medical supplies?

This pandemic took by surprise the whole world specially in Italy which was one of the first countries hit by the virus, but thanks to our experienced and dedicated healthcare professionals a more catastrophic health scenario was avoided, and we were able to treat all the critical patients that were sent to our facilities. 

Unfortunately, there is not only one factor affecting the good response to this disease, but the combination of several factors and all the concerned parties should work hand in hand to contain it and win the battle against the virus.

The group was also able to have the medical supplies necessary during the pandemic even if it was sometimes challenging after the closure of the frontiers and the high worldwide demand. 

Do you see the necessity in changing and transforming global health development and expenditure?

After this pandemic the whole world now is noticing the importance of the healthcare sector in the global economy, lessons should be learned from this disease and more global standards and guidelines, in addition of international collaboration in healthcare should be adopted to be more prepared in the future against other pandemics, more resources should be allocated, and let’s not forget the human resources that showed us how key their role is, especially that the world is having a significant shortage of healthcare staff. We should train more personnel and provide them with the best work conditions.

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