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J Subst Abuse Treat ; 120: 108163, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33298301


Historically, federal and state policies have narrowly defined treatment models that have resulted in limited access to and engagement in counseling for individuals receiving medications for opioid use disorder (MOUD; e.g., methadone and buprenorphine). In response to the coronavirus pandemic, outpatient MOUD treatment providers rapidly transitioned from traditional, in-person care delivery models to revised COVID-19 protocols that prioritized telehealth counseling to protect the health of patients and staff and ensure continuity in MOUD care. These telehealth innovations appear to mitigate many of the longstanding barriers to counseling in the traditional system and have the potential to forever alter MOUD care delivery. Drawing on data from a Rhode Island-based clinic, we argue that MOUD counseling is achievable via telehealth and outline the need for, and anticipated benefits of, hybrid telehealth/in-person MOUD treatment models moving forward.

Consejo/métodos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Telemedicina/organización & administración , Buprenorfina/administración & dosificación , Continuidad de la Atención al Paciente/organización & administración , Prestación de Atención de Salud/organización & administración , Humanos , Metadona/administración & dosificación , Tratamiento de Sustitución de Opiáceos/métodos , Rhode Island
Rehabilitación (Madr., Ed. impr.) ; 54(4): 269-274, oct.-dic. 2020.
Artículo en Español | IBECS | ID: ibc-192488


El sistema sanitario se encuentra ante una pandemia mundial en relación con la enfermedad por coronavirus 2019 (COVID-19). Los planes de preparación para emergencias a menudo no consideran cuestiones específicas de rehabilitación para pacientes hospitalizados ni para ambulatorios, aunque la Organización Mundial de la Salud aconseja incluir a profesionales de rehabilitación lo antes posible. Los planes de contingencia de los Servicios de Rehabilitación deben realizarse en coordinación con las otras áreas asistenciales. En esta revisión, se ha resumido y analizado la información disponible basada en una búsqueda cuidadosa de la literatura científica de COVID-19 y en la experiencia de un entorno concreto, para planificar la continuidad asistencial de rehabilitación para todos los pacientes y para ayudar a los equipos de rehabilitación en este periodo de confinamiento /desconfinamiento incierto

The health system is facing a global pandemic due to coronavirus disease 2019 (COVID-19). Emergency plans often fail to consider specific rehabilitation issues, whether inpatient or outpatient, although the World Health Organisation advises the inclusion of rehabilitation professionals as soon as possible. The contingency plans of rehabilitation services must be carried out in coordination with the other healthcare areas. This review was prepared with the current available evidence on COVID-19 and was based on the experience of a specific environment, to plan the continuity of rehabilitation care for all patients and to help rehabilitation teams in this period of lockdown and uncertain lifting of restrictions

Humanos , Cuarentena/psicología , Infecciones por Coronavirus/rehabilitación , Virus del SRAS/patogenicidad , Pandemias , Centros de Rehabilitación/organización & administración , Terapia por Ejercicio/métodos , Continuidad de la Atención al Paciente/organización & administración , Planes de Contingencia
Rehabilitación (Madr., Ed. impr.) ; 54(4): 276-283, oct.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-192491


La pandemia de COVID-19 es un desafío para el manejo de las patologías no COVID como la enfermedad linfática y el lipedema. La telemedicina puede evitar la propagación del coronavirus. Se necesita un sistema que nos ayude a determinar la prioridad clínica y la selección de la asistencia presencial o telemática para cada paciente y la forma de realizarlas durante la pandemia. El Grupo Español de Linfología ha realizado un documento de consenso con recomendaciones basadas en la bibliografía y experiencia clínica, como guía de práctica clínica en el manejo de anomalías linfáticas y lipedema durante la pandemia de COVID-19. Estas recomendaciones deben adaptarse a las características del paciente, las condiciones locales de los centros y las decisiones de los profesionales de la salud. Es un documento de criterios mínimos, sujeto a modificaciones según evolucione la pandemia, los conocimientos científicos y las instrucciones de las autoridades sanitarias

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities

Humanos , Infecciones por Coronavirus/rehabilitación , Lipedema/rehabilitación , Anomalías Linfáticas/rehabilitación , Linfedema/rehabilitación , Malformaciones Vasculares/rehabilitación , Telerrehabilitación/organización & administración , Pandemias , Centros de Rehabilitación/organización & administración , Continuidad de la Atención al Paciente/organización & administración , Prioridades en Salud/tendencias
Rev Saude Publica ; 54: 100, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146323


OBJECTIVE: To estimate the adequacy of health care during pregnancy and the postpartum period in puerperal women and newborn users of the Unified Health System and verify the factors associated with greater adequacy. METHODS: We used data obtained in the hospital interview, the prenatal card and the first telephone interview of 12,646 women participating in the study Nascer no Brasil (Birth in Brazil), conducted in 2011 and 2012. In the first stage of the analysis, the sociodemographic and obstetric characteristics of women and the estimation of adequacy of prenatal and postpartum care indicators are described. In the second stage, the cascade of care for actions related to puerperal women and their newborns is presented. Finally, maternal factors associated with the adequacy of the line of care are verified by means of multiple logistic regression. RESULTS: Only two of the four prenatal indicators were considered satisfactory: initiation up to the 16th week of pregnancy and adequate number of appointments. The guidance on which maternity to go for delivery, as well as the guidance to perform the puerperal appointment and the performance of the heel prick test have reached partial level of adequacy. The puerperal appointment, the first routine appointment of the newborn and the obtaining of the heel prick test results presented unsatisfactory adequacy. In the joint analysis of indicators regarding the effective use of services, only 1.5% of mothers and their babies received all recommended health care. Multiparous women living in the North, Northeast and Midwest, with lower schooling, presented the lowest chances of continuity of care. CONCLUSIONS: The indicators evaluated indicate that almost all women and their children presented partial and disjointed care, showing that the coordination of care is still a challenge in the health care of women and children in the puerperal pregnancy period.

Continuidad de la Atención al Paciente , Servicios de Salud Materna , Periodo Posparto , Atención Prenatal , Adolescente , Adulto , Brasil , Niño , Continuidad de la Atención al Paciente/organización & administración , Femenino , Humanos , Recién Nacido , Servicios de Salud Materna/organización & administración , Embarazo , Atención Prenatal/organización & administración , Adulto Joven
Soins Psychiatr ; 41(328): 12-15, 2020.
Artículo en Francés | MEDLINE | ID: mdl-33039084


We need to go back to the time of alienist doctors to understand the interest of the care programme established in 2011. In fact, the psychiatric clinic requires professionals to accompany the patient over time, while accepting the variability of suffering. In this context, this system proposes an alternative to full in-patient care while preserving the aspect of compulsory treatments. Caring for the patient, acquiring their consent while preserving their rights is a real challenge for the psychiatrist and their team.

Continuidad de la Atención al Paciente/organización & administración , Consentimiento Informado , Trastornos Mentales/terapia , Psiquiatría , Humanos
G Ital Cardiol (Rome) ; 21(10): 750-756, 2020 Oct.
Artículo en Italiano | MEDLINE | ID: mdl-32968307


BACKGROUND: During the COVID-19 pandemic, non-urgent outpatient activities were temporarily suspended. The aim of this study was to assess the impact of this measure on the management of the heart failure outpatient clinic at our institution. METHODS: We analyzed the clinical outcome of 110 chronic heart failure patients (mean age 73 ± 9 years) whose follow-up visit had been delayed. RESULTS: At their last visit before the lockdown, 80.9% was in NYHA class II, had an ejection fraction of 37 ± 7%, and B-type natriuretic peptide level was moderately elevated (266 ± 138 pg/ml). All patients received loop diuretics, 97.2% beta-blockers, 64.9% an aldosterone antagonist, 60.9% sacubitril/valsartan (S/V), and 72.2% of the remaining patients were on angiotensin-converting enzyme inhibitor or valsartan therapy. Patients were contacted by phone during and at the end of the lockdown period to fix a new appointment and underwent a structured interview to assess their clinical conditions and ongoing therapy and to verify whether they had contracted SARS-CoV-2 infection. Twelve patients (13.2%) contracted COVID-19. None was hospitalized for worsening heart failure or reported defibrillator shocks and none changed autonomously the prescribed therapy. Overall, 75% of patients reported stable or improved general well-being from the last in-person visit, while 25% described subjective worsening due to the social effect of the pandemic. Unchanged body weight and blood pressure values were reported by 86% and 78.4% of patients, respectively. Lower blood pressure values compared to baseline were recorded in 15.2% of patients on conventional renin-angiotensin system inhibition vs 21% of those on S/V, one of whom had to down-titrate S/V for persistent but asymptomatic hypotension; 4 patients up-titrated S/V to 200 mg/day following phone indications. CONCLUSIONS: Cancellation of scheduled follow-up visits during 3 months did not have significant negative effects in a cohort of stable patients with chronic heart failure on optimized medical therapy. Telephone support was effective in keeping connections with the patients during the lockdown, allowing appropriate management and implementation of drug therapy. In particular, patients who received S/V were not affected by delays in scheduled visits, confirming the tolerability and safety of this novel therapy in terms of both clinical and biohumoral parameters.

Betacoronavirus , Infecciones por Coronavirus/epidemiología , Insuficiencia Cardíaca/tratamiento farmacológico , Neumonía Viral/epidemiología , Cuarentena , Antagonistas Adrenérgicos beta/uso terapéutico , Anciano , Instituciones de Atención Ambulatoria , Aminobutiratos/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Enfermedad Crónica , Continuidad de la Atención al Paciente/organización & administración , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/psicología , Prestación de Atención de Salud , Progresión de la Enfermedad , Combinación de Medicamentos , Femenino , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/psicología , Humanos , Italia/epidemiología , Masculino , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Péptido Natriurético Encefálico/sangre , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/psicología , Recurrencia , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/uso terapéutico , Volumen Sistólico , Teléfono , Tetrazoles/uso terapéutico , Privación de Tratamiento
J Clin Psychiatry ; 81(5)2020 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-32936543


OBJECTIVE: This study examined a cohort of 15,520 inpatient psychiatric discharges to determine associations between scheduling an outpatient mental health appointment as part of discharge planning and attending outpatient care following discharge after control for patient, hospital, and system characteristics. METHODS: 2012-2013 New York State Medicaid and other administrative databases were used to examine patients who were aged under 65 years, admitted to an inpatient psychiatric unit, and discharged to the community. Outcomes included attending an outpatient mental health service within 7 and 30 days following inpatient discharge. Scheduling a mental health outpatient appointment as part of the discharge plan was the primary predictor variable, and potentially confounding covariates were addressed by adjusting for propensity scores estimating the likelihood of having an outpatient appointment scheduled. RESULTS: Among 15,520 discharged patients, 11,945 (77%) had an outpatient appointment scheduled with a mental health provider as part of their discharge planning. After adjustment for propensity scores, patients who had an outpatient appointment scheduled were significantly more likely to attend an outpatient mental health service within 7 (OR = 1.69; 95% CI, 1.48-1.94) and 30 days (OR = 1.65; 95% CI, 1.42-1.93) compared to patients who did not have an appointment scheduled. Even among those with a low propensity to have an appointment scheduled, scheduling an outpatient appointment was associated with attending outpatient services. CONCLUSIONS: Scheduling an outpatient mental health appointment is an effective and low-resource discharge planning practice that should be an important target for inpatient psychiatric clinical quality measurement and improvement.

Atención Ambulatoria , Continuidad de la Atención al Paciente , Trastornos Mentales/terapia , Alta del Paciente , Adolescente , Adulto , Atención Ambulatoria/métodos , Citas y Horarios , Niño , Preescolar , Servicios Comunitarios de Salud Mental/métodos , Servicios Comunitarios de Salud Mental/organización & administración , Continuidad de la Atención al Paciente/organización & administración , Femenino , Humanos , Masculino , Persona de Mediana Edad , New York , Puntaje de Propensión , Adulto Joven
Rev. psiquiatr. infanto-juv ; 37(3): 20-28, jul.-sept. 2020. tab
Artículo en Español | IBECS | ID: ibc-197399


INTRODUCCIÓN: En los últimos años ha crecido la preocupación y el interés, tanto en profesionales como en usuarios de los servicios de salud mental, por el proceso de transición que experimentan los pacientes desde las Unidades de Salud Mental del Niño y el Adolescente (USM-NA) a los servicios de Salud Mental de Adultos (CSM). Como resultado de ello, desde principios de siglo han surgido en distintos países numerosos estudios y proyectos para analizar esta situación y poder diseñar un modelo de mejores prácticas para la transición que asegure la continuidad de la atención y el trabajo realizado, aportando la mayor estabilidad posible a nuestros pacientes. OBJETIVO: Siguiendo con esta línea de actuación, el Plan Estratégico de Salud Mental de la Comunidad de Madrid 2018-2020 en su Línea estratégica 2 (Atención a la salud mental en niños y adolescentes) se plantea como objetivo la Implantación de Programas de Transición de los Servicios de Salud mental de Niños y Adolescentes a los de Adultos. Se siguieron las recomendaciones del Plan Estratégico de Salud Mental de la Comunidad de Madrid 2018-2020 en su Línea estratégica 2 y se realizaron reuniones de trabajo por un grupo de profesionales sensibilizados e implicados de forma voluntaria en la mejora de la atención a los pacientes en transición. RESULTADOS: Se presenta la Ficha de Transición que hemos diseñado como herramienta base del programa de transición en nuestra área de atención, siendo el resultado del trabajo multidisciplinar (trabajo social, enfermería, psicología y psiquiatría) de los profesionales, tanto de los CSM como de la USM-NA, que conforman el Grupo para la Transición del Área de Gestión Clínica de Psiquiatría y Salud Mental (AGCPSM) del Hospital 12 de Octubre

INTRODUCTION: During the last years there has been growing concern and interest, in both professionals and users of the mental health services, for the transition process experienced by patients from Child and Adolescent Mental Health (CAMHS) to Adult Mental Health Services (AMHS). As a result, since the beginning of the century, numerous studies and projects have emerged in different countries to analyze this situation and to enable the design of a best-practice model for the transition that ensures the continuity of the attention and the accomplished work, providing the greatest possible stability to our patients. Objetive: Following this line of action, the Strategic Plan for Mental Health of the Community of Madrid 2018-2020 in its Strategic Line 2 (Mental health care in children and adolescents) sets the objective of the Implementation of Services Transition Programs of Mental Health of Children and Adolescents to those of Adults. RESULTS: We present the Transition Card that we have designed, base tool of the transition program in our attention area, as a result of the multidisciplinary work (social work, nursing, psychology and psychiatry) of the professionals, both of the AMHS and the CAMHS, who make up the Group for the Transition of the Area of Clinical Management of Psychiatry and Mental Health (AGCPSM) of Hospital 12 de Octubre

Humanos , Niño , Adolescente , Adulto Joven , Adulto , Transición a la Atención de Adultos , Servicios de Salud Mental/organización & administración , Servicios de Salud del Adolescente , Servicios de Salud del Niño , Modelos Teóricos , Registros Médicos , Continuidad de la Atención al Paciente/organización & administración , Continuidad de la Atención al Paciente/normas
Inf. psiquiátr ; (241): 9-13, jul.-sept. 2020.
Artículo en Español | IBECS | ID: ibc-197440


En el año 2017, el Plan director de Salud Mental y Adicciones de Catalunya, puso en marcha el Programa PAE-TPI (Programa de Atención Específica al Trastorno Psicótico Incipiente) después de unos años de corroborar la eficacia de los programas pilotos implementados desde el año 2007 en el territorio catalán. Este programa, es la propuesta de un método organizativo y de un proceso activo de gestión de la psicosis focalizada en la comunidad. Se basa en la detección precoz y la atención individualizada en la que, el vínculo, es uno de los puntos fuertes. Este artículo recoge la puesta en marcha y la preparación previa así como el tipo de intervención propuesta y realizada. También se aportarán datos descriptivos derivados del primer año de asistencia clínica. El programa abarca el área geográfica de Terrassa y Sant Cugat del Vallés

In 2017, the Master Plan for Mental Health and Addictions of Catalonia, launched the PAE-TPI Program (Program for Specific Attention to Incipient Psychotic Disorder) after a few years of corroborating the effectiveness of the pilot programs implemented since 2007 in the Catalan territory. This program is the proposal of an organizational method and a process active management of community-focused psychosis. Is based on the early detection and individualized attention in which the reliance is one of the strengths. This article includes the start-up and previous preparation as well as the type of intervention proposed and carried out. Descriptive data derived from the first year of clinical care will also be provided. The program covers the geographical area of Terrassa and Sant Cugat del Vallés

Humanos , Servicios de Salud Mental/organización & administración , Trastornos Psicóticos/terapia , Implementación de Plan de Salud , Intervención Médica Temprana/organización & administración , Trastornos Psicóticos/diagnóstico , Continuidad de la Atención al Paciente/organización & administración , Calidad de Vida
Rev. chil. obstet. ginecol. (En línea) ; 85(supl.1): S16-S22, set. 2020. graf
Artículo en Español | LILACS | ID: biblio-1138644


La pandemia por COVID-19 ha generado un estancamiento mundial en la atención y resolución de todas las patologías graves y crónicas, debido al colapso de los sistemas de salud, a la dificultad de consulta, dada por la disminución de movilidad de las personas, por las cuarentenas establecidas y también por el temor de los pacientes al contagio en los centros de salud. Los enfermos oncológicos han visto canceladas sus atenciones, suspendidos o postergado sus tratamientos y diferidas sus cirugías. Esto no ha sido ajeno a las pacientes con cáncer de mama. En el presente trabajo, se reporta la experiencia de una Unidad de Patología Mamaria de un hospital público de Santiago de Chile y de las acciones realizadas para mantener la continuidad de atención en una comuna con una alta tasa de infección por SARS-CoV-2.

The COVID-19 pandemic has generated a global stagnation in the care and medical treatment of serious and chronic illnesses due to the collapse of the health systems, the difficulty of consulting due to decreased mobility caused by forced quarantines and also because of the fear of infection when attending a health center. Cancer patients have had their medical appointments canceled, their treatments suspended or postponed, and their surgeries delayed. Breast cancer patients have not been the exception. We report the experience of a Breast Pathology Unit of a public hospital in Santiago of Chile, and the actions carried out to maintain continuity of care in a community with a high infection rate of SARS-CoV-2.

Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Neoplasias de la Mama/terapia , Infecciones por Coronavirus/epidemiología , Continuidad de la Atención al Paciente/organización & administración , Oncología Médica/métodos , Neumonía Viral/complicaciones , Servicio de Ginecología y Obstetricia en Hospital , Chile , Epidemiología Descriptiva , Estudios Prospectivos , Cuidados a Largo Plazo/métodos , Telemedicina , Infecciones por Coronavirus/complicaciones , Betacoronavirus
Med Care ; 58(9): 785-792, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32732787


BACKGROUND: Telephone call programs are a common intervention used to improve patients' transition to outpatient care after hospital discharge. OBJECTIVE: To examine the impact of a follow-up telephone call program as a readmission reduction initiative. RESEARCH DESIGN: Pragmatic randomized controlled real-world effectiveness trial. SUBJECTS: We enrolled and randomized all patients discharged home from a hospital general medicine service to a follow-up telephone call program or usual care discharge. Patients discharged against medical advice were excluded. The intervention was a hospital program, delivering a semistructured follow-up telephone call from a nurse within 3-7 days of discharge, designed to assess understanding and provide education, and assistance to support discharge plan implementation. MEASURES: Our primary endpoint was hospital inpatient readmission within 30 days identified by the electronic health record. Secondary endpoints included observation readmission, emergency department revisit, and mortality within 30 days, and patient experience ratings. RESULTS: All 3054 patients discharged home were enrolled and randomized to the telephone call program (n=1534) or usual care discharge (n=1520). Using a prespecified intention-to-treat analysis, we found no evidence supporting differences in 30-day inpatient readmissions [14.9% vs. 15.3%; difference -0.4 (95% confidence interval, 95% CI), -2.9 to 2.1; P=0.76], observation readmissions [3.8% vs. 3.6%; difference 0.2 (95% CI, -1.1 to 1.6); P=0.74], emergency department revisits [6.1% vs. 5.4%; difference 0.7 (95% CI, -1.0 to 2.3); P=0.43], or mortality [4.4% vs. 4.9%; difference -0.5 (95% CI, -2.0 to 1.0); P=0.51] between telephone call and usual care groups. CONCLUSIONS: We found no evidence of an impact on 30-day readmissions or mortality due to the postdischarge telephone call program.

Continuidad de la Atención al Paciente/organización & administración , Readmisión del Paciente/estadística & datos numéricos , Teléfono/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Personal de Enfermería en Hospital/organización & administración , Satisfacción del Paciente , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Factores de Tiempo
Front Health Serv Manage ; 37(1): 20-26, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32842085


COVID-19 will remain a threat to millions of older adults for the foreseeable future, challenging healthcare providers to find successful ways to address this population's special needs. Thanks to well-defined core values and an experienced and innovative team of colleagues, Trinity Health's Continuing Care division has been able to adroitly support thousands of older adults throughout the COVID-19 pandemic. Our response has also included working to maintain the safety and well-being of thousands of staff who serve in this space every day. The pandemic is less than a year old, yet we have learned lessons that an organization typically takes many years to learn, and we are pleased to share them here. One of the greatest lessons is that, to best respond to a pandemic, everyone in an organization should have a clear understanding of purpose and strategy. In other words, know why you exist and what you need to do to weather the unknown until a vaccine or cure is available for all.

Continuidad de la Atención al Paciente/organización & administración , Infecciones por Coronavirus/terapia , Prestación de Atención de Salud/organización & administración , Cuidados a Largo Plazo/organización & administración , Neumonía Viral/terapia , Anciano , Anciano de 80 o más Años , Betacoronavirus , Femenino , Humanos , Masculino , Michigan , Persona de Mediana Edad , Pandemias/prevención & control
J Stroke Cerebrovasc Dis ; 29(9): 105009, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32807424


BACKGROUND: Acute stroke unit (ASU) care is proven to reduce mortality and morbidity. During the COVID-19 crisis, established physical units and care practices within existing physical units are likely to be disrupted. Stroke patients with possible suspected COVID-19 infection may be isolated in other wards outside the ASU. METHODS: Our hospital developed an adapted ASU protocol which includes key elements for stroke unit care, can be utilized by staff not familiar with stroke care with minimal training and can be implemented in various settings. RESULTS: The adapted protocol has 3 categories of Acute monitoring (neurological observations, blood pressure and input-output monitoring, investigations and specific post-reperfusion issues), Stroke complications (focusing on 5 common complications) and Unified team (describing daily check-ins, patient education, communication, discharge planning and post-discharge support). CONCLUSIONS: Details are presented in the article in a format that it can be adopted by other centers facing similar issues in order to ensure ASU care is not compromised.

Protocolos Clínicos , Continuidad de la Atención al Paciente/organización & administración , Infecciones por Coronavirus/terapia , Prestación Integrada de Atención de Salud/organización & administración , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/terapia , Accidente Cerebrovascular/terapia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Humanos , Salud Laboral , Pandemias , Seguridad del Paciente , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Neumonía Viral/virología , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Singapur , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología