La Direction des affaires juridiques et des droits des patients de l’AP–HP et la première vague de la pandémie Covid-19

IF 0.1 Q4 MEDICINE, LEGAL Medecine & Droit Pub Date : 2021-04-01 DOI:10.1016/j.meddro.2020.11.003
Jacques Belghiti (Professeur émérite chirurgie digestive, Coordonnateur de la cellule des médecins conseil de la DAJDP), Marie Pierre Dilly-Rushenas (Anesthésiste-Réanimateur, Directrice déléguée à la coordination de la qualité, gestions des risques et droit du patient de l’hôpital Bichât–Claude-Bernard), Sandra Fournier (Responsable du service de prévention du risque infectieux de la DPQAM de l’AP–HP), Magali Richard Piauger (Responsable du département médiation et responsabilité hospitalière de la DAJDP), Soisic Iroz (Directrice déléguée des affaires juridiques et des droits des patients), Daniel Vittecoq (Médecin-conseil DAJDP, SMIT Bicêtre), Charline Nicolas (Directrice des affaires juridiques et des droits des patients), Emmanuel Martinod (Professeur de Chirurgie thoracique et cardio-vasculaire de Coordonnateur cellule COVID-19, PCEML)
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Abstract

To facilitate the analysis and the management of claims related to the last Covid-19 pandemic, the DAJ of the AP–HP constituted a medical group assisted by lawyers intending to review the scientific knowledge and organizational measures during the first wave of this pandemic. This group brought together medical doctors with both scientific expertise in the main specialties requested during this viral infection and knowledge of repairing bodily damage. Based on the data provided by the hospital dashboards and the collection of hospital procedures for Covid-19 and non-Covid-19 patients, the goal of this group was to assess the level of scientific knowledge and organizational measures respectively at the start of the epidemic, its peak and at the end. During the three periods of this pandemic the main changes observed included a greater selectivity on admissions with increasing consideration on the patient's comorbidity; a continual evolution in drug management and more rigorous isolation measures with interruption of visiting rights. The target was to prevent contamination of the non-infected persons with an obsession to protect healthcare workers. The absence of selection for patients requiring intensive care for compensation of their respiratory failure forced AP–HP to double the number of intensive care beds and to refer some patients in other regions. In a context of unstable scientific knowledge and evolving organizational measures, the collection of these data should facilitate the management of claims related to Covid19 during the first wave of this pandemic and open a prospective study for the next pandemic.

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pa - HP法律事务和患者权利理事会和Covid-19大流行的第一波
为了便于分析和管理与上次Covid-19大流行有关的索赔,AP-HP的DAJ组成了一个由律师协助的医疗小组,旨在审查此次大流行第一波期间的科学知识和组织措施。这个小组汇集了在这种病毒感染期间所需要的主要专业方面具有科学专长和修复身体损伤知识的医生。基于医院仪表板提供的数据以及Covid-19和非Covid-19患者的医院流程收集,该组的目标是分别评估疫情开始、高峰和结束时的科学知识水平和组织措施。在这次大流行的三个时期,观察到的主要变化包括对入院的更大选择性,更多地考虑患者的合并症;药物管理的不断改进和更严格的隔离措施,并中断探视权。目标是防止未感染者受到污染,同时痴迷于保护医护人员。由于缺乏对需要重症监护以补偿呼吸衰竭的患者的选择,AP-HP不得不将重症监护床位的数量增加一倍,并将一些患者转介到其他地区。在科学知识不稳定和组织措施不断演变的背景下,收集这些数据应有助于在本次大流行的第一波期间管理与covid - 19相关的索赔,并为下一次大流行开启前瞻性研究。
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来源期刊
Medecine & Droit
Medecine & Droit MEDICINE, LEGAL-
CiteScore
0.30
自引率
0.00%
发文量
27
期刊介绍: The Scientific Committee of the journal Médecine et Droit includes professors of medicine, professors of law, magistrates, lawyers, court medical experts, and specialists in compensation for physical injury. Médecine et Droit provides: • rigorous and clear support for informative and educational matter • a tool for reflection and actualisation of knowledge • an essential link between doctors and lawyers. Médecine et Droit informs: • doctors on different aspects of law and regulations encountered in their profession • lawyers on the specific problems of the medical profession and important bio-ethical issues
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