Faced with a very high demand on services linked to the flu epidemic, the Toulon-La Seyne intercommunal hospital center and the Hyères hospital center triggered the internal mobilization plan last Friday, level 1 of the white plan. Yann Le Bras, the director of the two establishments, explains the difficulties which motivated this decision and details the effects it produces.
What are the difficulties encountered by the teams which led to the triggering of the internal mobilization plan?
Last week, requests to center 15, which centralizes all the department’s emergency calls, were constantly increasing.
The teams managed 1,900 calls per day, with a peak of 2,000 calls.
This seems to reflect both an epidemic peak, perhaps due to the tourist influx, but the teams also reported difficulties in directing patients to unscheduled care centers, because many are closed.
The access to care service, managed by center 15, which makes it possible to offer patients whose condition justifies it open slots in the diaries of voluntary private doctors, also encountered difficulties: the slots were quickly full and there were fewer of them, perhaps due to holidays.
What translation at the level of emergencies and hospital services?
-The emergency rooms at Sainte Musse hospital faced a very high volume of attendance, beyond the very high averages that we can have in summer, around 160 to 180 visits per day. On January 2, for example, we recorded a peak with 250 passages. This very strong tension also concerns the hospitals of La Seyne and Hyères, and our colleagues at Sainte-Anne hospital.
Staff face great difficulties in welcoming, sorting and directing patients. I would like to salute the remarkable work of the teams, in the emergency room but also in all downstream services which are also subject to these tensions.
Concretely, what are the effects of level 1 of the white plan?
Level 1 white plan implemented on Friday corresponds to internal mobilization: establishment of a crisis unit, reinforcements in human resources, adaptation of organizations (with an additional shock box for emergencies for example), mobilization of emergency services follow-up care downstream to discharge patients and free up beds… We are going beyond the normal operating framework.
The teams showed great responsiveness and returned overtime; doctors adapt their organizations; we resort to temporary work.
We have thus opened ten paramedical reinforcement positions, distributed in the most exposed departments: emergencies, pulmonology and geriatrics. But we are not at a level that involves deprogramming and we are not considering it. The plan has produced its effects, this is what the Samu and emergency teams in the crisis unit tell us. It allows them to cope in better conditions. Now, epidemiological forecasts remain a point of vigilance. The peak of the epidemic is expected within three weeks. We remain very attentive to an evolving situation.
