“We are in a situation that corresponds to the intensity of a blank plan,” warns director Freddy Serveaux, this Friday, January 10, while emergencies are in tension. Specific resources are being mobilized for patients affected by a particularly virulent flu this year, while maintaining the link with chronic patients.
At the national level, 87 health establishments have already triggered a white plan to deal with the consequences of winter epidemics. Upon returning from end-of-year holidays, the ARS Bourgogne-Franche-Comté sounded the alarm, demanding “solidarity and vigilance” from the population (read the press release).
However, the crisis has been going on for two weeks due to a particularly virulent flu epidemic. Asked by Information Dijonthis Friday, January 10, 2025, Freddy Serveaux, general director of the Dijon Bourgogne University Hospital, explained that he did not wish to trigger a white plan due to the lessons learned from the health crisis.
“We are in a situation which has the intensity of a white plan”
The director of the health establishment wants to be reassuring about “the capacity of the CHU teams to take care of all health needs, both this epidemic peak, all chronic patients and all patients who had interventions or planned medical or surgical treatment.
“The fact that we must not be in a white plan is not indicative of the volume of tension and the extraordinary mobilization of our teams,” insists Freddy Serveaux. “We are in a situation that has the intensity of a white plan. (…) It is not because we have not triggered a white plan that that means that it is less serious. (…) To maintain all its strength in the white plan, for the moment, we have managed to find other organizations.”
No “closure” of emergencies
The University Hospital has also not implemented a “closure” of emergency departments. “We are rather a pioneer at the CHU and in our department”, underlines the director of the Dijon health establishment, “emergencies in the metropolis are already regulated 24 hours a day”.
Even if the emergency department remains accessible to the population, the management of the Dijon Bourgogne University Hospital recommends contacting Center 15, before traveling, in order to contact the regulating doctors of the access to care service (SAS).
For situations other than those involving a life-threatening emergency, patients may be referred to community medicine or to the on-call medical center located near the emergency room and open from 8 p.m. to midnight.
Regulation to “mobilize the best means at the right time”
“We have an efficient, innovative and proactive Center 15,” claims Freddy Serveaux, “regulating access to the emergency service is not a solution to dealing with a difficulty.” “It’s a good structural system. Our position is that, even when there is no tension, regulation should exist. This allows us to mobilize the best resources at the right time, depending on the condition of the patients.”
In particular, during the holiday period, private general practitioners participating in the SAS were particularly mobilized. According to the Regulatory Association of Liberal Doctors (ARML), the number of files processed jumped by 23% compared to the same period of the previous year.
“Emergencies are under pressure”
Florent Cavelier, secretary general of the Dijon health establishment, develops the organizational arrangements put in place.
“The situation is tense with pressure on our adult emergency reception services. We are not recording an increase in activity but a significant number of patients who require hospitalization, much more than usual. These patients are rather elderly, fragile, oxygen-requiring subjects and who really need to be able to access a hospital bed for a few days before, possibly, considering either long-term care or a return home. »
“For two weeks, it is a situation which has become more acute and which we must face with all the partners in the relief chain such as private ambulances and the [Service départemental d’incendie et de secours] who contribute to the transport of these fragile, elderly, polypathological patients, also with low mobility, who concentrate on our adult emergencies, the emergencies are therefore under tension.
Resources dedicated to patients affected by a severe form of influenza
“The CHU organized itself internally accordingly by creating ad hoc medical units with beds and nursing reinforcements. We must salute the total commitment of our medical and healthcare teams who have been on the job for two weeks. We can regulate this flow by putting in additional resources.”
“All establishments in Burgundy-Franche-Comté are experiencing similar tensions. Several have even gone so far as to trigger their white plan because they are so saturated. This is one option, among others, which has not yet been chosen at the University Hospital. Our teams are coping. There is a certain agility and organizational intelligence in our teams.”
“We are preparing to last. In its forecasts, Public Health France indicates that we have not yet left the epidemic crest line. There are three influenza strains that coexist and are extremely virulent currently. We hope that there will be a drop in pressure in two weeks. Until then, we will have to make our ad hoc organizations robust and continue to ensure the best care for chronic patients.”
Maintain care for patients with chronic illness
“This is an extremely important point for our entire healthcare community: we are trying to maintain care for all our scheduled chronic patients who also need long-term care.”
“We learned the lessons of COVID where we suddenly only had COVID patients arriving – it was quite normal to take care of them – but chronic patients had a real fear of going to the hospital – at the time, we didn’t know much about COVID.”
“At the end of the crisis, we found ourselves with patients who had pathologies which had evolved in a much more worrying manner than would have been normal, therefore patients who had to be treated for much longer.”
“Avoid any loss of opportunity”
“We have an almost blank organization but which allows us to do everything with a maximalist approach which will be taxing for our teams. Our professionals are keen not to leave patients behind, particularly those they see regularly. We absolutely want to keep this link. All our professionals, doctors and caregivers, do everything possible to avoid the slightest loss of opportunity. It’s our mission, it’s our duty.”
A positive point emerges in this situation, caregivers are confronted with less bronchiolitis than in previous years, a priori thanks to the effect of the Beyfortus vaccine on children (read our article), which helps prevent pediatric emergencies from being under tension.
Jean-Christophe Tardivon
Access to emergency services at Dijon Bourgogne University Hospital is still regulated by Center 15
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Gabriel Attal applauds the “real coordination between city medicine and hospital” at the Dijon Burgundy University Hospital
Minister François Braun looks at the regulation of emergencies at the Dijon Bourgogne University Hospital
Inauguration of the new emergency rooms for children at the Dijon Burgundy University Hospital
The SAMU of the Dijon Bourgogne University Hospital has passed the 50-year mark
Freddy Serveaux, general director of the Dijon Bourgogne University Hospital (JC Tardivon archive image)
