COVID-19 treatment: Daily hospital bed notification to the DIVI intensive care register is now mandatory
16.04.2020 12:28
From now on, clinics with intensive care units must report their current bed capacities to the DIVI intensive care register by 9 a.m. every day. Federal Health Minister Jens Spahn issued a corresponding regulation a few days ago; the transition period ends on April 16, 20. Clinics must document data reports to their own state authorities on a weekly basis.
“Around 1,000 clinics have already contacted us in the past few days and have mostly updated data on a daily basis. The new regulation is an important building block in order to obtain valid, daily figures for the entire federal territory from now on,” said Professor Uwe Janssens, President of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) and Chief Physician of the Clinic for Internal Medicine and Internal Intensive Care Medicine St. Antonius Hospital in Eschweiler. “In addition, political decision-makers will be able to use the data from the DIVI intensive care register as a guide in the future.”
The primary goal of the DIVI intensive care register is to make the availability of ventilation beds and extended therapeutic measures for acute lung failure visible in Germany. “In an emergency, treating physicians must be able to quickly identify which hospital in their region has exactly what capacity,” says Professor Christian Karagiannidis, spokesman for the DIVI “Lung – Respiratory Failure” section, which played a key role in driving the register forward. The doctor is also head of the ECMO center at the Cologne-Merheim Lung Clinic. “The participating clinics currently see all the necessary data details in a protected internal area. But we will also publicly display more and more data within the scope of technical possibilities.” Those interested can find continuously updated figures at: www.intensivregister.de
Intensive care units must report treatment capacities by 9 a.m. every day
The federal government's new so-called "DIVI Intensive Care Register Ordinance" states that clinics must from now on report their intensive care treatment capacities to the DIVI Intensive Care Register every day by 9 a.m. This includes, for example, the number of beds already occupied, the number of beds that can be occupied in total, and an estimate of how many new admissions would be possible in the next 24 hours. In addition, the capacities of non-invasive and invasive ventilation options are also queried. Existing places for additional extracorporeal membrane oxygenation (ECMO), in which a machine partially or completely takes over the breathing function of patients, are also recorded in the DIVI intensive care register. In order to obtain a complete picture, hospitals must report once the number of intensive care beds they have set up as of January 1, 2020. The number of patients with a COVID-19 infection who are being treated in intensive care, who are being ventilated or who have been discharged from the hospital since January 1, 2020 must also be transmitted.
The next goal: Valid forecast models for the utilization of intensive care units
Meanwhile, the scientists behind the intensive care register are already planning the next steps: “Our next major milestone is to provide valid forecast models for the entire Federal Republic. “This can be used to predict the occupancy of intensive care units and the development of intensive care COVID-19 treatments for a few weeks,” explains Karagiannidis. The aim is to make these prognosis models available by the end of April based on the intensive care registry data as well as known incubation periods and the duration of necessary patient ventilation. “This is also fundamentally important in order to provide politicians with a helpful tool with which they can decide whether to relax or maintain the current restrictions,” said Karagiannidis. In addition, the experts are currently developing map models from which the exact situation in individual districts can be seen.
Clinics must report data delivery to the state authorities on a weekly basis
The daily data from the individual hospitals with intensive care units make a significant contribution to the success of the forecast models. In addition to registering in the DIVI intensive care register, the participating clinics also have to prove to their own state hospital planning authority once a week that they have transmitted the data daily. DIVI President Uwe Janssens calls out all employees in intensive care units: “We have already achieved important successes in the treatment of COVID-19 patients since the start of the DIVI intensive care register four weeks ago. The register is unique in the world and the international response is extraordinary. We can only overcome the enormous medical and social challenges surrounding the corona virus together.”