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In the context of the Psychosocial Intervention Plan (PSIP)[1], a Psychosocial Coordination Committee (PSCC) was set up by the FPS HSFCE in response to the COVID-19 pandemic.
The aim of this committee is to bring together representatives from all the services and bodies involved, to agree on a joint strategy, and to work together as a team in order to set up psychosocial support services. Through the PSCC, initiatives were coordinated so that a consistent message was always communicated and the actions would be complementary.
The overall objective was to encourage self-care, care for each other and improving the resilience of both the individual and society.
A lot of emphasis was placed on the importance of clear communication:
- A communication campaign was launched with tips on dealing with stress, both for the general public and the specific group of care providers;
- An e-learning module was set up to support psychosocial care providers;
- The information was communicated centrally through fixed channels in order to maintain an overview of all initiatives. The gateway for information on COVID-19 and psychosocial well-being is the website www.info-coronavirus.be. Information specifically for healthcare providers has been compiled on the website of the FPS HSFCE.
Find out more about the organisations and initiatives on psychosocial well-being during the COVID-19 pandemic: www.info-coronavirus.be
[1]You can find more information about the Psychosocial Intervention Plan in ‘Key data in healthcare – Emergency medical and psychosocial assistance’.
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Calls to 112 and 1733[1]requiring medical intervention are handled by the operators of the 112 centres via the Belgian Medical Regulation Manual. This manual provides an integrated set of medical protocols to uniformly determine the severity level of emergency calls by emergency centre operators and maintain the quality of service. It offers guidelines to staff members as to which resource (MUG, PIT, ambulance, on-call service, house call or own GP [2]) should be sent out or which actions should be recommended in a specific situation.
In the context of the coronavirus crisis, a new protocol was temporarily developed to respond adequately to calls from people potentially infected with COVID-19. Depending on the progress of the scientific knowledge on the virus, this medical protocol was revised and corrected several times, taking into account the Sciensano guidelines.
The 112 medical directorates and/or deputy medical directorates and the nursing regulators, who are part of the Emergency Assistance department of the FPS HSFCE, are present in the emergency centres to support and advise operators. Throughout the crisis, the medical directorates accompanied the 112 operators in monitoring the evolution of the COVID-19 protocols to ensure efficient and effective handling of calls for assistance in relation to coronavirus.
More information on the Belgian Medical Regulation Manual: www.health.belgium.be
[1]1733 is a central telephone number in Belgium to reach an on-call GP in the event of non-urgent medical assistance (see also the chapter ‘Care activity’)
[2]See ‘Key data in healthcare – Emergency medical and psychosocial assistance’ for more information on how the different channels work.
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Since the start of the COVID-19 pandemic, the nursing staff and other healthcare professionals have worked under great pressure. As a result of the continued flow of COVID-19 patients, there has been a risk of nursing staff shortage.
For this reason, the decision was made that some nursing activities could be carried out by individuals who are not legally entitled to do so, such as students, dentists and midwives. This was an exceptional and temporary measure during the COVID-19 pandemic. These activities may only be carried out under strict legal conditions[1]. For example, the activities could only take place under the supervision of a coordinating nurse or training was required. As such, the continuity, quality and safety of the nursing care were guaranteed as much as possible.
Some of these exceptional measures were extended until 1 July 2022 by the Act of December 2021[2], by which the measures were limited to conditions for specific services (e.g. testing patients and administering vaccines).
[1]Act of 4 November 2020 on various social measures following the COVID-19 pandemic
[2]Act of 23 December 2021 amending the Act of 4 November 2020 on various social measures following the COVID-19 pandemic
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An Act[1]was amended to include new operations that could be performed by pharmacists working in public pharmacies. This Act specified the strict conditions and circumstances under which these acts could be performed, including following training.
Since then, pharmacists have been authorised to prescribe and administer a COVID-19 vaccine. However, the vaccine may only be prescribed if it is administered immediately in the pharmacy. In addition, pharmacists are also authorised to prescribe adrenaline and to administer it subcutaneously or intramuscularly in case a patient should suffer an anaphylactic shock after administration of the vaccine.
Furthermore, since mid July 2021, pharmacists are temporarily authorised to take samples for a rapid antigen test and to communicate the results of this test to the competent body. This applies only for people from the age of 6 who do not have symptoms of COVID-19 and who need a COVID-19 certificate for travel or an event. Since 1 November 2021, pharmacists can also carry out tests for travellers returning from a red zone and for people with COVID-19 symptoms. Pharmaceuticaltechnical assistants may also carry out these acts under the responsibility and supervision of a pharmacist.
The graph below shows the number of tests taken by pharmacists. Here, increased activity can be observed from November 2021 to early February 2022.
NUMBER OF TESTS TAKEN AT PHARMACISTS
[1]Consolidated Act of 10 May 2015 on the exercise of healthcare professions
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With each new COVID-19 wave, the need to provide sufficient testing capacity in order to be able to take the necessary measures in due time increased. For this reason, it was decided to exceptionally authorise persons to carry out tests in order to be able to diagnose cases of COVID-19.[1]Once again, this could only take place under strict conditions. For instance, the persons concerned had to have a specific diploma and follow additional training. Furthermore, the acts had to be entrusted by a doctor or pharmacist specialised in clinical biology, and take place under their supervision.
This measure made it possible to employ more people in the laboratories. This way, the exceptionally high need for analyses during the COVID-19 pandemic could be met.
[1]Royal Decree of 21 September 2021 by which persons who are not legally authorised to practice medicine are granted permission, in the context of the COVID-19 epidemic, to carry out certain laboratory tests
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Context
The fight against the COVID-19 pandemic highlighted the need to strengthen collaboration between hospitals, residential institutions and primary care health professionals.
In March 2021, the FPS HSFCE launched a call in this respect, inviting general and university hospitals to take part in a pilot project called ‘Hospital Outbreak Support Team (HOST)’, aimed at, on the one hand, improving the management of epidemics and cluster outbreaks, and, on the other hand, supporting hygiene teams and management groups for antibiotics therapy in the prevention of and fight against infections and in antimicrobial management.
In 2021, 21 pilot projects with multidisciplinary HOST teams had already been created. In 2022, 3 new pilot projects have been started, which include the entire Belgian hospital landscape.
DISTRIBUTION OF THE HOST TEAM BY REGION
Achievements in the first year of the pilot project
The first year of the pilot project was aimed at:
- Specifying the coordination between the hospitals involved via cooperation protocols;
- Creating a multidisciplinary HOST team that complies with the minimum composition criteria[1];
- Creating a telephone hotline that can be reached both by hospitals and by other residential care centres.
Despite the difficult start due to the busy period during the COVID-19 pandemic, most participating networks met the above objectives. All participants said they had already drawn up a cooperation agreement, and for two out of three projects this had already been signed by all participating hospitals.
EXISTENCE OF A COOPERATION AGREEMENT
Where the creation of a HOST team is concerned, all participating networks reported that they had managed to set up a team: in 16 networks, the minimum requirements for this were met, and in 8 networks additional requirements were met. In 2021, 35% of the professionals needed were recruited. The other vacancies were filled by people who were already working within the hospital network.
PERCENTAGE OF HIRES
The majority of the HOST teams indicated that they had set up a 24/7 telephone line. However, discussions are still ongoing between the federal authorities and the federated entities to clarify the role and scope of this 24/7 service. In these discussions, it is attempted to provide an offer that meets the needs of the various regions and residential care centres, while respecting the powers of each party.
AVAILABILITY OF A 24/7 TELEPHONE LINE
Collaborations and exchanges
An important element of the success of this pilot project lies in the communication between the actors in the field, in the hospital management and in the regional and federal authorities. However, in the first year of the project, the pandemic made it impossible for the various actors to meet. For this reason, individual intervision sessions were set up by the Belgian Antibiotic Policy Coordination Committee (BAPCOC), where support was provided to the HOST teams. This initiative has led to the publication of a web page with FAQs.
On the other hand, dialogue sessions between the BAPCOC team and the different regions were set up in order to define their specific roles and tasks. In particular, the complementarity between the OST and HOST teams was defined. The regional authorities also contacted the newly created HOST teams to brainstorm about the best form of cooperation to meet specific local needs.
More information: BAPCOC page dedicated to the project
[1]A project manager (0.5 FTE), a HOST coordinator (1 FTE), a nurse (1 FTE), a hospital pharmacist (0.5 FTE).