Extend strategy: Fribourg, Switzerland
Canton Hospital
One example of the use of a COVID-19 command center is in the canton hospital of Fribourg through the peak of the crisis and beyond [1]. The hospital group of Fribourg, with a total of 5 sites and more than 400 beds, is located in a severely affected region in Switzerland. At the end of February, it was decided to take control of the fast-growing problem by initiating a COVID-19 command centre. Mission control COVID-19 is about attaining the greatest possible control over the situation and moving from a reactive approach to a proactive one by anticipating potential problems and making them transparent. The aim was to initiate the right countermeasures in good time, such as activating additional intensive care beds, before the situation escalated and additional stress factors arose.
The idea was to start focusing on finding solutions for the biggest hotspots. The first version of the Command Center went live with mostly analog elements within 7 days. The following core elements of the Command Center were critical:
Control room
- All critical decision-makers in one room
- COVID crisis management team
- Clinical and operational functions
Information flow
- Frontline-driven collection and interpretation of data
- Standardized information transmission protocols
- Targets & thresholds for escalation and deescalation
- Tiered problem-solving with a strong emphasis on solving problems at the point of care.
Cockpit
- Centralized data aggregation logic
- Regular update frequency, approaching real-time data
Once operationalized, Design Thinking helped to create an agile and stable environment to continuously improve the solutions throughout the crisis and beyond. A crisis offers the opportunity to tackle issues that have been lingering for years, not considered urgent and were repeatedly postponed. As the medical director of the hospital group mentioned one evening in the middle of the crisis, “the crisis also has good sides. Things can be developed that were not possible for more than 10 years” The Command Center digs deep into the hospital's DNA. The complexity of the system becomes tangible and controllable in the Command Center. The politics and power plays become tangible - but crises require joint efforts.
During this time, the following results were achieved:
- Faster communication & consistent information flow
- Transparency
- Relevant competencies on sight
