Table 2.
Results of the responses about the organisational responses of French psychiatric facilities according to their legal status
| Items | Response expected | Total number 94 N % |
Public 43 N % |
Private non-profit 19 N % |
Private 32 N% |
p |
|---|---|---|---|---|---|---|
| Profile of the individuals audited | ||||||
| Membership in the crisis management group | Yes | 91.49 | 81.40 | 100 | 100 | 0.0070 |
| Impact of the first wave of COVID-19 | ||||||
| Number of patients with COVID-19 at or after admission during the first wave (March to early May 2020) | > 15 |
10 10.64 |
6 13.95 |
4 21.05 |
0 0 |
0.0002 |
| Number of staff members with COVID-19 during the first wave (March to early May 2020) | 0 |
31 41.33 |
6 21.43 |
2 13.33 |
23 71.88 |
<.0001 |
| Planning and coordination of crisis management | ||||||
| Activation of the crisis plan ("plan blanc") before national activation | Yes | 36.17 | 23.26 | 42.11 | 50 | 0.0486 |
| Activation of the crisis management group before activation of the national "plan blanc" | Yes | 64.89 | 55.81 | 84.21 | 65.63 | 0.0965 |
| Territorial partnership in mental health with: | ||||||
| - A private facility | Yes | 22.34 | 23.26 | 21.05 | 21.88 | 0.9788 |
| - A public institution | Yes | 42.55 | 48.84 | 36.84 | 37.5 | 0.5267 |
| - A private non-profit facility | Yes | 8.51 | 9.3 | 21.05 | 0 | 0.0197 |
| Bed management system set up | Yes | 91.49 | 88.37 | 89.47 | 96.88 | 0.4470 |
| Real time inventory management for personal protective equipment set up | Yes | 91.49 | 83.72 | 94.74 | 100 | 0.0252 |
| Availability of medical equipment at the start of the epidemic: | ||||||
| - Blood pressure monitors, | Yes | 92.55 | 88.37 | 100 | 93.75 | 0.3524 |
| - Pulse oximeters, | Yes | 89.36 | 83.72 | 100 | 90.63 | 0.1536 |
| - Thermometers, | Yes | 57.45 | 58.14 | 57.89 | 56.28 | 0.9857 |
| - Thermometer tips and covers | Yes | 54.26 | 53.49 | 57.89 | 53.13 | 0.9380 |
| - Semiautomatic defibrillators, | Yes | 94.68 | 93.02 | 94.74 | 96.88 | 0.8450 |
| - Suction aspirators, | Yes | 90.43 | 88.37 | 94.74 | 90.63 | 0.9016 |
| - Oxygen bottles, | Yes | 89.36 | 90.7 | 78.35 | 93.75 | 0.3351 |
| - Oxygen concentrators | Yes | 82.98 | 86.05 | 68.42 | 87.50 | 0.1653 |
| - Special steps taken to increase the stocks of these types of medical equipment | Yes | 63.83 | 67.44 | 78.95 | 50 | 0.0919 |
| Presence of occupational physician in the crisis management group | At least often | 26.83 | 46.15 | 14.29 | 6.90 | <.0001 |
| In a research study about COVID-19 | Yes | 7.45 | 100 | 0 | 0 | 0.0104 |
| Specific measures related to the management of patients in psychiatry departments and their families | ||||||
| Activity during the lockdown period: | ||||||
| - Full-time hospitalisation, | Completely maintained/ partially maintained | 94.68 | 93.02 | 100 | 93.75 | 0.7083 |
| - Day hospitalisation, | Closed/partially |
83 96.39 |
42 97.67 |
18 94.74 |
20 95.24 |
0.7936 |
| - Consultation activity, | Completely maintained/ partially maintained |
60 90 |
39 92.86 |
14 87.5 |
1 50 |
0.1551 |
| - CATTP activities, | 56 | 38 | 14 | 2 | 1 | |
| Closed/partially | 96.43 | 95 | 100 | 100 | ||
| - Activity therapy | Closed/partially |
56 87.5 |
29 90.63 |
12 85.71 |
8 80 |
0.0876 |
| - Psychosocial rehabilitation activity |
58 86.21 |
28 90.32 |
16 94.12 |
6 60 |
0.0431 | |
| - Home care/visits | Closed/partially | 61 | 37 | 13 | 3 | 0.1597 |
| Completely/partially | 86.89 | 90.24 | 86.67 | 60 | ||
| Started specific activities | ||||||
| - In-person consultations with adherence to barrier | Yes | 75.53 | 86.05 | 84.21 | 56.25 | 0.0075 |
| - measures, | Yes | 74.47 | 74.42 | 84.21 | 68.75 | 0.4726 |
| - Telepsychiatry, | Yes | 92.55 | 100 | 94.74 | 81.25 | 0.0054 |
| - Telephone consultations, Home visits with barrier measures | Yes | 54.26 | 83.72 | 73.68 | 3.13 | <.0001 |
| Maintenance of some activities that are part of psychiatric support: | ||||||
| - Psychological follow-up | Yes |
86 96.51 |
41 100 |
18 94.74 |
24 92.31 |
0.1387 |
| - Social support | Yes |
81 90.12 |
39 94.87 |
19 100 |
23 73.91 |
0.0120 |
| Staff assigned for in-person or telephone availability for patient follow-up | Yes | 79.79 | 90.7 | 89.47 | 59.38 | 0.0019 |
| Update of provisions to ensure patients' rights, freedom of movement, protection of the dignity of hospitalised persons, organisation of hearings in front of the judge deciding on the liberty or detention of patients hospitalized without their consent, continuity of monitoring of patients obliged or mandated to attend psychiatric care | Yes | 58.06 | 50 | 11.11 | 38.89 | 0.0319 |
| Establishment officially listed as admitting patients with COVID-19 | Yes | 54.26 | 79.07 | 52.63 | 21.88 | <.0001 |
| Units exclusively for patients with COVID-19 | Yes | 79.79 | 95.35 | 68.42 | 65.63 | 0.0025 |
| Formal official protocol for operation of any COVID-19 unit opened | Yes | 86.84 | 83.33 | 86.67 | 94.74 | 0.5889 |
| Formalisation of a list of drugs at special risk with COVID-19 | Yes | 36.17 | 32.56 | 31.58 | 43.75 | 0.5453 |
| Distribution of written instructions to patients to explain the barrier measures | Yes | 86.17 | 88.37 | 78.95 | 87.5 | 0.6307 |
| Specific procedures established for | ||||||
| - Food services, | Yes | 91.49 | 86.05 | 100 | 93.75 | 0.1793 |
| - Laundry, | Yes | 65.96 | 69.77 | 78.95 | 53.13 | 0.1318 |
| - Mail, | Yes | 47.87 | 48.84 | 42.11 | 50 | 0.8490 |
| - Patient transport, | Yes | 54.26 | 65.12 | 57.89 | 37.5 | 0.0560 |
| "Listening services" for: | ||||||
| - patients | Yes | 67.02 | 79.07 | 68.42 | 50 | 0.0297 |
| - their families | Yes | 54.26 | 60.47 | 63.16 | 40.63 | 0.1596 |
| Maintenance of in-person visits by family and close friends | No or rarely | 96.81 | 100 | 84.21 | 100 | 0.0072 |
| Alternative means of communication | Yes | 85.71 | 92 | 85.71 | 79.17 | 0.3732 |
| Remote follow-up for carers | Yes | 100 | 100 | 100 | 100 | - |
| - By telephone | Yes | 47.87 | 60.47 | 42.11 | 34.38 | 0.0699 |
| - By video meetings | Yes | 25 | 27.91 | 42.11 | 15.63 | 0.1135 |
| Innovative arrangements | Yes | 43.62 | 46.51 | 57.89 | 31.25 | 0.1563 |
| Hospital hygiene and epidemic control measurement | ||||||
| Advice sought from the EOH | Yes | 95.74 | 100 | 100 | 87.5 | 0.0232 |
| Designation of an expert responsible for infection vigilance | Yes/present before the epidemic | 68.82 | 71.43 | 68.42 | 65.63 | 0.8664 |
| Shortages of personal protective equipment: | ||||||
| - Surgical masks | No | 25.53 | 25.58 | 21.05 | 37.5 | 0.8548 |
| - FFP2 masks | No | 43.62 | 51.16 | 31.58 | 40.63 | 0.3276 |
| - Gloves | No | 63.83 | 51.16 | 57.86 | 84.38 | 0.0104 |
| - Smocks | No | 29.79 | 20.93 | 10.53 | 53.13 | 0.0013 |
| - Detergents | No |
93 69.89 |
29 67.44 |
11 61.11 |
25 78.13 |
0.4039 |
| - Detergent/disinfectant sprays | No |
93 62.37 |
24 55.81 |
8 44.44 |
26 81.25 |
0.0173 |
| - Disinfectant wipes | No |
92 64.13 |
29 69.05 |
9 50 |
21 65.63 |
0.3615 |
| Systematic screening for signs suggestive of COVID-19 by a somatic physician at patient admission | Yes | 81.91 | 83.72 | 84.21 | 78.13 | 0.7896 |
| Systematic testing for COVID-19 at admission | No | 48.94 | 44.19 | 42.11 | 59.38 | 0.3433 |
| Specific procedure for patients with confirmed or suspected COVID | Yes | 100 | 100 | 100 | 100 | - |
| Screening at admission and specific follow-up of patients with risk factors for severe COVID-19 | Yes | 52.13 | 39.53 | 57.89 | 65.63 | 0.0699 |
| Dedicated channel of care for the persons at risk | Yes | 74.47 | 76.74 | 68.42 | 75 | 0.7837 |
| Specific programme educating patients about barrier measures and social distancing | Yes | 48.94 | 44.19 | 52.63 | 53.13 | 0.6988 |
| Specific training for professionals about additional precautions beyond hospital hygiene in the management of patients with COVID-19 | Yes | 84.04 | 88.37 | 84.21 | 78.13 | 0.4875 |
| Training some staff members to take nasopharyngeal samples for RT-PCR testing | Yes | 78.72 | 90.7 | 78.95 | 62.5 | 0.0128 |
| Procedure for specific follow-up of risk of infection among staff (monitoring symptoms, seeing the occupational physician, nasopharyngeal tests, etc.) | Yes | 87.23 | 90.70 | 73.68 | 90.63 | 0.1976 |
| Procedure for the management of bodies of patients who died with COVID-19 | Yes | 79.79 | 86.05 | 89.47 | 65.63 | 0.0467 |
| Human resource management | ||||||
| Staff attendance chart, and chart of persons who can be called on if needed | Yes | 92.55 | 93.02 | 94.74 | 90.63 | 1 |
| Human resources management enabling psychological care for staff (QoL at work plan), | Yes | 93.62 | 97.67 | 100 | 84.38 | 0.0517 |
| - Telephone "listening services" for the health care workers | Yes | 85.23 | 95.24 | 73.68 | 77.78 | 0.0272 |
| Organisational models to support and protect the health care staff and enable flexibility in staffing | Yes | 67.02 | 83.72 | 78.95 | 37.5 | <.0001 |
| Work at home for some occupational categories | Yes | 90.43 | 93.02 | 94.74 | 84.38 | 0.4234 |
| Study of the potential financial impact | Yes | 35.11 | 30.23 | 68.42 | 21.88 | 0.0032 |