New approach to managing COVID-19 pandemic in a complex tertiary care medical centre in Madrid, Spain

The COVID-19 pandemic is putting healthcare systems under unprecedented stress to accommodate unexpected numbers of patients forcing a quick re-organization. This article describes the staff management experience of a third level referral hospital in the city of Madrid, Spain, one of the cities and hospitals with the largest number of COVID19 cases. A newly created COVID-19-specific Clinical Management Unit (CMU) coordinated all clinical departments and conducted real-time assessments of the availability and needs of medical staff, alongside the hospital's general management board. The Unit was able to (i) redeploy up to 285 physicians every week to bolster medical care in COVID-19 wards and forecast medical staff requirements for the upcoming week so all departments could organize their work while coping with COVID-19 needs, (ii) overview all clinical activities conducted in a medicalized hotel, and (iii) recruit a team of roughly 90 volunteer medical students to accelerate data collection and evidence generation. The main advantage of a clinical management unit composed by a member of every job category - its ability to generate rapid, locally-adapted responses to unexpected challenges - made it perfect for the unprecedented increase in healthcare need generated by the COVID-19 pandemic.