COVID-19 Applications and PerspectivesThe Response of Emergency Departments (EDs) to the COVID-19 Pandemic: The Experience of 5 EDs in a Paris-Based Academic Hospital TrustGhazali, Daniel Aiham MD, PhD; Choquet, Christophe MD; Bouzid, Donia MD, PhD; Peyrony, Olivier MD, PhD; Fontaine, Jean-Paul MD; Sonja, Curac MD; Javaud, Nicolas MD, PhD; Plaisance, Patrick MD, PhD; Revue, Eric MD; Chauvin, Anthony MD, PhD; Casalino, Enrique MD, PhD Author Information Emergency Department, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France (Drs Ghazali, Choquet, Bouzid, and Casalino); Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France (Drs Ghazali, Choquet, Bouzid, Peyrony, Fontaine, Sonja, Revue, and Casalino); IAME (Infection, Antimicrobial, Modeling, Evaluation), INSERM, Université de Paris, Paris, France (Drs Ghazali, Bouzid, and Casalino); Emergency Department, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France (Drs Peyrony, Fontaine, and Casalino); Emergency Department, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France (Drs Sonja and Casalino); Emergency Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France (Drs Plaisance, Revue, Chauvin, and Casalino); and Emergency Department, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France (Dr Javaud). Correspondence: Daniel Aiham Ghazali, MD, PhD, Emergency Department, Bichat Academic Hospital, AP-HP, 46 Rue Henri Huchard, 75018 Paris, France ([email protected]). The authors would like to thank Jeffrey Arsham, an American scientific translator, for having reviewed the English-language text of the first version. D.A.G. and E.C. conceived the study and designed the method. A.C., C.C., E.C., E.R., J.P.F., N.J., P.P., and S.C. put in place the main organizational and managerial tools to ensure the reception of patients. D.B., O.P., D.A.G., and E.C. drafted the manuscript, and all authors contributed substantially to its revision. D.A.G. and E.C. take responsibility for the paper as a whole. All data analyzed during this study are included in the article. Extra data are available by emailing the corresponding author. The authors declare no conflicts of interest. Quality Management in Health Care 32(1):p 46-52, January/March 2023. | DOI: 10.1097/QMH.0000000000000351 Buy Metrics Abstract The coronavirus disease-2019 (COVID-19) pandemic has imposed unforeseen and unprecedented constraints on emergency departments (EDs). In this study, we detail the organizational and managerial tools recently implemented among 5 academic EDs in a French region particularly affected by COVID-19 and analyze how EDs responded to the COVID-19-related disease burden during different phases of the epidemic. Initially, they focused on the early detection of suspected cases by identifying 3 predominant COVID-19 syndromes. During this diagnostic process, patients were placed in respiratory isolation (facial mask before triage) and droplet isolation (ED rooms). A 3-level strategy for triage, clinical pathways in the EDs, and the organization of hospital spaces was based on the real-time polymerase chain reaction (RT-PCR) COVID-19 positivity rate, with ED strategies adapted to the exigencies of each level. This crisis demonstrated hospitals' adaptability and capacity to mobilize in the face of new risks, with hospitals and EDs coordinating their management to reallocate resources, optimize interoperability, and rethink patient pathways. This report on their processes may assist hospitals and EDs in areas currently spared by the new variants. © 2022 Wolters Kluwer Health, Inc. All rights reserved.