Hub-and-spoke and regional coordination
The first step was to coordinate the different hubs. To ensure sharing of the workload, resources and surgical priorities, a weekly briefing was held among all the hubs. The goal was to obtain an update on the number of ICU beds available among the hubs, because the access rate to each area was unprecedented and unpredictable (Monzino, up to 11; San Raffaele, up to 20; Legnano, up to eight; and Poliambulanza Brescia, up to six) and on the number of operations to be performed and to share ongoing strategies and surgical indications.