Considering context: Adaptive elements of a simulation program to improve primary care safety during the COVID-19 pandemic in Alberta, Canada.
COVID-19 pandemic response
Family medicine
Infection prevention and control
Interdisciplinary research
Knowledge translation
Quality improvement
Journal
American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
21
10
2021
revised:
23
12
2021
accepted:
27
12
2021
entrez:
31
7
2022
pubmed:
1
8
2022
medline:
3
8
2022
Statut:
ppublish
Résumé
Globally, primary care (PC) has been central to the COVID-19 response. The pandemic has strained PC systems and introduced novel infection prevention and control (IPC) risks to the provision of safe, accessible in-person care. Specifically, the implementation of IPC guidance developed outside of PC into its operational context has proved challenging. Our team of "action researchers" developed an innovative virtual tabletop simulations (TTS) intervention which assisted PC teams as they adapted, implemented, and integrated IPC guidance into their specific clinical contexts. While we have detailed the "technical" elements of the TTS program elsewhere, this paper examines the specific "adaptive" elements that made this intervention successful in the high-income country context of Alberta, Canada. Multiple factors influenced the uptake of this program in our Albertan setting, including: cultural geography; approach to financing and delivering PC; and policies and cultural norms supporting PC integration, medical education and research, and egalitarian teamwork. Virtual TTS may provide substantial benefits to IPC and safety improvements in PC settings globally. However, the specific technical and adaptive elements of our Albertan TTS program might, or might not, make these a viable IPC intervention for adapting, spreading, and scaling to other settings.
Sections du résumé
BACKGROUND
Globally, primary care (PC) has been central to the COVID-19 response. The pandemic has strained PC systems and introduced novel infection prevention and control (IPC) risks to the provision of safe, accessible in-person care. Specifically, the implementation of IPC guidance developed outside of PC into its operational context has proved challenging.
METHODS
Our team of "action researchers" developed an innovative virtual tabletop simulations (TTS) intervention which assisted PC teams as they adapted, implemented, and integrated IPC guidance into their specific clinical contexts. While we have detailed the "technical" elements of the TTS program elsewhere, this paper examines the specific "adaptive" elements that made this intervention successful in the high-income country context of Alberta, Canada.
RESULTS
Multiple factors influenced the uptake of this program in our Albertan setting, including: cultural geography; approach to financing and delivering PC; and policies and cultural norms supporting PC integration, medical education and research, and egalitarian teamwork.
CONCLUSIONS
Virtual TTS may provide substantial benefits to IPC and safety improvements in PC settings globally. However, the specific technical and adaptive elements of our Albertan TTS program might, or might not, make these a viable IPC intervention for adapting, spreading, and scaling to other settings.
Identifiants
pubmed: 35908827
pii: S0196-6553(22)00001-3
doi: 10.1016/j.ajic.2021.12.026
pmc: PMC9329075
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
885-889Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
Références
Healthc Policy. 2021 Nov;17(2):54-71
pubmed: 34895410
BMJ Qual Saf. 2011 Jul;20(7):560-3
pubmed: 21602561
BJGP Open. 2020 Oct 27;4(4):
pubmed: 32900708
BMJ Simul Technol Enhanc Learn. 2021 Jul;7(6):487-493
pubmed: 34422296
Ann Fam Med. 2022 Mar-Apr;20(2):149-156
pubmed: 35346931
BMJ Qual Saf. 2014 Feb;23(2):99-105
pubmed: 24096894
J Epidemiol Community Health. 2006 Oct;60(10):854-7
pubmed: 16973531
Healthc Policy. 2021 Nov;17(2):38-53
pubmed: 34895409
J Interprof Care. 2020 Sep-Oct;34(5):672-678
pubmed: 32962462
Ann Fam Med. 2022 Jan-Feb;20(1):90
pubmed: 35074776
BMC Health Serv Res. 2017 Jul 17;17(1):493
pubmed: 28716120
BMJ Glob Health. 2021 Jun;6(6):
pubmed: 34083244
BMJ. 2020 Aug 11;370:m3026
pubmed: 32784198
Eur J Gen Pract. 2020 Dec;26(1):129-133
pubmed: 32985278
BMC Fam Pract. 2020 Dec 5;21(1):258
pubmed: 33278880
Ann Fam Med. 2020 Jul;18(4):349-354
pubmed: 32661037
NPJ Prim Care Respir Med. 2020 Jun 18;30(1):30
pubmed: 32555160
BMJ Glob Health. 2020 Jul;5(7):
pubmed: 32718949
BMJ Open. 2020 Jan 7;10(1):e032662
pubmed: 31915165
BMJ Glob Health. 2020 Aug;5(8):
pubmed: 32759186
BMJ. 2019 Oct 1;367:l5514
pubmed: 31575526
Lancet Oncol. 2020 Jun;21(6):748-750
pubmed: 32359404
Br J Gen Pract. 2021 Jun 24;71(708):326-329
pubmed: 34319893