"Building the plane while flying it" Reflections on pandemic preparedness and response; an organisational case study.
Background
COVID-19
Hospital
Leadership
Operational
Pandemic
Response
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
01 Sep 2023
01 Sep 2023
Historique:
received:
30
01
2023
accepted:
04
08
2023
medline:
4
9
2023
pubmed:
2
9
2023
entrez:
1
9
2023
Statut:
epublish
Résumé
The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader's perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers. This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses. Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear 'my job is going to kill me', (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment. Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader's perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers.
METHODS
METHODS
This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses.
RESULTS
RESULTS
Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear 'my job is going to kill me', (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment.
CONCLUSION
CONCLUSIONS
Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation.
Identifiants
pubmed: 37658384
doi: 10.1186/s12913-023-09874-x
pii: 10.1186/s12913-023-09874-x
pmc: PMC10472588
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
940Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
J Adv Nurs. 2022 Aug;78(8):2383-2396
pubmed: 35170075
Lancet. 2021 May 1;397(10285):1603-1605
pubmed: 33865497
Women Birth. 2022 Sep;35(5):447-457
pubmed: 34627733
BMC Health Serv Res. 2021 Oct 04;21(1):1037
pubmed: 34602063
Health Econ Policy Law. 2022 Jan;17(1):95-106
pubmed: 34311803
J Multidiscip Healthc. 2022 Jun 14;15:1309-1321
pubmed: 35726265
Health Expect. 2021 Feb;24(1):95-110
pubmed: 33215857
Cochrane Database Syst Rev. 2020 Apr 21;4:CD013582
pubmed: 32315451
Front Public Health. 2022 Sep 29;10:965664
pubmed: 36249244
Clin Infect Dis. 2021 Aug 2;73(3):e808-e810
pubmed: 33354719