Liu Hueiming, Liu Darith, Moore Corey, Parcsi Lisa, Mukumbang Ferdinand, De Souza Denise, Shaw Miranda, Blunden Lou-Anne, Anderson Teresa, Eastwood John
Sydney Local Health District, NSW Health, AU.
Sydney Institute for Women, Children and their Families, AU.
Int J Integr Care. 2022 Feb 11;22(1):13. doi: 10.5334/ijic.5991. eCollection 2022 Jan-Mar.
Australia has been comparatively effective in preventing the transmission of COVID-19. The Sydney Local Health District [SLHD] used a "whole of health" integrated approach to respond to the pandemic. The aim of this study was to understand for whom, how and why this response worked, to inform a sustainable system transformation.
A critical realist qualitative study was conducted with 20 purposively selected key informants. Data were collected through in-depth interviews and analysed using thematic analysis guided by abduction and retroduction. The five strategies of the WHO integrated people-centred health services framework was used to guide the overall study.
An enabling environment of a strong governance, emergency preparedness, a committed and adaptable workforce, and a strong core infrastructure underpinned SLHD's effective response. With a culture of embracing innovation, the district adapted virtual care to effectively quarantine people through their special health accommodation, and coordinate care across tertiary and community services. The established interagency relationships prior to the pandemic, enabled service directors to quickly integrate their services, which empowered and engaged the community [and staff], working across relevant sectors to provide care "where the people are"; reaching marginalised populations, and reducing community transmission.
The SLHD's progress towards a 'whole of health' approach, empowered and enabled the district to effectively work within and across sectors to address the pandemic in a people-centred manner. Sustaining the contextual conditions and mechanisms, that facilitated effective integration, will be beneficial beyond the pandemic.
澳大利亚在预防新冠病毒传播方面相对有效。悉尼地方卫生区[SLHD]采用了“整体健康”综合方法应对疫情。本研究的目的是了解这种应对措施对谁有效、如何有效以及为何有效，以为可持续的系统转型提供参考。
对20名经过有目的挑选的关键信息提供者进行了一项批判性实在论定性研究。通过深入访谈收集数据，并采用以溯因推理和反绎推理为指导的主题分析法进行分析。世界卫生组织以人为本的综合卫生服务框架的五项策略被用于指导整个研究。
强大的治理、应急准备、敬业且适应性强的劳动力以及强大的核心基础设施所营造的有利环境，支撑了SLHD的有效应对。凭借拥抱创新的文化，该地区调整了虚拟护理，通过其特殊的健康住宿设施有效地对人员进行隔离，并协调三级医疗服务和社区服务之间的护理工作。疫情之前建立的跨部门关系，使服务主管能够迅速整合他们的服务，从而增强了社区[和工作人员]的权能并使其参与其中，跨相关部门开展工作，“在人们所在之处”提供护理；覆盖边缘化人群，并减少社区传播。
SLHD在朝着“整体健康”方法迈进的过程中，增强了该地区的权能，并使其能够在各部门内部和之间有效地开展工作，以以人为本的方式应对疫情。维持那些促进有效整合的背景条件和机制，在疫情之后仍将有益。
