Stennett Jack, Hou Renyou, Traverson Lola, Ridde Valéry, Zinszer Kate, Chabrol Fanny
Centre Population et Développement Institut de Recherche pour le Développement Université de Paris Paris France.
Centre de Recherche en Santé Publique Université de Montréal Montréal, QC Canada.
JMIRx Med. 2022 Apr 6;3(2):e31272. doi: 10.2196/31272. eCollection 2022 Apr-Jun.
The SARS-CoV-2 pandemic has brought substantial strain on hospitals worldwide; however, although the success of China's COVID-19 strategy has been attributed to the achievements of the government, public health officials, and the attitudes of the public, the resilience shown by China's hospitals appears to have been a critical factor in their successful response to the pandemic.
This paper aims to determine the key findings, recommendations, and lessons learned in terms of hospital resilience during the pandemic; analyze the quality and limitations of research in this field at present; and contribute to the evaluation of the Chinese response to the COVID-19 outbreak, building on a growing literature on the role of hospital resilience in crisis situations.
We conducted a scoping review of evidence on the resilience of hospitals in China during the COVID-19 crisis in the first half of 2020. Two online databases (the China National Knowledge Infrastructure and World Health Organization databases) were used to identify papers meeting the eligibility criteria. After extracting the data, we present an information synthesis using a resilience framework. Articles were included in the review if they were peer-reviewed studies published between December 2019 and July 2020 in English or Chinese and included empirical results pertaining to the resilience of Chinese hospitals in the COVID-19 pandemic.
From the publications meeting the criteria (n=59), we found that substantial research was rapidly produced in the first half of 2020 and described numerous strategies used to improve hospital resilience, particularly in three key areas: human resources; management and communication; and security, hygiene, and planning. Our search revealed a focus on interventions related to training, health care worker well-being, eHealth/telemedicine, and workplace organization, while other areas such as hospital financing, information systems, and health care infrastructure were less well represented in the literature. We also noted that the literature was dominated by descriptive case studies, often lacking consideration of methodological limitations, and that there was a lack of both highly focused research on specific interventions and holistic research that attempted to unite the topics within a resilience framework.
We identified a number of lessons learned regarding how China's hospitals have demonstrated resilience when confronted with the SARS-CoV-2 pandemic. Strategies involving interprovincial reinforcements, online platforms and technological interventions, and meticulous personal protective equipment use and disinfection, combined with the creation of new interdisciplinary teams and management strategies, reflect a proactive hospital response to the pandemic, with high levels of redundancy. Research on Chinese hospitals would benefit from a greater range of analyses to draw more nuanced and contextualized lessons from the responses to the crisis.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行给全球医院带来了巨大压力；然而，尽管中国新冠疫情防控策略的成功归功于政府、公共卫生官员的努力以及公众的态度，但中国医院展现出的适应能力似乎是其成功应对疫情的关键因素。
本文旨在确定疫情期间医院适应能力方面的关键发现、建议和经验教训；分析目前该领域研究的质量和局限性；并基于关于医院适应能力在危机情况下作用的越来越多的文献，为评估中国对新冠疫情爆发的应对措施做出贡献。
我们对2020年上半年新冠疫情期间中国医院适应能力的证据进行了范围综述。使用两个在线数据库（中国知网和世界卫生组织数据库）来识别符合纳入标准的论文。在提取数据后，我们使用适应能力框架进行信息综合。如果文章是2019年12月至2020年7月期间以英文或中文发表的同行评审研究，且包含与中国医院在新冠疫情中的适应能力相关的实证结果，则纳入综述。
从符合标准的出版物（n = 59）中，我们发现2020年上半年迅速产生了大量研究，描述了许多用于提高医院适应能力的策略，特别是在三个关键领域：人力资源；管理与沟通；以及安全、卫生和规划。我们的检索发现研究重点在于与培训、医护人员福祉、电子健康/远程医疗和工作场所组织相关的干预措施，而医院融资、信息系统和医疗基础设施等其他领域在文献中的体现较少。我们还注意到，文献主要是描述性案例研究，往往缺乏对方法局限性的考虑，并且既缺乏对特定干预措施的高度聚焦研究，也缺乏试图在适应能力框架内统一各主题的整体研究。
我们确定了一些关于中国医院在面对SARS-CoV-2大流行时如何展现适应能力的经验教训。涉及省际支援、在线平台和技术干预、细致的个人防护装备使用和消毒的策略，以及新跨学科团队和管理策略的创建，反映了医院对疫情的积极应对，具备高度的冗余性。对中国医院的研究将受益于更广泛的分析，以便从对危机应对措施中汲取更细致入微和因地制宜的经验教训。
