Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France.
Equipe de Prévention du Risque Infectieux, Hôpital Bichat Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.
Health Syst Reform. 2023 Dec 31;9(1):2165429. doi: 10.1080/23288604.2023.2165429.
Since the beginning of the COVID-19 pandemic, few studies have focused on crisis management of multiple services within one hospital over several waves of the pandemic. The purpose of this study was to provide an overview of the COVID-19 crisis response of a Parisian referral hospital which managed the first three COVID cases in France and to analyze its resilience capacities. Between March 2020 and June 2021, we conducted observations, semi-structured interviews, focus groups, and lessons learned workshops. Data analysis was supported by an original framework on health system resilience. Three configurations emerged from the empirical data: 1) reorganization of services and spaces; 2) management of professionals' and patients' contamination risk; and 3) mobilization of human resources and work adaptation. The hospital and its staff mitigated the effects of the pandemic by implementing multiple and varied strategies, which the staff perceived as having positive and/or negative consequences. We observed an unprecedented mobilization of the hospital and its staff to absorb the crisis. Often the mobilization fell on the shoulders of the professionals, adding to their exhaustion. Our study demonstrates the capacity of the hospital and its staff to absorb the COVID-19 shock by putting in place mechanisms for continuous adaptation. More time and insight will be needed to observe whether these strategies and adaptations will be sustainable over the coming months and years and to assess the overall transformative capacities of the hospital.
自 COVID-19 大流行开始以来,很少有研究关注一家医院内多个服务部门在多波大流行中的危机管理。本研究的目的是提供巴黎转诊医院应对 COVID-19 危机的概述,该医院管理了法国的前三例 COVID 病例,并分析其弹性能力。在 2020 年 3 月至 2021 年 6 月期间,我们进行了观察、半结构化访谈、焦点小组和经验教训研讨会。数据分析得到了一个关于卫生系统弹性的原始框架的支持。从经验数据中出现了三种配置:1)服务和空间的重组;2)管理专业人员和患者的污染风险;3)人力资源的调动和工作调整。医院及其工作人员通过实施多种不同的策略来减轻大流行的影响,工作人员认为这些策略具有积极和/或消极的后果。我们观察到医院及其工作人员为吸收危机而进行了前所未有的动员。通常,动员的重担落在专业人员身上,使他们更加疲惫。我们的研究表明,医院及其工作人员通过建立持续适应的机制,有能力吸收 COVID-19 的冲击。需要更多的时间和洞察力来观察这些策略和适应措施在未来几个月和几年是否可持续,并评估医院的整体变革能力。
Health Syst Reform. 2023-12-31
Health Syst Reform. 2023-6-15
Health Syst Reform. 2023-6-15
Health Syst Reform. 2023-6-15
BMC Health Serv Res. 2024-10-3