Clemson University, USA.
Children's Hospital of Philadelphia, USA.
Appl Ergon. 2023 Jul;110:104009. doi: 10.1016/j.apergo.2023.104009. Epub 2023 Mar 6.
The COVID-19 pandemic has challenged organizations to adapt under uncertainty and time pressure, with no pre-existing protocols or guidelines available. For organizations to learn to adapt effectively, there is a need to understand the perspectives of the frontline workforce involved in everyday operations. This study implemented a survey-tool to elicit narratives of successful adaptation based on the lived experiences frontline radiology staff at a large multispecialty pediatric hospital. Fifty-eight members of the radiology frontline staff responded to the tool between July and October of 2020. Qualitative analysis of the free-text data revealed five categories of themes that underpinned adaptive capacity of the radiology department during the pandemic: information flow, attitudes and initiative, new and adjusted workflows, availability and utilization of resources, and collaboration and teamwork. Enablers of adaptive capacity included timely and clear communication about procedures and policies from the leadership to frontline staff, and revised workflows with flexible work arrangements, such as remote patient screening. Responses to multiple choice questions in the tool helped identify the main categories of challenges faced by staff, factors that enabled successful adaptation, and resources used. The study demonstrates the use of a survey-tool to proactively identify frontline adaptations. The paper also reports a system-wide intervention resulting directly from a discovery enabled by the findings based on the use of RETIPS in the radiology department. In general, the tool could be used in concert with existing learning mechanisms, such as safety event reporting systems, to inform leadership-level decisions to support adaptive capacity.
COVID-19 大流行使各组织在不确定和时间压力下不得不进行调整，而没有现成的协议或指南可用。为了使组织能够有效地学习适应，有必要了解参与日常运营的一线工作人员的观点。本研究实施了一项调查工具，以根据大型多专业儿科医院一线放射科工作人员的实际经验，引出成功适应的叙述。2020 年 7 月至 10 月期间，放射科一线工作人员中有 58 名人员对该工具做出了回应。对自由文本数据的定性分析揭示了支持放射科在大流行期间适应能力的五个主题类别：信息流、态度和主动性、新的和调整后的工作流程、资源的可用性和利用、以及协作和团队合作。适应能力的促成因素包括领导层向一线工作人员及时、清晰地传达程序和政策，以及修订具有灵活工作安排的工作流程，例如远程患者筛查。工具中的多项选择题的回答有助于确定员工面临的主要挑战类别、使适应成功的因素以及使用的资源。该研究展示了使用调查工具主动识别一线适应的方法。本文还报告了一项系统范围的干预措施，该措施直接源于放射科使用 RETIPS 发现的结果。总的来说，该工具可以与现有的学习机制（如安全事件报告系统）一起使用，为领导层的决策提供信息，以支持适应能力。
