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实施 COVID-19 野战医院的策略、挑战和机遇:范围综述。

Strategies, challenges and opportunities in the implementation of COVID-19 field hospitals: a scoping review.

机构信息

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia

出版信息

BMJ Open. 2023 Mar 14;13(3):e067227. doi: 10.1136/bmjopen-2022-067227.

Abstract

OBJECTIVES

COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted implementation strategies and maximise field hospital functionality to address the issue of overflow of patients with COVID-19. This scoping review was based on the main research question, 'What are the implementation strategies, challenges and opportunities in managing the field hospital during the COVID-19 pandemic?', and aimed to consolidate all recent evidence on COVID-19 field hospital implementation approaches, challenges and potentialities.

DESIGN

Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

DATA SOURCES

PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.

ELIGIBILITY CRITERIA

Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.

DATA EXTRACTION AND SYNTHESIS

Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.

RESULTS

Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.

CONCLUSIONS

The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.

摘要

目的

COVID-19 对医疗系统造成了压力,需要重新设计其结构、人力资源管理和临床方法。各国已采取实施策略,并最大限度地发挥野战医院的功能,以解决 COVID-19 患者过多的问题。本范围综述基于主要研究问题,“在 COVID-19 大流行期间管理野战医院的实施策略、挑战和机遇是什么?”,旨在整合 COVID-19 野战医院实施方法、挑战和潜力的所有最新证据。

设计

根据 Arksey 和 O'Malley 的框架和系统评价和荟萃分析扩展的首选报告项目进行范围综述。

数据来源

从 2020 年 1 月 1 日至 2021 年 12 月 31 日,在 PubMed、Web of Science 和 Scopus 上进行了搜索。

入选标准

包括原创文章、综述、病例研究和报告,均以英文撰写。排除没有全文的作品和没有回答研究问题的作品。

数据提取和综合

使用 Microsoft Excel 中的标准数据提取表提取数据。综合所有纳入文章的发现进行叙述性描述。

结果

共审查了 85 条记录,纳入了 25 项研究。野战医院实施策略方面,除了药房、康复、食品和营养等其他服务的准备和工作流程外,还讨论了“扩充能力”,即空间、人力资源、供应和系统。管理 COVID-19 野战医院面临着人员和资源短缺、无法预测患者量和沟通不畅等挑战。还强调了管理方面的机会和改进建议。

结论

总结经验教训可能有助于改进野战医院的未来管理,包括行政和临床管理。

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