Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada.
École de santé publique de l'Université de Montréal (ESPUM), Montréal, Quebec, Canada.
Health Syst Reform. 2023 Jun 15;9(2):2200566. doi: 10.1080/23288604.2023.2200566.
Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospitals and their staff to contend with the crisis and then analyzing the implications of those strategies. We base our description and analysis on two hospital case studies in Quebec. We used a multiple case study approach, wherein each hospital is considered a unique case. In both cases, work adaptation through staff reassignment was one of the critical measures undertaken to ensure absorption of the influx of patients into the hospitals. Our results showed that this general strategy was designed and applied differently in the two cases. More specifically, the reassignment strategies revealed numerous healthcare resource disparities not only between health territories, but also between different types of facilities within those territories. Comparing the two hospitals' adaptation strategies showed that past reforms in Quebec determined what these reorganizations could achieve, as well as how they would affect workers and the meaning they gave to their work.
在全球范围内应对 COVID19 大流行的医院对策中,服务重组和人员调配是适应医院工作以应对预期大量涌入患者的最突出方式之一。在本文中,我们通过确定两家医院及其工作人员实施的应对危机的运营策略来考察大流行引发的工作重组,然后分析这些策略的影响。我们以魁北克的两家医院案例研究为基础来进行描述和分析。我们使用了多案例研究方法,将每家医院视为一个独特的案例。在这两种情况下,通过人员调配来适应工作是确保将大量患者吸收到医院的关键措施之一。我们的研究结果表明,这种普遍策略在这两种情况下的设计和应用方式有所不同。具体而言,人员调配策略不仅揭示了不同卫生领域之间,而且还揭示了这些领域内不同类型的医疗机构之间的医疗资源差距。比较两家医院的适应策略表明,魁北克过去的改革决定了这些重组可以实现什么目标,以及它们将如何影响工人以及他们对工作的意义。