Research Division, The Aga Khan University Medical College East Africa, Nairobi, Kenya
Research Division, The Aga Khan University Medical College East Africa, Nairobi, Kenya.
BMJ Lead. 2024 Jul 1;8(2):111-118. doi: 10.1136/leader-2023-000833.
Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.
We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, protocols, brochures and flyers. We evaluated and described pandemic preparedness at the hospital under four main themes: (a) leadership, governance and incident management structures; (b) coordination and partnerships; (c) communication strategies; and (d) framework to resolve ethical dilemmas.
The hospital expeditiously established three emergency governance structures, namely a task force, an operations team and an implementation team, to direct and implement evidence-based preparedness strategies. Leveraging on partners, the hospital ensured that risk analyses and decisions made: (1) were based on evidence and in line with the national and global guidelines, (2) were supported by community leaders and (3) expedite financing for urgent hospital activities. Communication strategies were put in place to ensure harmonised COVID-19 messaging to the hospital staff, patients, visitors and the public to minimise misinformation or disinformation. An ethical framework was also established to build trust and transparency among the hospital leadership, staff and patients.
The establishment of a hospital leadership structure is crucial for efficient and effective implementation of pandemic preparedness and response strategies which are evidence based, well resourced and ethical. The role of leadership discussed is applicable to healthcare facilities across low and middle-income countries to develop contextualised pandemic preparedness plans.
大流行防备是指为应对公共卫生危机做好准备、做出响应并从中恢复，这对卫生安全至关重要。医院领导力是有效医疗体系的重要基石，可为卫生危机提供政策、问责制和管理。
我们旨在描述 COVID-19 大流行后，内罗毕 Aga Khan 大学医院（一家私立非营利性三级保健机构）建立的领导和治理结构。我们审查了 COVID-19 存储库中存档的 200 多份医院文件，包括从肯尼亚卫生部收到的文件、电子邮件、备忘录、公告、会议记录、协议、小册子和传单。我们从四个主要主题评估和描述了医院的大流行防备情况：（a）领导、治理和事件管理结构；（b）协调与伙伴关系；（c）沟通策略；和（d）解决伦理困境的框架。
医院迅速建立了三个紧急治理结构，即工作队、运营团队和实施团队，以指导和实施基于证据的防备策略。通过利用合作伙伴关系，医院确保风险分析和决策：（1）基于证据，符合国家和全球准则；（2）得到社区领导的支持；（3）加快为紧急医院活动提供资金。还制定了沟通策略，以确保向医院工作人员、患者、访客和公众传达一致的 COVID-19 信息，以最大程度减少错误或虚假信息。还建立了道德框架，以在医院领导层、员工和患者之间建立信任和透明度。
建立医院领导结构对于高效和有效地实施基于证据、资源充足和合乎道德的大流行防备和应对策略至关重要。所讨论的领导作用适用于中低收入国家的医疗保健设施，以制定有针对性的大流行防备计划。
