Health Services Manager Infection Prevention, Mercy Health, Victoria, Australia.
Centre for Quality and Patient Safety Research in the Institute for Health Transformation, School of Nursing and Midwifery, Deakin University Geelong, Victoria, Australia.
BMC Health Serv Res. 2023 Sep 1;23(1):940. doi: 10.1186/s12913-023-09874-x.
The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader's perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers.
This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses.
Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear 'my job is going to kill me', (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment.
Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation.
COVID-19 大流行提供了一个独特的机会，可以实时了解急性卫生组织实施大流行应对计划的经验。本研究旨在探讨组织领导者在其卫生服务中激活 COVID-19 大流行应对计划的观点和经验，以及这对服务提供、临床医生和消费者的影响。
本研究在澳大利亚一家大型大都市卫生服务机构进行，该机构提供急性、亚急性和住院老年护理服务。2021/2022 年 11 月至 1 月期间，对 COVID-19 领导层的 12 名关键参与者进行了半结构化访谈。制定了一份半结构化访谈指南，以探讨卫生服务机构如何制定临床治理结构、政策和程序，并在运营控制框架的每个要素时体验这些内容。使用主题分析对数据进行编码并确定主题。2021 年还完成了一项针对一线医护人员的横断面调查，了解他们在 COVID-19 大流行期间对感染控制措施的影响和看法，共收到 559 份回复。
12 名组织领导者完成了半结构化访谈。出现的主要主题是：(1) 边飞边建飞机，(2) 统一的沟通策略，(3) 临床医生担心“我的工作会杀了我”，(4) 个人防护设备(PPE) 的供应和需求，以及(5) 保持劳动力。在调查中，一线医护人员总体上对卫生服务机构的大流行应对措施反应积极，包括沟通、获得 PPE、教育、培训以及提供安全环境的资源。
卫生服务组织需要迅速做出反应以满足服务需求，包括实施大流行计划、制定指挥结构以及沟通和解决劳动力需求的战略。本研究为卫生服务领导者应对未来大流行时提供了重要的见解。未来的大流行计划应包括与组织责任、供应链物流和劳动力准备相关的急性和长期护理提供者的详细指导。
