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填补 COVID-19 大流行应对中的空白:美国军事卫生系统中的医务人员。

Filling the gaps in the COVID-19 pandemic response: medical personnel in the US military health system.

机构信息

Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, MD, 20817, USA.

The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA.

出版信息

BMC Health Serv Res. 2024 Sep 27;24(1):1140. doi: 10.1186/s12913-024-11616-6.

Abstract

BACKGROUND

The COVID-19 pandemic was an unprecedented public health emergency that heavily affected the healthcare workforce. Although the Military Health System (MHS) has robust capabilities and was able to deploy medical staff to support civilian hospitals during the crisis, it too was adversely impacted by personnel issues. We aimed to identify and address gaps in understanding the impact of the COVID-19 pandemic on healthcare personnel in the MHS.

METHODS

We conducted semi-structured key informant interviews with 28 MHS stakeholders, including policymakers, program managers, and healthcare providers. We recruited respondents using purposive and snowball sampling until we reached thematic saturation. Interviews were conducted virtually from December 2022 to March 2023 and coded by deductive thematic analysis using NVivo.

RESULTS

Burnout and mental health concerns across the workforce increased during the pandemic, although some felt military culture facilitated resilience. Reduction in personnel was noted and slow hiring processes and noncompetitive wages hindered hiring, contributing to staffing shortages. Initial disruptions occurred in training and skills readiness, although these issues were reduced over time. Concerns remain about newer trainees' preparedness and teaching staff's availability in the MHS.

CONCLUSION

This study uniquely assessed the impact of the COVID-19 pandemic response on the MHS healthcare workforce through in-depth key informant interviews. Multi-pronged strategies are needed to promote personnel well-being in complex healthcare systems like the MHS.

摘要

背景

COVID-19 大流行是一场前所未有的公共卫生紧急事件,对医疗保健工作者产生了重大影响。尽管军事卫生系统(MHS)具有强大的能力,并能够在危机期间部署医务人员来支持民用医院,但它也受到人员问题的不利影响。我们旨在确定并解决对 COVID-19 大流行对 MHS 医疗保健人员影响的理解差距。

方法

我们对 28 名 MHS 利益相关者进行了半结构化的关键意见访谈,包括政策制定者、项目管理人员和医疗保健提供者。我们使用目的性和滚雪球抽样招募受访者,直到达到主题饱和。访谈于 2023 年 12 月至 3 月在线进行,并使用 NVivo 进行演绎主题分析进行编码。

结果

尽管一些人认为军事文化促进了韧性,但整个劳动力的倦怠和心理健康问题在大流行期间有所增加。人员减少,招聘过程缓慢且工资缺乏竞争力,阻碍了招聘,导致人员短缺。培训和技能准备最初出现中断,但随着时间的推移,这些问题有所减少。人们仍然对新兵的准备情况和 MHS 中教学人员的可用性表示担忧。

结论

这项研究通过深入的关键意见访谈,独特地评估了 COVID-19 大流行应对措施对 MHS 医疗保健人员的影响。需要采取多管齐下的策略来促进像 MHS 这样复杂的医疗保健系统中的人员福祉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97cc/11430540/6172cedc3107/12913_2024_11616_Fig1_HTML.jpg

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