Abstract
Introduction: Resilient hospitals have the capabilities to maintain their core functionality, which is directly related to the delivery of services for acute and chronic health conditions, even during a crisis. Hospitals are increasingly recognised as complex adaptive systems and the understanding of how these systems work, especially in a crisis, will contribute to the existing body of knowledge on hospital resilience. This study explored the dynamic interactions between hospital building blocks in supporting the organisation of a whole-of-hospital response in a single case setting-University Malaya Medical Centre during the COVID-19 pandemic. Methods: A qualitative holistic case study was used. The case was hospital resilience defined as the system 's capabilities to prepare for (anticipating), manage (coping), and learn from (adapting) a crisis. Purposive sampling was applied to select the documents and participants for an in-depth understanding of the hospital 's pandemic response between January 2020 and April 2021. A conceptual framework developed based on the theoretical pluralism approach supported data collection, analysis and interpretation of the study findings. Thematic analysis and the charting approach were used for data analysis. Results: A total of 316 documents were reviewed, and 17 in-depth interviews were conducted. The unfolding challenges such as the day-to-day evolution of COVID-19 epidemiology, in-hospital outbreaks, supply chain failures, and resource constraints contributed to the constant review of hospital policies and response strategies. The whole-of-hospital approach, which involved various departments and health workers at all levels, was imperative in ensuring a comprehensive and collective response strategy. Hospital leadership supported the hospital 's self-sufficient response. It served as an important catalyst for the continuous reorganisation of available resources to deal with the emerging risks (governance and leadership building block). The hospital paid close attention to the safety and well-being of health workers while working within time pressures and resource constraints to anticipate, cope and adapt to a range of impacts of the pandemic on hospital services (health workforce building block). The constant change in the hospital 's service provision demonstrated that it could learn and change in facing the ever-changing healthcare environment (service delivery building block). The availability of timely information supported the hospital 's evidence-informed decision-making process and improved the credibility of rapidly evolving decisions (information building block). Discussion: The study identified several factors that contributed to the hospital 's resilience in the face of the COVID-19 crisis. Able past and present leaders ensured that built-up of hospital building blocks were not done in silo but in consideration of all other building blocks. The measures taken demonstrated the hospital 's capability to learn, cope and adapt, from past crises to enable it to function in the present. Policymakers, hospital managers, and healthcare professionals need to consider the intricacies of interactions between building blocks and leadership as the key driver in influencing the contributions and functions of all other building blocks in building a resilient healthcare system. It could allow healthcare systems to be better prepared and respond effectively and that the core healthcare systems, such as hospital services, are disrupted as little as possible.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-49.pdf
- https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed1909[...]
BibTeX (Download)
@proceedings{APCPH2022-P-49,
title = {Exploring the dynamic interactions between hospital building blocks in supporting University Malaya Medical Centre 's COVID-19 pandemic response: A holistic single-case study},
author = {Diane Woei-Quan Chong and Chiu-Wan Ng and Sanjay Rampal},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-49.pdf
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/APCPH2022-P-49-b939640ebdb3b4b0740040c556e8d82d.pdf},
year = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: Resilient hospitals have the capabilities to maintain their core functionality, which is directly related to the delivery of services for acute and chronic health conditions, even during a crisis. Hospitals are increasingly recognised as complex adaptive systems and the understanding of how these systems work, especially in a crisis, will contribute to the existing body of knowledge on hospital resilience. This study explored the dynamic interactions between hospital building blocks in supporting the organisation of a whole-of-hospital response in a single case setting-University Malaya Medical Centre during the COVID-19 pandemic. Methods: A qualitative holistic case study was used. The case was hospital resilience defined as the system 's capabilities to prepare for (anticipating), manage (coping), and learn from (adapting) a crisis. Purposive sampling was applied to select the documents and participants for an in-depth understanding of the hospital 's pandemic response between January 2020 and April 2021. A conceptual framework developed based on the theoretical pluralism approach supported data collection, analysis and interpretation of the study findings. Thematic analysis and the charting approach were used for data analysis. Results: A total of 316 documents were reviewed, and 17 in-depth interviews were conducted. The unfolding challenges such as the day-to-day evolution of COVID-19 epidemiology, in-hospital outbreaks, supply chain failures, and resource constraints contributed to the constant review of hospital policies and response strategies. The whole-of-hospital approach, which involved various departments and health workers at all levels, was imperative in ensuring a comprehensive and collective response strategy. Hospital leadership supported the hospital 's self-sufficient response. It served as an important catalyst for the continuous reorganisation of available resources to deal with the emerging risks (governance and leadership building block). The hospital paid close attention to the safety and well-being of health workers while working within time pressures and resource constraints to anticipate, cope and adapt to a range of impacts of the pandemic on hospital services (health workforce building block). The constant change in the hospital 's service provision demonstrated that it could learn and change in facing the ever-changing healthcare environment (service delivery building block). The availability of timely information supported the hospital 's evidence-informed decision-making process and improved the credibility of rapidly evolving decisions (information building block). Discussion: The study identified several factors that contributed to the hospital 's resilience in the face of the COVID-19 crisis. Able past and present leaders ensured that built-up of hospital building blocks were not done in silo but in consideration of all other building blocks. The measures taken demonstrated the hospital 's capability to learn, cope and adapt, from past crises to enable it to function in the present. Policymakers, hospital managers, and healthcare professionals need to consider the intricacies of interactions between building blocks and leadership as the key driver in influencing the contributions and functions of all other building blocks in building a resilient healthcare system. It could allow healthcare systems to be better prepared and respond effectively and that the core healthcare systems, such as hospital services, are disrupted as little as possible.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Ministry of Health Malaysia, Putrajaya, Malaysia; Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia},
keywords = {building block, case study, Covid-19, hospital resilience, whole-of-hospital approach},
pubstate = {published},
tppubtype = {proceedings}
}