应对危机的临时医疗服务:组织和管理大规模疫苗接种中心。

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
John Ovretveit, Mikael Ohrling
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引用次数: 0

摘要

目的:科学描述临时大规模卫生保健(T-LSHc)疫苗接种诊所的组织和管理,为今后的临时卫生保健(T-Hc)服务提供循证指导。设计/方法/方法:混合方法快速反馈案例研究,使用访谈,文件分析和定量数据,数据收集和分析由临床研究系统程序理论指导。调查结果:私人承包商不愿意竞标2022年建立和关闭T-LSHc疫苗接种诊所的合同,尽管他们在今年早些时候已经这样做了。公共卫生系统能够成功地建立并运行诊所两个月,在高峰时期每天为3000人提供服务。成功的部分原因是在2020年建立了一个专门的部门来建立和运行T-Hc服务。斯德哥尔摩组织模式与米兰模式的不同之处在于,它利用信息技术减少了对大量现场医生的需求。研究局限性/启示:由于访谈是在诊所关闭四个月后进行的,因此访谈数据可能存在回忆偏差。结论适用于临床简单但管理复杂的T-Hc服务,但仅限于在与案例研究服务相似的背景下运作的公共卫生系统。该研究为医疗危机组织和管理的新科学做出了贡献,并填补了持久和波动健康危机的灾难医学知识空白。研究结果显示了建立和管理T-Hc的能力的重要性,以及卫生系统需要建立的专家管理和HIT能力的重要性,以应对现在和未来威胁我们健康的危机。实际意义:如果公共卫生系统具有规划和建立此类服务的经验和能力、受到工作人员尊重的熟练的业务管理人员、可以重新部署的工作人员以及适当的卫生信息技术,则可以快速成功地提供临床简单和管理复杂的T-Hc服务。社会影响:未来对应对危机的保健服务的需求可能会增加。用于创建服务的信息最初可能是有限的,并且会不断变化。健康威胁的确切性质可能不确定,亚群体和个人的需求和需要也可能不确定。当现有服务无法重组以满足需求规模时,研究结果可以通过创建和组织临时大规模公共医疗保健服务来帮助迅速作出反应,以减少发病率和死亡率。原创性/价值:本文是第一个详细的实证描述和分析大型临时医疗服务由综合公共医疗保健系统的初级保健部门运作,研究为类似背景下的此类未来服务提供了指导。本文比较了T-LSHc服务的两种组织模型,并为灾害和危机医疗保健组织和管理的新兴分支学科做出了贡献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Temporary healthcare services for crisis response: organization and management of a mass vaccination center.

Purpose: Scientific description of the organization and management of a temporary large scale healthcare (T-LSHc) vaccination clinic and evidence-based guidance for future temporary healthcare (T-Hc) services.

Design/methodology/approach: Mixed-methods rapid feedback case study, using interviews, document analysis and quantitative data, with both data collection and analysis guided by a research-informed systems program theory of the clinic.

Findings: Private contractors were not willing to bid for contracts to set up and close a T-LSHc vaccination clinic in 2022, although they had done so earlier in the year. The public health system was able successfully to set up and run the clinic itself for 2 months, serving 3,000 people a day at its peak. Part of the success was because a dedicated unit to set up and run T-Hc services had been created in 2020. The Stockholm organization model differed from the Milan model by using information technology to reduce the need for a large number of on-site doctors.

Research limitations/implications: There may be recall bias in interview data as interviews were carried out four months after the closing of the clinic. The conclusions apply to clinically simple but managerially complex T-Hc services but are limited to public healthcare systems operating in a similar context to that of the case study service. The study contributes to the new science of healthcare crisis organization and management and fills gaps in knowledge in disaster medicine for enduring and fluctuating health crises. The findings show the importance of a capacity to establish and manage T-Hc, and of the specialist management and HIT competence that health systems will need to build to meet the crises that threaten our health, both now and in the future.

Practical implications: Public healthcare systems can provide clinically simple and managerially complex T-Hc services quickly and successfully if they have experience and capacity to plan and set up such services, skilled operational managers respected by staff, staff who can be redeployed, and suitable health information technology.

Social implications: The need for healthcare services to respond to crises is likely to increase in the future. Information for creating the service may be limited at first and changing. The exact nature of the health threat may be uncertain, as may the demand and needs of subpopulations and individuals. The study findings can help to respond quickly to reduce morbidity illness and death through creating and organizing temporary large-scale public healthcare services when existing services cannot be reorganized to meet the scale of the need.

Originality/value: This article is the first detailed empirical description and analysis of a large-scale temporary healthcare service operated by the primary care division of an integrated public healthcare system, with research informed guidance for future services of this type in similar contexts. This article compares two organization models of T-LSHc services, and contributes to an emerging subdiscipline of the organization and management of disaster and crisis healthcare.

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来源期刊
CiteScore
3.20
自引率
7.10%
发文量
72
期刊介绍: ■International health and international organizations ■Organisational behaviour, governance, management and leadership ■The inter-relationship of health and public sector services ■Theories and practices of management and leadership in health and related organizations ■Emotion in health care organizations ■Management education and training ■Industrial relations and human resource theory and management. As the demands on the health care industry both polarize and intensify, effective management of financial and human resources, the restructuring of organizations and the handling of market forces are increasingly important areas for the industry to address.
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