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1.
BMJ Glob Health ; 7(Suppl 3)2022 06.
Article in English | MEDLINE | ID: covidwho-1909735

ABSTRACT

Since the COVID-19 pandemic began, hospitals in the Eastern Mediterranean Region (EMR) have faced significant challenges in providing essential services, while simultaneously combatting this pandemic and responding to new and ongoing shocks and emergencies. Despite these challenges, policy-makers and hospital managers adapted their hospital responses to maintain operations and continue providing essential health services in resource-restraint and fragile and conflict affected, offering valuable insights to others in similar contexts. The aim of this paper is to share the lessons learnt from hospital responses to COVID-19 from the EMR. To do this, we triangulated findings from literature review, open-ended online surveys and 46 in-depth key informant interviews from 18 EMR countries. Qualitative findings from semistructured key informant interviews along with the open-ended survey responses resulted in nine major themes for lessons learnt in the EMR. These themes include Preparedness, Leadership and Coordination, Communication, Human Resources, Supplies and Logistics, Surge Capacity and Essential Services, Clinical Management (including Rapid Identification, Diagnosis and Isolation), Infection Prevention and Control, and Information and Research. Each of the nine themes (domains) included 4-6 major subthemes offering key insights into the regional hospital response to health emergencies. Resilient hospitals are those that can provide holistic, adaptable, primary-care-based health systems to deliver high-quality, effective and people-centred health services and respond to future outbreaks. Both bottom-up and top-down approaches are needed to strengthen collaboration between policy-makers, hospitals, front-line workers and communities to mitigate the continued spread of SARS CoV2, build resilient hospital systems and improve public health preparedness and emergency response.


Subject(s)
COVID-19 , Emergencies , Hospitals , Humans , Pandemics/prevention & control , Public Health
2.
PLoS One ; 17(6): e0268386, 2022.
Article in English | MEDLINE | ID: covidwho-1879306

ABSTRACT

BACKGROUND: During rapidly evolving outbreaks, health services and essential medical care are interrupted as facilities have become overwhelmed responding to COVID-19. In the Eastern Mediterranean Region (EMR), more than half of countries are affected by emergencies, hospitals face complex challenges as they respond to humanitarian crises, maintain essential services, and fight the pandemic. While hospitals in the EMR have adapted to combat COVID-19, evidence-based and context-specific recommendations are needed to guide policymakers and hospital managers on best practices to strengthen hospitals' readiness, limit the impact of the pandemic, and create lasting hospital sector improvements towards recovery and resilience. AIM: Guided by the WHO/EMR's "Hospital readiness checklist for COVID-19", this study presents the experiences of EMR hospitals in combatting COVID-19 across the 22 EMR countries, including their challenges and interventions across the checklist domains, to inform improvements to pandemic preparedness, response, policy, and practice. METHODS: To collect in-depth and comprehensive information on hospital experiences, qualitative and descriptive quantitative data was collected between May-October 2020. To increase breadth of responses, this comprehensive qualitative study triangulated findings from a regional literature review with the findings of an open-ended online survey (n = 139), and virtual in-depth key informant interviews with 46 policymakers and hospital managers from 18 out of 22 EMR countries. Purposeful sampling supported by snowballing was used and continued until reaching data saturation, measures were taken to increase the trustworthiness of the results. Led by the checklist domains, qualitative data was thematically analyzed using MAXQDA. FINDINGS: Hospitals faced continuously changing challenges and needed to adapt to maintain operations and provide essential services. This thematic analysis revealed major themes for the challenges and interventions utilized by hospitals for each of hospital readiness domains: Preparedness, Leadership, Operational support, logistics, supply management, Communications and Information, Human Resources, Continuity of Essential Services and Surge Capacity, Rapid Identification and Diagnosis, Isolation and Case Management, and Infection, Prevention and Control. CONCLUSION: Hospitals are the backbone of COVID-19 response, and their resilience is essential for achieving universal health coverage. Multi-pronged (across each of the hospitals readiness domains) and multi-level policies are required to strengthen hospitals resilience and prepare health systems for future outbreaks and shocks.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Hospitals , Humans , Pandemics/prevention & control , Surge Capacity
3.
Front Public Health ; 10: 873219, 2022.
Article in English | MEDLINE | ID: covidwho-1792868

ABSTRACT

The prolonged ongoing conflict in Palestine exacerbated socioeconomic conditions and weakened the health system, complicating the management of COVID-19 pandemic, especially for cancer patients who are doubly-at risk. Augusta Victoria Hospital (AVH) is Palestine's only specialized cancer hospital, receiving patients from the Gaza Strip and the West Bank for oncology, nephrology, hematology, and radiotherapy. AVH's preparedness measures enabled its agile response. These proactive and innovative preparedness measures included: implementing a facility-level preparedness and response plan; utilizing multidisciplinary team-based and evidence-informed approaches to decision making; prioritizing health workers' safety and education; establishing in-house PCR testing to scale up timely screenings; and accommodating health workers, patients, and their relatives at hospital hotels, to maintain daily, continuous and critical health care for cancer patients and limit the spread of infection. At the facility-level, the biggest challenge faced by AVH was continuing essential and daily care for immunocompromised patients while protecting them from potential infection from relatives, hospital staff and other suspected patients. At the national level, the lack of preparedness, inequalities in vaccine distribution, political instability, violence, delays in obtaining medical exit permits to reach Jerusalem, weakened AVH's response. AVH's flexible financing, hospital accreditation, and strong leadership and coordination enabled its agility and resilience. Despite compiling challenges, the hospital's proactive and innovative interventions minimized the risk of infection among two high-risk groups: the immunocompromised patients and their health workers, providing invaluable lessons for health facilities in other fragile-and-conflict-affected settings.


Subject(s)
COVID-19 , Neoplasms , Arabs , Cancer Care Facilities , Humans , Neoplasms/therapy , Pandemics/prevention & control
4.
Health Serv Manage Res ; 35(1): 2-6, 2022 02.
Article in English | MEDLINE | ID: covidwho-1341413

ABSTRACT

Hospitals all around the world play an essential role in response to the COVID-19 pandemic. During an epidemic event, hospital leaders frequently face new challenges requiring them to perform unaccustomed tasks, which might be well beyond the scope of their previous practice and experience. While no absolute set of characteristics is necessary in all leadership situations, certain traits, skills and competencies tend to be more critical than others in crisis management times. We will discuss some of the most important ones in this manuscript. To strengthen those managerial competencies needed to face outbreaks, healthcare leaders should be better supported by competency-based training courses as it is more and more clear that traditional training courses are not as effective as they were supposed to be. It seems we should look at the COVID-19 pandemic as a learning opportunity to re-frame what we expect from hospital leaders and to re-think the way we train, assess and evaluate them.


Subject(s)
COVID-19 , Leadership , Hospitals , Humans , Pandemics/prevention & control , SARS-CoV-2
5.
Eastern Mediterranean Health Journal ; 26(6):626-629, 2020.
Article in English | ProQuest Central | ID: covidwho-1220407

ABSTRACT

[...]work has been done to support implementation of a package of emergency care tools including: the Integrated Interagency Triage Tool (prehospital, routine and mass casualty);Emergency Medical and Trauma Care Checklists;the Basic Emergency Care - an open-access training course for frontline health-care providers who manage acute illness and injury with limited resources;and the International Registry of Trauma and Emergency care to help gather essential data about the performance of emergency care systems (6,7). Despite countries' efforts to control patient flow by directing suspected COVID-19 patients to dedicated facilities, many "self-present" to facilities of their choosing. [...]patients presenting for unrelated emergencies (e.g., trauma) may also be co-infected with COVID-19 - whether or not they are symptomatic. Additionally, many EMR countries lack legislation guaranteeing access to emergency care for all (a key WHO Health System Building Block under governance), which limits access to marginal communities (10). Since the Region is host to the largest number of displaced persons in the world, region-specific guidance has been developed to guide health system response to COVID-19 in the context of displacement (22). [...]there is a paucity of high-quality published data on emergency care systems in the Region and an urgent need for operational research to understand the emergency care needs and emergency care systems performance in EMR countries.

6.
East Mediterr Health J ; 26(6): 626-629, 2020 Jun 24.
Article in English | MEDLINE | ID: covidwho-634614

ABSTRACT

The COVID-19 pandemic began as a cluster of reported cases of acute respiratory illness in China on 31 December 2019 and went on to spread with exponential growth across the globe. By the time it was characterized as a global pandemic on 11 March 2020, 17 of 22 countries in the Eastern Mediterranean Region (EMR) had reports of infected persons. EMR countries are particularly susceptible to such outbreaks due to the presence of globally interconnected markets; complex emergencies in more than half of the countries; religious mass gatherings that draw tens of millions of pilgrims annually; and variation in emergency care systems capacity and health systems performance within and between countries.


Subject(s)
Coronavirus Infections/therapy , Emergency Medical Services/organization & administration , Emergency Service, Hospital/organization & administration , Epidemiology/education , International Cooperation , Pneumonia, Viral/therapy , Public Health/education , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Health Policy , Health Services Accessibility , Humans , Mediterranean Region/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Public Health Practice , SARS-CoV-2 , World Health Organization
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