Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327793

ABSTRACT

Background: In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed ‘Hospital of Hope’ was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town. Methods We aimed to systematically describe and assess the effects on staff and the local health system. A cross-sectional descriptive study design was employed using mixed methods including record reviews and interviews with key informants. Results Quantitative results confirmed high job satisfaction and low staff infection rates. The emerging themes from the qualitative data are grouped around a “bull’s eye” of the common purpose of person-centredness, from both patient and staff perspectives, and include staff safety and support, rapid communication, continuous learning and adaptability, underpinned by excellent teamwork. The explanations for the positive feedback included good disaster planning, adequate resources, and an extraordinary responsiveness to the need. Conclusions The ‘Hospital of Hope’ staff experience produced significant learnings for the design and management of routine health services outside of a disaster situation. The adaptability and responsiveness of the facility and its staff was largely a product of the unprecedented nature of the pandemic, but such approaches could benefit routine health services enormously, as individual hospitals and health facilities realize their place in a system that is ‘more than the sum of its parts’.

2.
Afr J Prim Health Care Fam Med ; 14(1): e1-e7, 2022 Jan 18.
Article in English | MEDLINE | ID: covidwho-1687150

ABSTRACT

BACKGROUND:  Non-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse. AIM:  This study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave. SETTING:  Two public health sector primary care sites in the Cape Town Metro, including a Community Orientated Primary Care (COPC) learning site. METHODS:  A rapid appraisal with convergent mixed-methods design, including semi-structured interviews with facility and community health workers (CHWs) (n = 20) and patients living with NCDs (n = 8), was used. Interviews were conducted in English and Afrikaans by qualified interviewers. Transcripts were analysed by thematic content analysis. Quantitative data of health facility attendance, chronic dispensing unit (CDU) prescriptions and routine diabetes control were sourced from the Provincial Health Data Centre and analysed descriptively. RESULTS:  Qualitative analysis revealed three themes: disruption (cancellation of services, fear of infection, stress and anxiety), service reorganisation (communication, home delivery of medication, CHW scope of work, risk stratification and change management) and outcomes (workload and morale, stigma, appreciation and impact on NCD control). There was a drop in primary care attendance and an increase in CDU prescriptions and uncontrolled diabetes. CONCLUSION:  This study described the service disruption together with rapid reorganisation and change management at primary care level during the first COVID-19 wave. The changes were strengthened by the COPC foundation in one of the study sites. The impact of COVID-19 on primary-level NCD care and management requires more investigation.


Subject(s)
COVID-19 , Noncommunicable Diseases , Community Health Workers , Humans , Noncommunicable Diseases/therapy , SARS-CoV-2 , South Africa
3.
Afr J Prim Health Care Fam Med ; 13(1): e1-e9, 2021 Dec 09.
Article in English | MEDLINE | ID: covidwho-1580227

ABSTRACT

BACKGROUND: The coronavirus pandemic has put extreme pressure on health care services in South Africa. AIM: To describe the design, patients and outcomes of a field hospital during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. SETTING: The Cape Town International Convention Centre was the first location in Cape Town to be commissioned as a field hospital that would serve as an intermediate care bed facility. METHODS: This was a retrospective descriptive study of patients admitted to this facility between 8th June 2020 and 14th August 2020 using deidentified data extracted from patient records. RESULTS: There were 1502 patients admitted, 56.4% female, with a mean age of 58.6 years (standard deviation [s.d.]: 14.2). The majority of patients (82.9%) had at least one comorbidity, whilst 15.4% had three or more. Nearly 80.0% (79.8%) of patients required oxygen and 63.5% received steroids, and only 5.7% of patients were required to be transferred for escalation of care. The mean length of stay was 6 days (s.d.: 4.8) with an overall mortality of 5.7%. CONCLUSION: This study highlights the role of a field hospital in providing surge capacity. Its use halved the predicted duration of stay at acute care hospitals, allowing them the capacity to manage more unstable and critical patients. Adaptability and responsivity as well as adequate referral platforms proved to be crucial. Daily communication with the whole health care service platform was a critical success factor. This study provides information to assist future health planning and strategy development in the current pandemic and future disease outbreaks.


Subject(s)
COVID-19 , Female , Humans , Male , Middle Aged , Mobile Health Units , Retrospective Studies , SARS-CoV-2 , South Africa/epidemiology , United States
4.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Oct 26.
Article in English | MEDLINE | ID: covidwho-1073607

ABSTRACT

This short report captures the week-by-week reflections of a group of family physicians who joined the clinical and operational management teams tasked with providing the in-patient service of an 862-bed COVID-19 field hospital. The 'Hospital of Hope' at the Cape Town International Convention Centre (CTICC) was established as an intermediate care facility specifically to cope with the effects of the COVID-19 pandemic in Cape Town metropole. In an extraordinary feat of engineering, the conference centre floor was transformed within a matter of weeks into wards with piped oxygen at each bed. Whilst the emergency medicine specialists took the lead in designing and commissioning the facility, the medical management and staff were drawn mostly from family physicians. This report is a short reflection on the experience of the first 4 weeks of managing patients in this repurposed space. Our insights evolved during various formal and informal learning conversations as the in-patient service became more organised over time. We hope that these insights, as well as the process of reaching them, will assist other colleagues in serving their communities during this difficult moment in history; moreover, it may reflect a renewed appreciation for team-based interdisciplinary efforts in achieving person-centred care.


Subject(s)
Coronavirus Infections/therapy , Delivery of Health Care/methods , Hospitalization , Hospitals , Pandemics , Patient Care Team , Physicians, Family , Pneumonia, Viral/therapy , Betacoronavirus , COVID-19 , Case Management , Cities , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Emergency Medical Services , Humans , Mobile Health Units , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , South Africa/epidemiology
5.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Jul 15.
Article in English | MEDLINE | ID: covidwho-1073602

ABSTRACT

As the coronavirus disease 2019 (Covid-19) pandemic evolves globally, we are realising its impact on communities from the disease itself and the measures being taken to limit infection spread. In South Africa (SA), 62 300 adults die annually from alcohol-attributable causes. Alcohol-related harm can be reduced by interventions, such as taxation, government monopolising retail sales, outlet density restriction, hours of sales and an advertising ban. To mitigate the impact of the Covid-19 pandemic, SA instituted a lockdown that also prohibited alcohol sales. This led to a sharp reduction in unnatural deaths in the country from 800-1000/week to around 400/week during the lockdown. We reviewed three 2-week periods at a large rural regional hospital: Before Covid-19 (February), during social distancing (March) and during lockdown with alcohol ban (April). A dramatic drop in patient numbers from 145 to 64 (55.8%) because of assault, from 207 to 83 (59.9%) because of accidents, from 463 to 188 (59.4%) because of other injuries and from 12 to 1 (91.6%) because of sexual assaults was observed during the first 2 weeks of lockdown. As healthcare professionals, we need to advocate for the ban to remain until the crisis is over to ensure that health services can concentrate on Covid-19 and other patients. We encourage other African states to follow suit and implement alcohol restrictions as a mechanism to free up health services. We see this as an encouragement to lobby for a new normal around alcohol sales after the pandemic. The restrictions should focus on all evidence-based modalities.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Commerce/legislation & jurisprudence , Coronavirus Infections/epidemiology , Emergency Service, Hospital/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Cross-Sectional Studies , Humans , South Africa/epidemiology
6.
South African Journal of Science ; 116(7/8):1-2, 2020.
Article in English | WHO COVID | ID: covidwho-822299

ABSTRACT

As of early Jul 2020, the full force of COVID-19 has yet to strike in South Africa, though it has already impacted the economy further and disrupted the healthcare system. While much has been said about the former, with few exceptions, little has been discussed about the disruption to routine, essential healthcare services. The pandemic brings threats previously unknown and has reordered priorities for health. Hospitals have reprogrammed care units to accommodate COVID-19 patients, while others have temporarily closed. To date, government leadership has done a remarkable job of trying to limit the spread of SARS-CoV-2 infection by promoting the most effective prevention toolkit currently available--social-behavioral measures such as social distancing, handwashing and ensuring that transportation and workplaces apply safety protocols. Here, Ataguba et al discuss the challenges in addressing South Africa's quadruple disease.

SELECTION OF CITATIONS
SEARCH DETAIL