Strategic planning and response to COVID-19 in a London emergency department

Whitwell, Kerrie; Maynard, Rachel; Barry, Natalia; Cowling, Victoria H.; Sood, Tara

doi:10.1136/emermed-2020-209797

Cited by 14 publications

(17 citation statements)

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“…After patients who visited emergency medical centers were confirmed with the infection, 2 regional emergency medical centers and r local emergency medical centers were temporarily shut down. [ 3 ] As COVID-19 accompanied several symptoms, it was difficult to differentiate patients with suspected infection, and there were no separate zones established to isolate patients besides a few existing isolation beds. Furthermore, because we could not accept new patients with suspected infection until test results of the patients already in the isolation beds were confirmed, the bed turnover rate also decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Patients suspected of having the infection were treated in the isolation zone, whereas those who are not suspected were instructed to enter the clean zone. Whitwell et al [ 3 ] documented the separation of isolation and clean zones in places with wide space available for patient care, and Chung et al [ 4 ] reported cases in which the area outside the ED was utilized to provide care for suspected patients or perform X-ray and cardiopulmonary resuscitation. Although we were able to isolate multiple patients as a cohort in the isolation zone, the COVID-19 screening test was time-consuming, and proactively isolating suspected patients as a cohort was associated with a risk of spreading the infection among these patients.…”

Section: Discussionmentioning

confidence: 99%

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Effects of dynamic response to coronavirus disease outbreak in a regional emergency medical center

Kim²,

Ko³

et al. 2021

Medicine

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Emergency departments (EDs) are on the frontline of the coronavirus disease (COVID-19) outbreak. To resolve the abrupt overloading of COVID-19–suspected patients in a community, each ED needs to respond in various ways. In our hospital, we increased the isolation beds through temporary remodeling and by performing in-hospital COVID-19 polymerase chain reaction testing rather than outsourcing them. The aim of this study was to verify the effects of our response to the newly developed viral outbreak. The medical records of patients who presented to an ED were analyzed retrospectively. We divided the study period into 3: pre-COVID-19, transition period of response (the period before fully implementing the response measures), and post-response (the period after complete response). We compared the parameters of the National Emergency Department Information System and information about isolation and COVID-19. The number of daily ED patients was 86.8 ± 15.4 in the pre-COVID-19, 36.3 ± 13.6 in the transition period, and 67.2 ± 10.0 in the post-response period ( P < .001). The lengths of stay in the ED were significantly higher in transition period than in the other periods [pre-COVID-19 period, 219.0 (121.0–378.0) min; transition period, 301 (150.0–766.5) min; post-response period, 281.0 (114.0–575.0) min; P < .001]. The ratios of use of an isolation room and fever (≥37.5°C) were highest in the post-response period [use of isolation room: pre-COVID-19 period, 0.6 (0.7%); transition period, 1.2 (3.3%); post-response period, 16.1 (24.0%); P < .001; fever: pre-COVID-19 period, 14.8(17.3%); transition period, 6.8 (19.1%); post-response period, 14.5 (21.9%), P < .001]. During an outbreak of a novel infectious disease, increasing the number of isolation rooms in the ED and applying a rapid confirmation test would enable the accommodation of more suspected patients, which could help reduce the risk posed to the community and thus prevent strain on the local emergency medical system.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of dynamic response to coronavirus disease outbreak in a regional emergency medical center

Kim²,

Ko³

et al. 2021

Medicine

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“…The gap identified from the review highlighted a need to focus on reviewing healthcare workers about who, how, and why they conduct strategy in hospitals. In light of the coronavirus disease 2019 (COVID-19) pandemic becoming the major disruptor for healthcare and hospital sites in particular (Bowman et al, 2020;Pellino et al, 2020;Staib & Small, 2020;Steier & Moxham, 2020;Whitwell et al, 2020;Zeng et al, 2020), it would be of benefit to examine the literature to see how hospitals conduct strategy, to inform future research in the field.…”

Section: Strategy In Different Organisational Sectorsmentioning

confidence: 99%

“…However, as we enter a new decade, hospitals are already struggling to cope with increasing service demands and activity. They need to become more responsive to changes in their environment and demonstrate more effective use of available resources (Bowman et al, 2020;Staib & Small, 2020;Steier & Moxham, 2020;Whitwell et al, 2020;Zeng et al, 2020). On an international level, growing numbers of hospitals within the public sector are empowered to develop their own strategic, financial and clinical directions, so they must be ready to redefine roles and set clear goals for service delivery (Saltman et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

'Strategy-as-practice' by hospital personnel in hospitals: a scoping review protocol

et al. 2021

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Background: Strategy in hospitals is based on distinct principles and rules which lead organisations to act on chosen priorities. Hospitals are struggling to cope with increasing service demands and activity and need to become more responsive to changing environments while demonstrating effective use of resources. Strategizing involves the active process of sensing, planning, implementing and evaluating strategy. Strategy-as-practice is concerned with what people do about strategy in an organisation, as opposed to the traditional focus on what the organisation has as a strategy. It is recognised that there is a disconnection between strategic planning and implementation, however little is known about how organisational context influences the strategic process or how hospital personnel engage in strategic activities. The aim of this scoping review is to explore the literature on strategizing by hospital personnel in hospitals, and will include literature for hospital both professional and managerial backgrounds, to establish the extent and breadth of strategizing or as it is often termed ‘strategy-as-practice’ in hospitals. Methods: The systematic scoping review will search the literature within the databases of PubMed, Embase, CINAHL, PsycINFO, ABI/INFORM (Proquest) and OpenGrey.net to explore the scientific evidence on strategizing in hospitals. The review will be based on the Arksey & O’Malley (2005) framework of five mandatory steps which was updated (Levac et al 2010, Colquhoun et al 2014 & Peters 2015) and is published online by the Joanna Briggs Institute. It will follow the PRISMA-ScP reporting guidelines. Conclusion: A scoping review methodology will provide a framework to explore strategizing in hospitals comprehensively and map the body of literature for this subject, which has not been conducted previously. This review will summarise the evidence on the use of strategy as practice in hospitals. Based on the findings we will identify knowledge gaps and areas for future research.

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“…Nowadays the afore mentioned propositions require more intense attention, since our experience from CoViD-19 pandemic, demonstrated globally that the current organisation of public health sector poses obstacles for the management and must be reorganized with the application of horizontal procedures which should overcome the slow bureaucratic rhythms and the conventional hierarchical system structure (Whitwell, Maynard, Barry, Cowling, & Taraet, 2020). An important factor towards success, by implementing lean management or other organisational changes, is the existence of efficient and competent managers who promote collective work (Kotter, 1996;Diefenbach, 2013;Lytras, 2016: p. 40) while at the same time, we must bear in mind that professionally defined strategies, "resting upon clearly defined laws, rules, and principles, as a foundation" and under "complete written instructions" (Taylor, 2003: pp.…”

Section: Theoretical Framework-setting the "Lean" Scenementioning

confidence: 99%

Organisational Change in Greece: Exploring Bottlenecks in Public Sector’s Hospital Management

Oikonomopoulou¹

2021

JSS

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During the last twenty years, Greek governments have been announcing, using a plethora of synonyms, such as "modernization, upgrade, reform, transformation", changes in the public health sector. However, the pathogenic bureaucratic model still exists in public hospitals as well, as shown in the relevant literature, albeit the lack of research regarding hospital managers and the need for organisational change. This study focuses through theoretical triangulation on lean management model advantages and explores via empirical research on the bottlenecks in hospital's management social mission. By shedding light on managers profile the paper sought to assess their ability to imagine-capture new organisational structures, to think lean, and guide future action for the fulfillment of human needs and values in healthcare delivery in the country.

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Strategic planning and response to COVID-19 in a London emergency department

Cited by 14 publications

References 0 publications

Effects of dynamic response to coronavirus disease outbreak in a regional emergency medical center

Effects of dynamic response to coronavirus disease outbreak in a regional emergency medical center

'Strategy-as-practice' by hospital personnel in hospitals: a scoping review protocol

Organisational Change in Greece: Exploring Bottlenecks in Public Sector’s Hospital Management

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