Towards a liquid healthcare: primary care organisational and management strategies during the COVID-19 pandemic - a qualitative study

Abstract

Background The COVID-19 pandemic has changed the organisational and management strategies of healthcare institutions such as primary care centres. Organisational culture as well as leadership style are key issues for the success of these institutions. Due to the multidimensional nature of identity processes, it is necessary to explore the changes experienced by health professionals from these perspectives. This study explores health professionals’ organisational and management strategies in primary care settings during the COVID-19 pandemic. Design Qualitative, exploratory study based on the analysis of participants’ accounts within a hermeneutic phenomenologicaly approach. Methods Research was conducted in primary care settings in two neighbouring Spanish healthcare regions. The sample included participants with different demographics (gender, age), professional roles (practice managers, general practitioners, paediatricians), employment status (permanent, temporary, zero-hours), and years of experience (under or over ten years’ experience). Data were collected between July and December 2020 through focus groups and in-depth, semi-structured individual interviews. Results A total of 53 primary care workers participated in the study, of which 38 were individually interviewed and 15 participated in three focus groups. Of these, 78.4% were healthcare professionals, 49% were female nurses, and 70.5% had more than 10 years of work experience in primary care. Two main themes emerged: “liquid” healthcare and “the best healthcare system in the world”. During the first wave of the COVID-19 pandemic, new, more fluid organisational and management models were implemented in primary care settings, which have remained in place since. Primary care workers’ perceived a lack of appreciation and inclusion in decision-making that risked their alienation and disengagement. Conclusion Primary care workers’ professional identity became gradually blurred due to shifting perceptions of their professional roles in a context of increasing improvisation and flexible working practices. This affected their professional performance. Trial Registration The study was approved by the Clinical Research Ethical Committee of the Talavera de la Reina Integrated Management Area (CEIm del AGI de Talavera de la Reina in Spain, Hospital Nuestra Señora del Prado, ref: 23/2020).

Influence of the Sanitary, Economic, and Social Crisis of COVID-19 on the Emotional State of Dentistry in Galicia (Spain)

“…The SARS-CoV-2 pandemic has changed the ways of life and social habits throughout much of the world and has generated significant cultural and emotional impacts. The pandemic has also highlighted the fragilities and weaknesses of society on a global scale, as well as its strengths, including the dedication of healthcare personnel, the work of research laboratories and pharmaceutical companies around the world, and the social collaboration in the face of this new situation that is fraught with social and emotional difficulties [ 1 ].…”