Learning from the resilience of hospitals and their staff to the COVID-19 pandemic: a scoping review.

BackgroundThe COVID-19 pandemic has brought huge strain on hospitals worldwide. It is crucial that we gain a deeper understanding of hospital resilience in this unprecedented moment. This paper aims to report the key strategies and recommendations in terms of hospitals and professionals resilience to the COVID-19 pandemic, as well as the quality and limitations of research in this field at present. MethodsWe conducted a scoping review of evidence on the resilience of hospitals and their staff during the COVID-19 crisis in the first half of 2020. The Stephen B. Thacker CDC Library website was used to identify papers meeting the eligibility criteria, from which we selected 65 publications. After having extracted data, we presented the results synthesis using an "effects-strategies-impacts" resilience framework. ResultsWe found a wealth of research rapidly produced in the first half of 2020, describing different strategies used to improve hospitals resilience, particularly in terms of 1) planning, management, and security, and 2) human resources. Research focuses mainly on interventions related to healthcare workers well-being and mental health, protection protocols, space reorganization, personal protective equipment and resources management, work organization, training, e-health and the use of technologies. Hospital financing, information and communication, and governance were less represented in the literature. ConclusionThe selected literature was dominated by quantitative descriptive case studies, sometimes lacking consideration of methodological limitations. The review revealed a lack of holistic research attempting to unite the topics within a resilience framework. Research on hospitals resilience would benefit from a greater range of analysis to draw more nuanced and contextualized lessons from the multiple specific responses to the crisis. We identified key strategies on how hospitals maintained their resilience when confronted with the COVID-19 pandemic and a range of recommendations for practice.

Lessons learned from the resilience of Chinese hospitals to the COVID-19 pandemic: a scoping review.

As the SARS-CoV-2 pandemic has brought huge strain on hospitals worldwide, the resilience shown by Chinas hospitals appears to have been a critical factor in their successful response to the pandemic. This paper aims to determine the key findings, recommendations and lessons learned in terms of hospital resilience during the pandemic, as well as the quality and limitations of research in this field at present. We conducted a scoping review of evidence on the resilience of hospitals in China during the COVID-19 crisis in the first half of 2020. Two online databases (the CNKI and WHO databases) were used to identify papers meeting the eligibility criteria, from which we selected 59 publications (English: n= 26; Chinese: n= 33). After extracting the data, we present an information synthesis using a resilience framework. We found that much research was rapidly produced in the first half of 2020, describing certain strategies used to improve hospital resilience, particularly in three key areas: human resources; management and communication; and security, hygiene and planning. Our search revealed that considerable attention was focused on interventions related to training, healthcare worker well-being, e-health/ telemedicine, and work organization, while other areas, such as hospital financing, information systems and healthcare infrastructure, were less well represented in the literature. We identified a number of lessons learned regarding how Chinas hospitals have maintained resilience when confronted with the SARS-CoV-2 pandemic. However, we also noted that the literature was dominated by descriptive case studies, often lacking consideration of methodological limitations, and that there was a lack of both highly-focused research on individual interventions and holistic research that attempted to unite the topics within a resilience framework. Research on Chinese hospitals would benefit from a greater range of analysis in order to draw more nuanced and contextualised lessons from the responses to the crisis.

A rapid review of equity considerations in large-scale testing campaigns during infectious disease epidemics

ContextLarge-scale testing is an intervention that is instrumental for infectious disease control and a central tool for the COVID-19 pandemic. Our rapid review aimed to identify if and how equity has been considered in large-scale testing initiatives. MethodsWe searched Web of Science and PubMed in November 2020 and followed PRISMA recommendations for scoping reviews. Articles were analyzed using descriptive and thematic analysis. ResultsOur search resulted in 291 studies of which 41 were included for data extraction after full article screening. Most of the included articles (83%) reported on HIV-related screening programs, while the remaining programs focused on other sexually transmitted infections (n=3) or COVID-19 (n=4). None of the studies presented a formal definition of (in)equity in testing, however, 23 articles did indirectly include elements of equity in the program or intervention design, largely through the justification of their target population. ConclusionThe studies included in our rapid review did not explicitly consider equity in their design or evaluation. It is imperative that equity is incorporated into the design of infectious disease testing programs and serves as an important reminder of how equity considerations are needed for SARS-CoV-2 testing and vaccination programs.