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1.
Pan Afr Med J ; 39: 91, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34466193

RESUMO

Introduction: Mozambique is one of the poorest nations in the world and its health budget is heavily dependent on external funding. Increasingly, donors prefer to direct their funds through international non-governmental organizations instead of direct donations to the State budget. In the current climate of increased emphasis on health system strengthening, a strong and stable partnership between government and international non-governmental organizations is pivotal for health system strengthening in Mozambique. Methods: the study evaluates the current partnership through a standardized survey to healthcare workers employed by international non-governmental organizations in health (INGO, private) and the ministry of health (MOH, public). Results of the survey have been analyzed only descriptively and no statistical evaluations have been performed. Results: out of the valid 109 responses obtained 55.1% were from MOH cadres and 45.0% from INGO cadres. Most have been in the health sector for more than 5 years. Most of the respondents recognize that INGOs assist the government in strengthening the health system (71.6%), see the internal brain drain to INGOs and salary scale difference as major problems (70.6% and 78.0%); 87.2% reported that the coordination between INGOs and government needs to be improved. MOH cadres perceived the migration of cadres to INGOs and the need for improving coordination as major issues more acutely than their INGO counterparts (80.0% vs. 59.2% and 88.3% vs. 85.7% respectively). INGOs were perceived to offer better quality health services by 51.4% of respondents (of these 69.4% were INGO respondents). The quality of health services was alike between INGOs and MOH for 33% of the respondents. Conclusion: through the various efforts outlined the MOH and INGOs are moving towards an environment of mutual accountability, joint planning and coordination as well as harmonization of activities; but there are still challenges to be addressed. Prioritization and increased funding of the planning unit and planning and cooperation directorate as well as strategies for workforce retention are urgently needed.


Assuntos
Atenção à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Organizações/organização & administração , Parcerias Público-Privadas/organização & administração , Estudos Transversais , Humanos , Agências Internacionais , Moçambique , Setor Privado , Setor Público , Qualidade da Assistência à Saúde , Inquéritos e Questionários
2.
Pan Afr Med J ; 38: 387, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381531

RESUMO

In sub-Saharan Africa, there is a significant unmet need for emergency care, with a shortage of trained providers. One model to increase the number of providers is to task-share: roles traditionally filled by clinicians are shared with lay workers who have received task-specific training. Separately, there has been much recent interest in the possible implications of artificial intelligence (AI) on healthcare. This paper proposes that, by combining the task-sharing model with AI, it is possible to design an Emergency Unit (EU) that shares the tasks currently undertaken by physicians and nurses with lay providers, with the activities of lay providers guided and supervised by AI. The proposed model would free emergency care clinicians to focus on higher-acuity and complex cases while AI-supervised routine care is provided by lay providers. The paper outlines the model for such an implementation and considers the potential benefits to patient care, as well as considering the risks, costs, effect on providers, and ethical questions. The paper concludes that AI and healthcare workers can operate as a team, with significant potential to augment human resources for health in sub-Saharan Africa.


Assuntos
Inteligência Artificial , Atenção à Saúde/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Pessoal de Saúde/organização & administração , África ao Sul do Saara , Humanos , Enfermeiras e Enfermeiros/organização & administração , Assistência ao Paciente/métodos , Médicos/organização & administração
3.
JAMA Netw Open ; 4(7): e2120295, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34236416

RESUMO

Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage. Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic. Evidence Review: A literature search in PubMed, MEDLINE, and Embase revealed 10 910 articles published between 2000 and 2021 that included the terms leadership and variations of emergency, crisis, disaster, pandemic, COVID-19, or public health. Using the Standards for Quality Improvement Reporting Excellence reporting guideline for consensus statement development, this assessment adopted a 6-round modified Delphi approach involving 32 expert coauthors from 17 countries who participated in creating and validating a framework outlining essential leadership imperatives. Findings: The 10 imperatives in the framework are: (1) acknowledge staff and celebrate successes; (2) provide support for staff well-being; (3) develop a clear understanding of the current local and global context, along with informed projections; (4) prepare for future emergencies (personnel, resources, protocols, contingency plans, coalitions, and training); (5) reassess priorities explicitly and regularly and provide purpose, meaning, and direction; (6) maximize team, organizational, and system performance and discuss enhancements; (7) manage the backlog of paused services and consider improvements while avoiding burnout and moral distress; (8) sustain learning, innovations, and collaborations, and imagine future possibilities; (9) provide regular communication and engender trust; and (10) in consultation with public health and fellow leaders, provide safety information and recommendations to government, other organizations, staff, and the community to improve equitable and integrated care and emergency preparedness systemwide. Conclusions and Relevance: Leaders who most effectively implement these imperatives are ideally positioned to address urgent needs and inequalities in health systems and to cocreate with their organizations a future that best serves stakeholders and communities.


Assuntos
COVID-19 , Pessoal de Saúde , Liderança , Pandemias , Consenso , Planejamento em Desastres , Pessoal de Saúde/legislação & jurisprudência , Pessoal de Saúde/organização & administração , Humanos , Modelos Organizacionais , SARS-CoV-2
4.
G Ital Cardiol (Rome) ; 22(8): 610-619, 2021 Aug.
Artigo em Italiano | MEDLINE | ID: mdl-34310563

RESUMO

The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic, new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.


Assuntos
COVID-19 , Cardiologia/organização & administração , Atenção à Saúde/organização & administração , Doenças Cardiovasculares/terapia , Pessoal de Saúde/organização & administração , Humanos , Itália , Programas Nacionais de Saúde/organização & administração
6.
Arq. ciências saúde UNIPAR ; 25(2): 161-166, maio-ago. 2021.
Artigo em Português | LILACS | ID: biblio-1252422

RESUMO

A função de gestor hospitalar é invariavelmente complexa, independentemente da região, de fato que, ainda em certos aspectos, os serviços de saúde são mais desafiadores em alguns países, devido à regulação de leitos, financiamento e tecnologias à disposição. Acrescenta-se à extensa relação de demandas gerenciais, a exigência por conhecimentos específicos na gestão dos recursos humanos e físicos. A influência do modelo fragmentado de organização do trabalho, em que cada profissional realiza parcelas do trabalho sem uma integração com as demais áreas envolvidas, tem sido apontada como uma das razões que dificultam a realização de um trabalho em saúde mais integrador e de melhor qualidade, tanto na perspectiva daqueles que o realizam como para aqueles que dele usufruem. A partir do momento em que profissionais de saúde, que trabalham diretamente com o paciente, ocupam coordenações, na medida em que ascendem na organização, passam a desempenhar mais tarefas administrativas. Como exemplo, é possível perceber que uma enfermeira ou médico que coordenam uma unidade de internamento, realizam mais funções administrativas e quase nenhuma técnica, usando seus conhecimentos técnicos para atuar na chefia. Esses profissionais, ao ocupar determinados cargos, nem sempre entendem das atividades administrativas. Com isso, o hospital perde um bom técnico e pode não ganhar um bom chefe. Este trabalho tem uma descrição reflexiva acerca do processo de gestão hospitalar.(AU)


The role of hospital manager is invariably complex, regardless of the region. In some countries, health services are even more challenging due to the regulation of beds, financing, and technologies available. In addition to the extensive list of managerial demands, there is also the requirement for specific knowledge in the management of human and physical resources. The influence of the fragmented model of work organization, where each professional performs portions of the work without integration with the other involved areas, has been pointed out as one of the reasons hindering the accomplishment of a more integrating and better-quality health work, both from the perspective of those who perform it and of those who use it. From the moment health professionals, who work directly with the patient, occupy managerial positions, as they ascend in the organization, they inevitably start to have more administrative tasks. As an example, it is possible to notice that a nurse or doctor who coordinates an inpatient unit performs more administrative functions and almost no technical ones. They use their technical expertise to act in managerial positions. These professionals, when occupying certain positions, are not always fully trained to understand administrative activities. Thus, the hospital ends up losing a good technician worker and may not always get a good manager in return. This work presents a reflexive description on the hospital management process.(AU)


Assuntos
Administração de Recursos Humanos , Planos e Programas de Saúde/organização & administração , Demandas Administrativas em Assistência à Saúde , Administração Hospitalar/tendências , Pessoal de Saúde/organização & administração
7.
J Oncol Pharm Pract ; 27(5): 1073-1079, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33983080

RESUMO

PURPOSE: In response to the COVID-19 pandemic, changes to chemotherapy services were implemented as a means of managing imposed workload strains within health services and protecting patients from contracting COVID-19. Given the rapidly evolving nature of the pandemic many changes were rapidly adopted and were not substantiated by robust evidence. This study aimed to describe the changes adopted internationally to chemotherapy services, which may be used to guide future changes to treatment delivery. METHODS: A survey was developed to understand the impact of COVID-19 on the delivery of systemic anti-cancer therapies (SACT). It comprised 22 questions and examined the strategies implemented during the pandemic to prioritise and protect patients receiving SACT and the participants' professional opinion of the strategies employed. The survey was available in English, Spanish and French and was distributed via professional bodies. RESULTS: 129 responses were obtained from healthcare professionals working across 17 different countries. 45% of institutions had to implement treatment prioritisation strategies and all hospitals implemented changes in the delivery of treatment, including: reduction in treatments (69%), using less immunosuppressive agents (50%), allowing treatment breaks (14%) and switching to oral therapies (45%). Virtual clinic visits were perceived by participants as the most effective strategy to protect patients. CONCLUSIONS: The pandemic has forced chemotherapy healthcare professionals to adopt new ways of working by reducing health interactions. Many areas of research are needed following this period, including understanding patients' perceptions of risks to treatment, utilisation of oral treatments and the impact of treatment breaks on cancer outcomes.


Assuntos
Antineoplásicos/administração & dosagem , COVID-19 , Pessoal de Saúde/organização & administração , Neoplasias/tratamento farmacológico , Humanos , Inquéritos e Questionários , Carga de Trabalho
8.
Pan Afr Med J ; 38: 233, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34046138

RESUMO

Across Africa, there is some evidence of COVID-19 private sector activities to tackle COVID-19 which include the development of rapid diagnostic kits, deployment of e-health platforms for bespoke health workforce training, disease surveillance, reporting, auto-screening and advisories. Inequities in living and access to care by disadvantaged populations in the rural areas have been ameliorated by multi-pronged responses such as that mounted by the Joseph Ukpo Hospitals and Research Institute (JUHRI) in Nigeria. The provision, production and donation of personal protective equipment (PPE), the production of hand sanitizers and the engagement of the local community in the process represents an effective strategy to contain COVID-19, protect health workers and provide pathways for economic support for people whose sources of income have been upended during the pandemic. The JUHRI experience underpinned by Catholic medical ethics provides concrete evidence of the value of private sector participation in dealing with public health emergencies.


Assuntos
COVID-19/epidemiologia , Atenção à Saúde/organização & administração , Setor Privado , COVID-19/prevenção & controle , Higienizadores de Mão , Pessoal de Saúde/organização & administração , Acesso aos Serviços de Saúde , Humanos , Nigéria , Equipamento de Proteção Individual , Saúde Pública , População Rural
9.
Bull World Health Organ ; 99(4): 312-318, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33953449

RESUMO

Since January 2020, the coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching impact on global morbidity and mortality. The effects of varying degrees of implementation of public health and social measures between countries is evident in terms of widely differing disease burdens and levels of disruption to public health systems. Despite Thailand being the first country outside China to report a positive case of COVID-19, the subsequent number of cases and deaths has been much lower than in many other countries. As of 7 January 2021, the number of confirmed COVID-19-positive cases in Thailand was 9636 (138 per million population) and the number of deaths was 67 (1 per million population). We describe the nature of the health workforce and function that facilitated the capacity to respond to this pandemic. We also describe the public health policies (laboratory testing, test-and-trace system and mandatory 14-day quarantine of cases) and social interventions (daily briefings, restriction of mobility and social gatherings, and wearing of face masks) that allowed the virus to be successfully contained. To enhance the capacity of health-care workers to respond to the pandemic, the government (i) mobilized staff to meet the required surge capacity; (ii) developed and implemented policies to protect occupational safety; and (iii) initiated packages to support morale and well-being. The results of the policies that we describe are evident in the data: of the 66 countries with more than 100 COVID-19-positive cases in health-care workers as at 8 May 2020, Thailand ranked 65th.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/organização & administração , Pessoal de Saúde/organização & administração , Política de Saúde , Técnicas e Procedimentos Diagnósticos , Humanos , Saúde Mental , Saúde do Trabalhador , Pandemias , SARS-CoV-2 , Tailândia
10.
Rural Remote Health ; 21(2): 6256, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33822637

RESUMO

CONTEXT: The COVID-19 outbreak at the North West Regional Hospital (NWRH) site in Tasmania, Australia in April 2020 was both rapid and tragic. Within 10 days of identification of the first healthcare worker infection, both hospitals had closed, and all patients were discharged or decanted to other facilities within the state. The entire hospital staff (approximately 1300 people) and their households (approximately 3000-4000 people) were furloughed for 14 days to halt the spread of infection. During the furlough period, a decommissioning, terminal clean and recommissioning process was undertaken alongside recovery and reorientation of the workforce to personal protective equipment. Within 4 days of closure, an Australian Defence Force and Australian Medical Assistance Team team opened the prioritised emergency department to provide emergency care for the local community, supported by modified diagnostic services. The decommissioning and cleaning rolled on over the ensuing month, in a predetermined priority order. As staff returned from quarantine, they recommissioned their clinical areas. The final ward, a modified medical isolation wing, reopened on day 29. ISSUE: Disaster management activities may be grouped under four main headings: prevention, preparedness, response and recovery. There are many opportunities for improvement and learning, and this article focuses on the local response and recovery, describing the process undertaken from the perspective of a small management group. Authors CC, HE, TB and MW were on the ground during the decommissioning process, then managed aspects of the cleaning and recommissioning remotely from furlough. Authors TA and TC provided specialist IPC support and developed education remotely. LESSONS LEARNED: Almost 2 months on, no new COVID-19 infections had been reported. The aim of this article is to provide a foundation for site-specific adaptation to include in pandemic escalation plans in other regional and rural settings.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde/organização & administração , Hospitais/estatística & dados numéricos , Controle de Infecções/organização & administração , Pandemias , Quarentena/métodos , Recursos Humanos/organização & administração , Humanos , Tasmânia/epidemiologia
11.
Pediatr Emerg Care ; 37(5): 286-289, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33903290

RESUMO

BACKGROUND: The coronavirus disease 2019 pandemic has challenged hospitals and pediatric emergency department (PED) providers to rapidly adjust numerous facets of the care of critically ill or injured children to minimize health care worker (HCW) exposure to severe acute respiratory syndrome coronavirus 2. OBJECTIVE: We aimed to iteratively devise protocols and processes that minimized HCW exposure while safely and effectively caring for children who may require unanticipated aerosol-generating procedures. METHODS: As part of our PED's initiative to optimize clinical care and HCW safety during the coronavirus disease 2019 pandemic, regular multidisciplinary systems and process simulation sessions were conducted. These sessions allowed us to evaluate and reorganize patient flow, test and improve communication modalities, alter the process for consultation in resuscitations, and teach and reinforce the appropriate donning and use of personal protective equipment. RESULTS: Simulation was a highly effective method to disseminate new practices to PED staff. Numerous workflow modifications were implemented as a result of our in situ systems and process simulations. Total number of persons in the resuscitation room was minimized, use of a "command post" with remote providers was initiated, communication devices and strategies were trialed and adopted, and personal protective equipment standards that optimized HCW safety and communication were enacted. CONCLUSIONS: Simulation can be an effective and agile tool in restructuring patient workflow and care of the most critically ill or injured patients in a PED during a novel pandemic.


Assuntos
COVID-19/terapia , Simulação por Computador , Serviço Hospitalar de Emergência/organização & administração , Pessoal de Saúde/organização & administração , Pandemias , Equipamento de Proteção Individual/provisão & distribuição , Ressuscitação/métodos , COVID-19/epidemiologia , Criança , Humanos
12.
J Patient Saf ; 17(4): 256-263, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33797460

RESUMO

OBJECTIVES: This study aimed to determine the strategies used and critical considerations among an international sample of hospital leaders when mobilizing human resources in response to the clinical demands associated with the COVID-19 pandemic surge. METHODS: This was a cross-sectional, qualitative research study designed to investigate strategies used by health system leaders from around the world when mobilizing human resources in response to the global COVD-19 pandemic. Prospective interviewees were identified through nonprobability and purposive sampling methods from May to July 2020. The primary outcomes were the critical considerations, as perceived by health system leaders, when redeploying health care workers during the COVID-19 pandemic determined through thematic analysis of transcribed notes. Redeployment was defined as reassigning personnel to a different location or retraining personnel for a different task. RESULTS: Nine hospital leaders from 9 hospitals in 8 health systems located in 5 countries (United States, United Kingdom, New Zealand, Singapore, and South Korea) were interviewed. Six hospitals in 5 health systems experienced a surge of critically ill patients with COVID-19, and the remaining 3 hospitals anticipated, but did not experience, a similar surge. Seven of 8 hospitals redeployed their health care workforce, and 1 had a redeployment plan in place but did not need to use it. Thematic analysis of the interview notes identified 3 themes representing effective practices and lessons learned when preparing and executing workforce redeployment: process, leadership, and communication. Critical considerations within each theme were identified. Because of the various expertise of redeployed personnel, retraining had to be customized and a decentralized flexible strategy was implemented. There were 3 concerns regarding redeployed personnel. These included the fear of becoming infected, the concern over their skills and patient safety, and concerns regarding professional loss (such as loss of education opportunities in their chosen profession). Transparency via multiple different types of communications is important to prevent the development of doubt and rumors. CONCLUSIONS: Redeployment strategies should critically consider the process of redeploying and supporting the health care workforce, decentralized leadership that encourages and supports local implementation of system-wide plans, and communication that is transparent, regular, consistent, and informed by data.


Assuntos
COVID-19/terapia , Atenção à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Liderança , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Humanos , Nova Zelândia/epidemiologia , Pesquisa Qualitativa , República da Coreia/epidemiologia , Singapura/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
13.
Pan Afr Med J ; 38: 129, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33912299

RESUMO

COVID-19 is the disease caused by SARS-CoV-2, one of a large family of coronaviruses. Severe forms of the disease can lead to respiratory failure with multiple organ failure necessitating rehabilitation in both acute and long-term care. With the increasing prevalence of COVID-19 and rehabilitation needs, the African Rehabilitation Network (AFRENET) produced a guidance document to assist in reducing variation in clinical practice among rehabilitation professionals in the Africa Region. This report outlines the process of the guideline development.


Assuntos
COVID-19/reabilitação , Pessoal de Saúde/organização & administração , Guias de Prática Clínica como Assunto , África , Humanos
14.
Am J Manag Care ; 27(4): e135-e136, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33877781

RESUMO

OBJECTIVES: To describe a complete panel of actions of the Service de Santé des Armées (SSA) (ie, French Military Health Service) that together contributed to prevent French health system saturation during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: Observational retrospective study. METHODS: Actions taken by military practitioners in the Parisian military hospitals, which contained 500 beds, to fight COVID-19 were listed and described. RESULTS: The Parisian military hospitals were fully reorganized to offer 147% more intensive care unit beds and took care of 665 inpatients with COVID-19 while continuing their core mission of war-wounded military care. A strategy to prioritize the use of medicine and medical devices was designed to avoid shortages. Field intensive care unit deployment and airborne collective medical evacuation by the SSA's MoRPHEE system avoided hospital saturation. CONCLUSIONS: Key facets of this achievement were interunit collaboration, esprit de corps, and health workers' adaptability. Small hospitals can provide a coherent answer to the COVID-19 pandemic, as long as they organize and prioritize the patients' care.


Assuntos
COVID-19/prevenção & controle , Hospitais Militares/organização & administração , França/epidemiologia , Pessoal de Saúde/organização & administração , Humanos , Unidades de Terapia Intensiva/organização & administração , Estudos Retrospectivos , SARS-CoV-2
15.
Nutr. hosp ; 38(n.extr.1): 41-45, abr. 2021.
Artigo em Inglês | IBECS | ID: ibc-201895

RESUMO

The debate from the course preceding the SENPE (Spanish Society of Clinical Nutrition and Metabolism) 2020 Conference gathered together well-known professionals who form part of nutritional support teams (NSTs), as well as other specialists from departments whose patients benefit from the services offered by these NSTs. In this article, relevant points from the round table, including strengths and weaknesses detected in the implementation of nutrition support teams, are summarized


El debate del curso previo al congreso de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) 2020 reunió en una mesa redonda a profesionales de prestigio que forman parte de unidades de nutrición y dietética, y a otros especialistas de servicios cuyos pacientes se benefician de los servicios de estas unidades. En este artículo se muestran los puntos relevantes que se trataron en el mismo y se muestran algunas fortalezas y debilidades que se han detectado en la implementación de las unidades de nutrición


Assuntos
Humanos , Grupos Focais , Pandemias , Infecções por Coronavirus/dietoterapia , Apoio Nutricional , Sociedades Médicas/organização & administração , Pessoal de Saúde/organização & administração , Implementação de Plano de Saúde/organização & administração , Dietoterapia/métodos
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48067

RESUMO

O Dia Mundial da Obesidade, que acontece nesta quinta-feira (4/3), relembra as pessoas anualmente sobre os riscos que esta condição traz à saúde e a importância das medidas para a prevenção e cuidado aos indivíduos com obesidade


Assuntos
Obesidade/prevenção & controle , Pessoal de Saúde/organização & administração , Manejo da Obesidade
17.
J Child Adolesc Psychiatr Nurs ; 34(3): 225-235, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33738882

RESUMO

INTRODUCTION: The coronavirus disease 2019 pandemic has necessitated significant changes in working practices across healthcare services. The current study aimed to assess the wellbeing of health professionals and quantify the adaptations to working practices in a Child and Adolescent Mental Health Service (CAMHS) during the pandemic. METHOD: The study was conducted in a UK CAMH team six weeks into lockdown measures. All clinicians were invited to complete a survey eliciting their experiences of working practices during the pandemic, degree of worry about the virus and mental wellbeing. RESULTS: Clinicians had significantly lower levels of mental wellbeing during the pandemic than population normative data, to the extent that some clinicians were classified as at heightened risk of depression. A significant shift to remote working, reduction in face-to-face appointments, and decrease in clinicians' perceived ability to undertake clinical tasks was observed. Themes emerging from clinicians' experiences of working during the pandemic include being supported within the team, providing a service, working adaptations, and working as a team. A further theme highlights the needs of clinicians to complete their clinical role effectively. CONCLUSION: CAMHS clinicians require additional support, training, and guidance during a pandemic to promote mental wellbeing and effectiveness in completing clinical tasks.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , COVID-19/epidemiologia , Serviços de Saúde da Criança/organização & administração , Pessoal de Saúde , Serviços de Saúde Mental/organização & administração , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Atitude do Pessoal de Saúde , Criança , Controle de Doenças Transmissíveis , Feminino , Pessoal de Saúde/organização & administração , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Inquéritos e Questionários , Telemedicina/métodos , Telemedicina/organização & administração , Reino Unido , Adulto Jovem
18.
Int J Health Plann Manage ; 36(S1): 9-13, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33763920

RESUMO

COVID-19 has reinforced the centrality of health workers at the core of a well performing and resilient health system. It has concomitantly exposed the risks of staffing and skills shortages and the importance of protecting the health workforce. The present commentary focuses on highlighting some of the lessons learnt, challenges and future needs of the health workforce in Europe in the context of COVID-19. During the pandemic innovative and flexible approaches were implemented to meet increasing demand for health workers and new skills and responsibilities were adopted over a short period of time. We have seen the rapid adaptation and use of new technologies to deliver care. The pandemic has underlined the importance of valuing, protecting and caring for our health workforce and the need to invest appropriately and adequately in the health workforce to have sufficient, capable and well-motivated health workers. Some of the main challenges that lie ahead of us include the imperative for better investment, to need to improve recruitment and retraining whilst better retaining health workers, a focus on domestic sustainability, redeploying and developing new skills and competences among health workers, enabling more effective multi-professional collaboration and team work, improving the quality of education and training, increasing the public health focus and promoting ethical and sustainable international recruitment of health workers. The WHO European Region through its European Programme of Work 2020-2025 is fully committed to support countries in their efforts to continue to respond to COVID-19 and whilst addressing upcoming health workforce challenges.


Assuntos
COVID-19 , Pessoal de Saúde/organização & administração , Pandemias , Desenvolvimento de Pessoal , Europa (Continente) , Humanos , SARS-CoV-2
19.
BMC Pregnancy Childbirth ; 21(Suppl 1): 233, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33765963

RESUMO

BACKGROUND: Policymakers need regular high-quality coverage data on care around the time of birth to accelerate progress for ending preventable maternal and newborn deaths and stillbirths. With increasing facility births, routine Health Management Information System (HMIS) data have potential to track coverage. Identifying barriers and enablers faced by frontline health workers recording HMIS source data in registers is important to improve data for use. METHODS: The EN-BIRTH study was a mixed-methods observational study in five hospitals in Bangladesh, Nepal and Tanzania to assess measurement validity for selected Every Newborn coverage indicators. We described data elements required in labour ward registers to track these indicators. To evaluate barriers and enablers for correct recording of data in registers, we designed three interview tools: a) semi-structured in-depth interview (IDI) guide b) semi-structured focus group discussion (FGD) guide, and c) checklist assessing care-to-documentation. We interviewed two groups of respondents (January 2018-March 2019): hospital nurse-midwives and doctors who fill ward registers after birth (n = 40 IDI and n = 5 FGD); and data collectors (n = 65). Qualitative data were analysed thematically by categorising pre-identified codes. Common emerging themes of barriers or enablers across all five hospitals were identified relating to three conceptual framework categories. RESULTS: Similar themes emerged as both barriers and enablers. First, register design was recognised as crucial, yet perceived as complex, and not always standardised for necessary data elements. Second, register filling was performed by over-stretched nurse-midwives with variable training, limited supervision, and availability of logistical resources. Documentation complexity across parallel documents was time-consuming and delayed because of low staff numbers. Complete data were valued more than correct data. Third, use of register data included clinical handover and monthly reporting, but little feedback was given from data users. CONCLUSION: Health workers invest major time recording register data for maternal and newborn core health indicators. Improving data quality requires standardised register designs streamlined to capture only necessary data elements. Consistent implementation processes are also needed. Two-way feedback between HMIS levels is critical to improve performance and accurately track progress towards agreed health goals.


Assuntos
Coleta de Dados/estatística & dados numéricos , Documentação/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Assistência Perinatal/organização & administração , Sistema de Registros/estatística & dados numéricos , Bangladesh/epidemiologia , Confiabilidade dos Dados , Feminino , Pessoal de Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Morte Materna/prevenção & controle , Nepal/epidemiologia , Assistência Perinatal/estatística & dados numéricos , Morte Perinatal/prevenção & controle , Gravidez , Natimorto , Tanzânia/epidemiologia
20.
Am J Nurs ; 121(4): 50-55, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33755630

RESUMO

ABSTRACT: The COVID-19 pandemic has resulted in a significant increase in accommodation requests from employees seeking temporary alterations to or relief from their job demands. To maintain consistency and ensure a standard approach, Johns Hopkins Medicine established a COVID-19 Accommodation Review committee that includes experts from the occupational health, legal, and human resources departments, as well as an Americans with Disabilities Act coordinator. In this article, the authors describe the workflow and various components of their institution's accommodations review process, which has resulted in a more consistent and equitable approach to granting requests.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde/organização & administração , Saúde do Trabalhador , Política Organizacional , Administração de Recursos Humanos , COVID-19/prevenção & controle , COVID-19/transmissão , Humanos , Estados Unidos
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