Challenge of Managing Hospitals during the COVID-19 Pandemic: A Qualita-tive Study

Marziyeh Najafi, Mohammad Arab, B. Pouragha, Morteza Nazari, Roya Rajaee, Masoumeh Vaziri-Seta, Mohsen Seyed Mahmoudi
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Abstract

Background: The COVID-19 pandemic has posed many challenges on the health system and hospitals to provide services. This study investigated the difference between factors affecting hospital management which considered in preparing a disaster management plan for hospital in the face of a pandemic based on the experiences of hospital managers. Methods: This qualitative research was conducted on selected hospitals affiliated in Alborz University of Medical Sciences in 2021. Data were gathered with purposive sampling and semi-structured interviews with 16 hospital managers. MAXQDA 10 and framework analysis were used to analyze the data. Results: The results were categorized in four categories: 1) Mitigation including staffing, bed capacity, enough space for quarantines, protective equipment, diagnosis and treatment equipment, funding, medicines, patient follow-up, management and leadership; 2) Preparedness such as crisis committee, preparedness and response plan, measures, action plan; 3) Response including motivating health workers, cooperation and coordination; 4) Recovery and lessons learned including providing facilities, expediting patient processes, control, economic conditions, and planning better, passive defense, regular crisis committee meetings, human resources, documentation and use of information systems in planning. Conclusion: In addition to providing the necessary infrastructure, it is important to plan for fair distribution of resources and effective supply chain management. A mechanism should also be developed at the national level to anticipate future health crises and to prevent and control diseases in the most effective way.  
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COVID-19 大流行期间医院管理面临的挑战:质量研究
背景:2019冠状病毒病大流行给卫生系统和医院提供服务带来了许多挑战。本研究调查了影响医院管理的因素之间的差异,这些因素是根据医院管理人员的经验在面对大流行时为医院制定灾害管理计划所考虑的。方法:选取阿尔博尔斯医科大学附属医院于2021年进行定性研究。通过有目的的抽样和对16家医院管理人员的半结构化访谈收集数据。采用MAXQDA 10和框架分析对数据进行分析。结果:结果分为四类:1)缓解措施包括人员配备、床位容量、足够的隔离空间、防护装备、诊疗设备、资金、药品、患者随访、管理和领导;2)准备工作,如危机委员会、准备和应对计划、措施、行动计划;3)应对措施,包括激励卫生工作者、合作和协调;4)恢复和经验教训,包括提供设施,加快病人流程,控制,经济条件和更好的计划,被动防御,定期危机委员会会议,人力资源,文件和计划中信息系统的使用。结论:除了提供必要的基础设施外,规划资源的公平分配和有效的供应链管理也很重要。还应在国家一级建立一种机制,以预测未来的健康危机,并以最有效的方式预防和控制疾病。
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