Framing the pandemic: Multiplying “crises” in Dutch healthcare governance during the emerging COVID-19 pandemic

Graaff, B de; Huizenga, Sabrina; Bovenkamp, Hester van de; Bal, Roland

doi:10.1016/j.socscimed.2023.115998

Cited by 7 publications

(9 citation statements)

References 39 publications

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“…During the second wave, the shortage of staff aggravated as hospitals found physical space for additional "ventilated" beds on the regular wards. Besides, the pressure to continue providing essential and urgent non-COVID-19 care became much higher (de Graaff et al, 2023). Patients needing more invasive therapies, such as Optiflow ventilation, also require additional monitoring by staff, whereas these kinds of monitoring systems (and skills) are usually not available outside the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…In their report, "Dancing with the Virus", Dutch researchers identified five issues with the COVID-19 pandemic that needed to be balanced by governing bodies at the national, regional, and institutional levels: (1) availability of ICU capacity and PPE; (2) delayed care alongside coordinating and balancing COVID-19 and non-COVID-19 care; (3) the acute care chain (developing scenarios for a "code black"); (4) client representation (highlighting existing bottlenecks); and (5) burden on nurses (de Graaff et al, 2023). The aforementioned EuHPN field guide's insights highlight, in a similar fashion to De Graaff et al, that enhancing preparedness for future pandemics requires focus on a combination of elements.…”

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confidence: 99%

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Perspectives on Assessing the Flexibility of Hospitals for Crisis Mode Operations: Lessons From the COVID-19 Pandemic in the Netherlands

van Heel,

Pretelt,

Herweijer

et al. 2023

HERD

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Background: The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as rapidly increasing their intensive care unit capacity, enabling physical distancing measures, quickly converting to telehealth and telework practices, and above all, keeping patients and staff safe. Improving flexibility in hospital facility design and adaptability of hospital operations to function in “crisis mode” can be seen as ways of future-proofing for pandemics. In a design brief, flexibility is typically mentioned as an important target. Meanwhile, robustness of technical infrastructure is called for, and standardization at unit level with single-occupancy inpatient accommodation may be considered a way to enhance flexibility and adaptability in dealing with a surge in infectious patients. Aim: To future-proof facility design with pandemic preparedness and resilience in mind, this study evaluated what kinds of interventions were taken in Dutch hospital facilities and what perspectives need to be considered when hospitals operate in crisis mode. Methods: We have collected data from facility and estate professionals from 30 Dutch hospitals. Using a practice-based approach, in-depth interviewing helped uncover and compare successful operational strategies and design elements that provided the flexibility needed in the early stages of the recent crisis. Results: As we looked at existing facilities and alterations made to allow hospitals to operate during the COVID-19 pandemic, we discovered that staff availability and adaptability were deemed crucial. Conclusion: We add the perspective of staff as an essential factor to be considered when future-proofing hospital facility desigr crisis mode operation.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Perspectives on Assessing the Flexibility of Hospitals for Crisis Mode Operations: Lessons From the COVID-19 Pandemic in the Netherlands

van Heel,

Pretelt,

Herweijer

et al. 2023

HERD

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show abstract

“…The ability to broaden discussions and bring different perspectives to the fore is important especially during times of crisis in which the tendency is doing the opposite; namely arguing for de‐politization and letting ‘the experts’ decide. This tendency results in specific frames of the crisis to become dominant 25 . As these frames emphasize certain values at the cost of others they are in fact highly political in nature 31 .…”

Section: Discussionmentioning

confidence: 99%

“…The study started in March 2020 in a specific region in the Netherlands and, from September 2020, expanded to include two more regions and national level stakeholders as well. We elaborate on this broader study elsewhere 25 . One of the focus points of our research was the question if and how patients were represented in decision‐making.…”

Section: Methodsmentioning

confidence: 99%

“…We conducted a thematic analysis of the interview and focus group data 26 . This analysis was a combination of an inductive and deductive approach as these themes were partly grounded in the findings of our broader study 25 . The analysis came to focus on the themes of the language of ‘crisis’ and re‐framing, representatives’ dependent position, the diversity of their perspectives, the layered decision‐making structure, and strategies representatives used to influence decision‐making.…”

Section: Methodsmentioning

confidence: 99%

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The patient representation struggle during the COVID‐19 pandemic: Missed opportunities for resilient healthcare systems

van de Bovenkamp,

de Graaff,

Kalthoff

et al. 2023

Health Expectations

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BackgroundThe role of patient participation and representation during crises, such as the COVID‐19 pandemic, has been under‐researched. Existing studies paint a pessimistic picture of patient representation during the pandemic. However, there are indications that patient representatives have adapted to the new situation and can contribute to the resilience of healthcare systems. This paper aims to further explore the potential contribution of patient representatives for healthcare system resilience during the COVID‐19 pandemic.MethodsThe study used a qualitative approach. We conducted a thematic analysis on the following data: interviews with client council members (n = 32) and representatives from patient organizations (n = 6) and focus groups (n = 2) to investigate patient representation on both the national policy level and organizational level in the Netherlands.ResultsWe identified the crisis discourse, the dependent position, the diversity of patient perspectives and the layered decision‐making structure as themes that help to understand what made patient representation in pandemic times a struggle for national and local patient representatives. The analysis of the subjects these representatives put forward during decision‐making shows that their input can play an important role in broadening discussions, challenging decisions, and suggesting alternatives during a crisis. We identified several strategies (e.g., collaborating with other actors, proactively putting subjects on the policy agenda, finding new ways of contacting their ‘constituency’) used by the patient representatives studied to exert influence despite the difficulties encountered.ConclusionsThe struggle for patient representation during pandemic decision‐making is a missed opportunity for resilient healthcare systems as these representatives can play a role in opening up discussions and putting different perspectives to the fore. Moreover, the adaptive strategies used by representatives to influence decision‐making offer lessons for future representation activities. However, adaptations to the crisis decision‐making structure are also needed to enable patient representatives to play their role.Patient ContributionWe conducted interviews with patient representatives and discussed our preliminary findings with patient representatives during the focus groups. Zorgbelang, a patient organization supporting client councils and enabling and organizing patient participation for organizations and municipalities, was partner in this research and contributed to the interview guide, conducting interviews and focus groups. Additionally, the analysis made by the first author was discussed and refined multiple times with the partners of Zorgbelang and one of them co‐authored this paper.

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COVID futures: Social imaginaries of post-pandemic lives in Australia

Lupton

2024

Futures

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Framing the pandemic: Multiplying “crises” in Dutch healthcare governance during the emerging COVID-19 pandemic

Cited by 7 publications

References 39 publications

Perspectives on Assessing the Flexibility of Hospitals for Crisis Mode Operations: Lessons From the COVID-19 Pandemic in the Netherlands

Perspectives on Assessing the Flexibility of Hospitals for Crisis Mode Operations: Lessons From the COVID-19 Pandemic in the Netherlands

The patient representation struggle during the COVID‐19 pandemic: Missed opportunities for resilient healthcare systems

COVID futures: Social imaginaries of post-pandemic lives in Australia

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