Modelo de evaluación del plan de respuesta frente a la pandemia de COVID-19 en un hospital de tercer nivel

Abstract

Background and purpose. During the first wave of the epidemic caused by SARS-CoV-2, hospitals have come under significant pressure. This scenario of uncertainty, low scientific evidence, and insufficient resources, has generated significant variability in practice between different health organisations. In this context, it is proposed to develop a standards-based model for the evaluation of the preparedness and response system against COVID-19 in a tertiary hospital. Materials and methods. The study, carried out at the University Hospital of Vall d'Hebron in Barcelona (Spain), was designed in two phases: 1) development of the standards-based model, by means of a narrative review of the literature, analysis of plans and protocols implemented in the hospital, a review process by expert professionals from the centre, and plan of action, and 2) validation of usability and usefulness of the model through self-assessment and hospital audit. Results. The model contains 208 standards distributed into 9 criteria: leadership and strategy; prevention and infection control; management of professionals and skills; public areas; healthcare areas; areas of support for diagnosis and treatment; logistics, technology and works; communication and patient care; and information and research systems. The evaluation achieved 85.2% compliance, with 42 areas for improvement and 96 good practices identified. Conclusions. Implementing a standards-based model is a useful tool to identify areas for improvement and good practices in COVID-19 preparedness and response plans in a hospital. In the current context, it is recommended to repeat this methodology in other non-hospital and public health settings.

How Much Dialogic Coordination Practices Matter to Healthcare Professionals—A Delphi Approach towards a Tool for Identification and Measurement

“…According to [21], although coordination is recognised as a central aspect in the literature on health system resilience and emergency management, there is very little scientific evidence on the subject. At the intra-organisational and team level, this also occurs [22,23], but there is clear evidence of the critical role of dialogue in the process of knowledge transformation and integration, the important role of informal coordination practices in contexts of high uncertainty, and the alternation between formal and informal coordination practices in FRO [5,6,8,10,24].…”