Organisational responses to mitigate the effects of COVID-19 on healthcare workers: a qualitative case study from Bogotá, Colombia

Abstract

Background Healthcare organisations have undergone organisational change to respond to COVID-19. This pandemic has presented challenges for employee adjustment, with impacts on the availability and coordination of human resources in healthcare. This study aimed to characterise the organisational actions regarding the coordination of human resources in healthcare within Bogotá, Colombia, to respond to the COVID-19 pandemic. Methods We followed a case study approach to understand the response to the emergency taking into account the narratives of managerial actors who have been directly involved in the planning of guidelines oriented to face the pandemic or in the implementation of health services for COVID-19. Twenty-two interviews with multiple health system organisations within Bogotá were conducted between May and September 2020 and analysed thematically. Results Three themes emerged from the analysis of the interview data: to retain human resources, to implement actions to improve the mental and physical health of the healthcare workers, and to enhance healthcare workers knowledge, skills and availability to respond to COVID-19. Conclusions Organisational actions led by hospital managers to retain, protect, and train human health resources in the dynamic context of the COVID-19 pandemic were identified. Other system-wide organisations like scientific associations contributed to the coordination of human resources across hospitals to respond to COVID-19 in Bogotá, Colombia. The actions of hospital managers, and roles of system-wide intermediary organisations, in coordinating human resources need to be explored in other health system contexts facing COVID-19.

Lessons from the frontline: The COVID-19 pandemic emergency care experience from a human resource perspective in the Pacific region

“…Consistent with the handful of qualitative studies on HCWs responding to the COVID-19 crisis in LMICs (e.g. Colombia, Nepal, Iran, China, Indonesia, Brazil, Sri Lanka) and high-income nations, 12 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 we found Pacific EC and other frontline HCWs experienced physical exhaustion and mental health challenges exacerbated by workforce shortages, being stretched well-beyond capacity, limited access to mental health services, lack of appropriate compensation and incentive, and the experience of isolation, stigma and discrimination from colleagues, family and community. Participants spoke of the overlapping personal and professional tensions they faced in protecting their family and local community from COVID-19, versus their duty to serve their patients, profession, and country.…”

“…‘Healthcare personnel-centric’ COVID-19 care policies – aiming to reduce risk of HCW infection, ensure HCW welfare and safety, and improve HCW willingness to present for duty – are lauded as complementing traditional ‘patient-centric’ pandemic management approaches. 5 Reports from Africa, 6 the Middle East, 7 , 8 Asia 9 , 10 , 11 and Latin America and the Caribbean 12 , 13 , 14 reinforce how HCWs operating in diverse systems and settings are putting their physical and mental health and wellbeing – and lives – on the line to counter COVID-19 outbreak, transmission, morbidity and mortality in local populations. The ethical, place-based tensions, stigma, and moral conflict overstretched HCWs face are increasingly documented.…”

Resilience of the primary health care system – German primary care practitioners’ perspectives during the early COVID-19 pandemic

“…In terms of triangulation, the role of the ASHIP in setting up the Corona contact points showed itself to be more pronounced in the survey conducted by us in Baden-Wuerttemberg [ 20 ]. When looking specifically at the relevance of the stakeholders, the necessity of including them at the organizational level becomes clear [ 31 , 34 ], and across states the importance of inter-organizational collaboration to manage the COVID-19 pandemic is confirmed [ 8 , 15 , 16 , 31 ].…”

“…Primary care is a part of the health care system that is a relevant pillar in the management of medical crises, including the current COVID-19 pandemic [6][7][8][9][10]. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system that are the subject of diverse qualitative and quantitative studies across the globe [7,[11][12][13][14][15][16].…”

The Role of Intersectoral Action in Response to COVID-19: A Qualitative Study of the Roles of Academia and the Private Sector in Colombia

“…Such work might examine the potential impact on the wellbeing of rankand-file staff in universities associated with responding to COVID-19, to see how this compares with the impact on those involved on the front-line in the delivery of health services, for example, stress and burnout in both sectors has been reported. [44][45][46] Observation of practices of intersectoral activity could not be undertaken, as collecting primary data needed to respect physical distancing measures. As we only conducted online interviews, the study reflected narration through actors' voices, which can be considered as a limitation because the actors' accounts have not been triangulated with other data (eg, observations of meetings).…”