“Building the plane while flying it” Reflections on pandemic preparedness and response; an organisational case study.

Publication date: Sep 01, 2023

The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader’s perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers. This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses. Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear ‘my job is going to kill me’, (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment. Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation.

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Concepts Keywords
Australia Background
Healthcare COVID-19
Interviews Hospital
Pandemic Leadership


Type Source Name
disease MESH COVID-19 pandemic
disease VO time
disease MESH infection
drug DRUGBANK Coenzyme M
pathway REACTOME Reproduction
disease VO population
disease VO organization
drug DRUGBANK Etoperidone
disease MESH emergency
disease IDO process
drug DRUGBANK Serine
disease MESH Infectious Diseases
drug DRUGBANK Methylergometrine
disease VO volume
disease IDO pathogen
disease MESH influenza
disease VO efficient
drug DRUGBANK Nonoxynol-9
disease VO Thing
disease IDO history
drug DRUGBANK Polyethylene glycol
drug DRUGBANK Dacarbazine
drug DRUGBANK Isoxaflutole
disease VO document
drug DRUGBANK Trestolone
disease MESH panic
drug DRUGBANK Aspartame
disease VO vaccinated
disease MESH measles
pathway KEGG Measles
disease MESH uncertainty
drug DRUGBANK Indoleacetic acid
disease VO frequency
drug DRUGBANK Methionine
disease VO vaccination
drug DRUGBANK Tropicamide
disease VO Gap
disease IDO infectious disease
disease MESH paranoia
disease MESH mania
disease VO organ
disease IDO site
drug DRUGBANK Water
disease VO LACK
drug DRUGBANK Naproxen
disease VO storage
drug DRUGBANK Hexadecanal
disease VO Ply
disease IDO contact tracing
drug DRUGBANK Stavudine
disease VO effectiveness
disease VO protocol
drug DRUGBANK Gold
drug DRUGBANK Pentaerythritol tetranitrate

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