| Autor: |
Gautier L; School of Public Health, Université de Montréal, Montréal, Quebec, Canada.; Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada.; Université Paris Cité, IRD, Inserm, Ceped, Paris, France., Noda S; Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan., Chabrol F; Université Paris Cité, IRD, Inserm, Ceped, Paris, France., David PM; Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada., Duhoux A; Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada., Hou R; Université Paris Cité, IRD, Inserm, Ceped, Paris, France., Rosana de Araújo Oliveira S; Department of Public Health, Instituto Aggeu Magalhães - Fiocruz, Pernambuco, Brazil., Traverson L; Université Paris Cité, IRD, Inserm, Ceped, Paris, France., Zinszer K; School of Public Health, Université de Montréal, Montréal, Quebec, Canada.; Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada., Ridde V; Université Paris Cité, IRD, Inserm, Ceped, Paris, France. |
| Abstrakt: |
In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals' governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hospital cases from four countries on different continents: Brazil, Canada, France, and Japan. Our study examined how governance strategies (e.g., special task forces, communications management tools, etc.) were perceived by hospital staff. Key findings from a total of 177 qualitative interviews with diverse hospital stakeholders were analyzed using three categories drawn from the European Observatory on Health Systems and Policies framework on health systems resilience during the COVID-19 pandemic: 1) delivering a clear and timely COVID-19 response strategy; 2) coordinating effectively within (horizontally) and across (vertically) levels of decision-making; and 3) communicating clearly and transparently with the hospital's diverse stakeholders. Our study gleaned rich accounts for these three categories, highlighting significant variations across settings. These variations were primarily determined by the hospitals' environment prior to the COVID-19 crisis, namely whether there already existed a culture of managerial openness (including spaces for social interactions among hospital staff) and whether preparedness planning and training had been routinely integrated into their activities. |
