The art and science of achieving zero COVID-19 transmissions in staff at a large community care facility in Singapore using implementation science: a retrospective analysis
| Autor: | Nigel Ck Tan, Arif Tyebally, Weien Chow, Lai Chee Lee, Moi Lin Ling, Sze Ling Chan, Elaine Lum, Hiang Khoon Tan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Medical education
Teamwork General Immunology and Microbiology business.industry media_common.quotation_subject 010102 general mathematics Collaborative learning General Medicine Audit 01 natural sciences General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Work (electrical) Transparency (graphic) Health care 030212 general & internal medicine Business 0101 mathematics General Pharmacology Toxicology and Pharmaceutics Baseline (configuration management) PDCA media_common |
| Zdroj: | F1000Research. 10:212 |
| ISSN: | 2046-1402 |
| Popis: | Background:The Singapore COVID-19 multi-ministry taskforce commissioned community care facilities (CCFs) as a hospital-sparing strategy amidst rising coronavirus disease 2019 (COVID-19) cases. An exhibition centre was repurposed within ten days as an ad-hoc 3200-bed medical facility (CCF@EXPO) to isolate and treat infected patients amidst concerns of potential COVID-19 transmissions to healthcare staff. This paper deconstructs the implementation of the CCF@EXPO infection prevention and control (IPC) innovation and elicits critical factors which enabled zero transmission of COVID-19 to staff during 100 days of operation using an implementation science framework.Methods:This study employed retrospective analysis using the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. The CCF@EXPO IPC innovation comprised five key elements: (a) physical environment, (b) work practices, (c) tools and technology, (d) staff training, and (e) audits. Contextual assessment was conducted for baseline and 100thday of CCF@EXPO operations. Actions taken to improve scores between these timepoints were mapped against the Expert Recommendations for Implementing Change (ERIC) tool to surface key implementation strategies.Results:Positive shifts were observed in all constructs of the i-PARIHS framework, between baseline and 100thday. The largest shifts were in work practices, tools and technology, and staff training. Key implementation strategies used included: rapid Plan-Do-Study-Act (PDSA) cycles, identifying champions, team building, creating a culture of collaborative learning, multi-disciplinary teamwork, transparency in communications and decision-making, and skillful facilitation.Conclusions:Rapid PDSA cycles anchored by principles to ensure staff safety, was the key approach used in implementation of the CCF@EXPO IPC innovation. Retrospective analysis using the i-PARIHS framework is useful to elicit success factors and to inform preparedness planning of future pandemics. |
| Databáze: | OpenAIRE |
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