What Makes Health Systems More Susceptible To Error? Exploring The “Vulnerable System Syndrome” Case Study – Gross Negligence Manslaughter and The Case Against HBG

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Tim Ojo
Keyword(s):  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chiara Pomare ◽  
Kate Churruca ◽  
Janet C. Long ◽  
Louise A. Ellis ◽  
Jeffrey Braithwaite

Abstract Background Organisational change in health systems is common. Success is often tied to the actors involved, including their awareness of the change, personal engagement and ownership of it. In many health systems, one of the most common changes we are witnessing is the redevelopment of long-standing hospitals. However, we know little about how hospital staff understand and experience such potentially far-reaching organisational change. The purpose of this study is to explore the understanding and experiences of hospital staff in the early stages of organisational change, using a hospital redevelopment in Sydney, Australia as a case study. Methods Semi-structured interviews were conducted with 46 clinical and non-clinical staff working at a large metropolitan hospital. Hospital staff were moving into a new building, not moving, or had moved into a different building two years prior. Questions asked staff about their level of awareness of the upcoming redevelopment and their experiences in the early stage of this change. Qualitative data were analysed using thematic analysis. Results Some staff expressed apprehension and held negative expectations regarding the organisational change. Concerns included inadequate staffing and potential for collaboration breakdown due to new layout of workspaces. These fears were compounded by current experiences of feeling uninformed about the change, as well as feelings of being fatigued and under-staffed in the constantly changing hospital environment. Nevertheless, balancing this, many staff reported positive expectations regarding the benefits to patients of the change and the potential for staff to adapt in the face of this change. Conclusions The results of this study suggest that it is important to understand prospectively how actors involved make sense of organisational change, in order to potentially assuage concerns and alleviate negative expectations. Throughout the processes of organisational change, such as a hospital redevelopment, staff need to be engaged, adequately informed, trained, and to feel supported by management. The use of champions of varying professions and lead departments, may be useful to address concerns, adequately inform, and promote a sense of engagement among staff.


2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Victoria N. Mutiso ◽  
Christine W. Musyimi ◽  
Isaiah Gitonga ◽  
Albert Tele ◽  
Romaisa Pervez ◽  
...  

2002 ◽  
Vol 92 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Benjamin Loevinsohn ◽  
Bruce Aylward ◽  
Robert Steinglass ◽  
Ellyn Ogden ◽  
Tracey Goodman ◽  
...  

2019 ◽  
Vol 35 (3) ◽  
pp. 245-256 ◽  
Author(s):  
Manuela Colombini ◽  
Abdulsalam Alkaiyat ◽  
Amira Shaheen ◽  
Claudia Garcia Moreno ◽  
Gene Feder ◽  
...  

Abstract Domestic violence (DV) against women is a widespread violation of human rights. Adoption of effective interventions to address DV by health systems may fail if there is no readiness among organizations, institutions, providers and communities. There is, however, a research gap in our understanding of health systems’ readiness to respond to DV. This article describes the use of a health system’s readiness assessment to identify system obstacles to enable successful implementation of a primary health-care (PHC) intervention to address DV in the occupied Palestinian Territory (oPT). This article describes a case study where qualitative methods were used, namely 23 interviews with PHC providers and key informants, one stakeholder meeting with 19 stakeholders, two health facility observations and a document review of legal and policy materials on DV in oPT. We present data on seven dimensions of health systems. Our findings highlight the partial readiness of health systems and services to adopt a new DV intervention. Gaps were identified in: governance (no DV legislation), financial resources (no public funding and limited staff and infrastructure) and information systems (no uniform system), co-ordination (disjointed referral network) and to some extent around the values system (tension between patriarchal views on DV and more gender equal norms). Additional service-level barriers included unclear leadership structure at district level, uncertain roles for front-line staff, limited staff protection and the lack of a private space for identification and counselling. Findings also pointed to concrete actions in each system dimension that were important for effective delivery. This is the first study to use an adapted framework to assess health system readiness (HSR) for implementing an intervention to address DV in low- and middle-income countries. More research is needed on HSR to inform effective implementation and scale up of health-care-based DV interventions.


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