How Medical Studies in Poland Prepare Future Healthcare Managers for Crises and Disasters: Results of a Pilot Study

In the event of a crisis, rapid and effective assistance for victims is essential, and in many cases, medical assistance is required. To manage the situation efficiently, it is necessary to have a proactive management system in place that ensures professional assistance to victims and the safety of medical personnel. We evaluated the perceptions of students and graduates in public health studies at the Medical University of Lublin, Poland, concerning their preparation and management skills for crises such as the COVID-19 pandemic. This pilot study was conducted in March 2020; we employed an online survey with an anonymous questionnaire that was addressed to students and graduates with an educational focus in healthcare organization and management. The study involved 55 people, including 14 men and 41 women. Among the respondents, 41.8% currently worked in a healthcare facility and only 21.7% of them had participated in training related to preparation for emergencies and disasters in their current workplace. The respondents rated their workplaces’ preparedness for the COVID-19 pandemic at four points. A significant number of respondents stated that if they had to manage a public health emergency, they would not be able to manage the situation correctly and not be able to predict its development. Managers of healthcare organizations should have the knowledge and skills to manage crises. It would be advisable for them to have been formally educated in public health or healthcare administration. In every healthcare facility, it is essential that training and practice of performing medical procedures in full personal protective equipment (PPE) be provided. Healthcare facilities must implement regular training combined with practical live scenario exercises to prepare for future crises.

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Developing a Public Health Model for Regional Infection Prevention Collaboration Among Healthcare Facility Networks

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.725 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s187-s187

Author(s):

Erin P. Garcia ◽

Erin Epson

Keyword(s):

Public Health ◽

Infection Prevention ◽

Skilled Nursing Facility ◽

Healthcare Facility ◽

Professional Organization ◽

Healthcare Organizations ◽

California Department ◽

Local Public Health ◽

Healthcare Facilities ◽

Clostridioides Difficile

Background: Antimicrobial resistance (AR), including Clostridioides difficile infection (CDI), can spread across the healthcare continuum when patients move between facilities. In 2015, the CDC recommended that healthcare facilities (HCFs) and local public health departments (LPH) coordinate their efforts to prevent the spread of AR and CDI. Accordingly, the California Department of Public Health (CDPH) Healthcare-Associated Infections (HAI) Program developed a model for implementing regionally based AR/CDI prevention collaboratives within HCF networks. Methods: The CDPH HAI Program began identifying regions in California with high AR/CDI incidence or risk for AR/CDI emergence using NHSN data. During 2015–2019, we organized AR/CDI prevention collaboratives in these regions. We recruited HCFs for participation by presenting at local professional organization meetings and engaging skilled nursing facility corporate leadership. HAI Program infection preventionists conducted onsite infection prevention assessments at each participating HCF. HAI Program and LPH staff convened quarterly in-person learning and discussion sessions focused on infection prevention and antimicrobial stewardship best practices. Participating HCFs committed to facility-tailored process improvement plans and conducted self-assessments to evaluate infection prevention practice changes at the conclusion of the collaborative. For CDI-focused collaboratives, we used data reported to CDPH via NHSN to assess changes in hospital- and community-onset CDI incidence among participating hospitals before and after the collaboratives. Results: Since 2015, 205 HCFs in 15 LPH jurisdictions have participated in 6 regional AR/CDI prevention collaboratives. Participating HCFs reported improved implementation of AR/CDI prevention strategies. For CDI-focused collaboratives, hospital-onset CDI incidence decreased by ~3% per month among participating hospitals. The collaboratives created forums for communication and relationship building, which previously did not exist among LPH and the HCF networks. We used our experience and feedback from partners to develop an HAI Program AR Prevention Collaborative Tool Kit to help LPHs and healthcare organizations develop and implement regional AR/CDI prevention collaboratives in other at-risk or high AR/CDI prevalence areas in California. The tool kit includes materials developed for each of our collaboratives, which may be adapted to meet local needs. Conclusions: Regionally coordinated AR/CDI prevention initiatives among LPHs and HCFs can contribute to increased AR awareness, improved AR prevention practices, and decreased AR/CDI incidence. The effectiveness of regional AR/CDI prevention collaboratives may be the result of concurrent efforts to improve AR prevention practices both within individual HCFs and across patient sharing networks.Funding: NoneDisclosures: None

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BURNOUT AND SOURCES OF STRESS AMONG HEALTHCARE RISK MANAGERS & PATIENT SAFETY PERSONNEL DURING THE COVID-19 PANDEMIC: A PILOT STUDY

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.120 ◽

2021 ◽

pp. 1-9

Author(s):

Alan J. Card

Keyword(s):

Risk Management ◽

Patient Safety ◽

Pilot Study ◽

Thematic Analysis ◽

Online Survey ◽

Healthcare Organizations ◽

Work Related ◽

Oldenburg Burnout Inventory ◽

Related Stress ◽

Risk Managers

Abstract Objective: This study investigates burnout and sources of COVID-related stress among a group of healthcare risk managers/patient safety practitioners. Methods: An online survey including Oldenburg Burnout Inventory (OLBI), and one open-ended question: “Since the start of the COVID-19 pandemic, what work or non work-related issues have been causing you the most stress?” Results: 31 participants completed the OLBI; 27 answered the open-ended question. Over 70% of participants qualified as burned out. Thematic analysis was used to analyze stressors. Key themes included: Impacts of social distancing, changing duties and workload, real and potential impacts of the virus (e.g., fear of infection for self or others), and financial concerns (personal and organizational). Less common themes included untrustworthy and constantly changing guidance, feeling abused by persons in power, and positive comments about the experience of working during the pandemic. Conclusion: Burnout and pandemic-related stress may be very common in the healthcare risk management and patient safety workforce. Additional research is required to more robustly estimate the prevalence of burnout in this population. Meanwhile, the sources of stress identified here may aid healthcare organizations in taking immediate action to protect this vital workforce.

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Anticipating on a post covid-19 world and the pivotal role of science and technology

Coronaviruses ◽

10.2174/2666796701999201116121451 ◽

2020 ◽

Vol 01 ◽

Author(s):

Saeed Khan ◽

Tusha Sharma ◽

Basu Dev Banerjee ◽

Scotty Branch ◽

Shea Harrelson

Keyword(s):

Public Health ◽

Pivotal Role ◽

Public Healthcare ◽

Healthcare Organizations ◽

Health Crisis ◽

Outbreak Management ◽

The Public ◽

Public Health Crisis ◽

Future Outbreak

: Currently, Coronavirus disease 2019 (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses and highlighted the urgent need for investments in scientific programs and policies. A comprehensive program utilizing the science and technologydriven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.

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Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

Palliative Medicine ◽

10.1177/02692163211019885 ◽

2021 ◽

pp. 026921632110198

Author(s):

Catriona R Mayland ◽

Rosemary Hughes ◽

Steven Lane ◽

Tamsin McGlinchey ◽

Warren Donnellan ◽

...

Keyword(s):

Public Health ◽

Family Support ◽

Online Survey ◽

Free Text ◽

Professional Networks ◽

Dying Patients ◽

The Face ◽

Individualised Care ◽

The Impact ◽

Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

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Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116070 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6070

Author(s):

Yubin Lee ◽

Byung-Woo Kim ◽

Shin-Woo Kim ◽

Hyunjin Son ◽

Boyoung Park ◽

...

Keyword(s):

Public Health ◽

South Korea ◽

Emergency Preparedness ◽

Online Survey ◽

Early Stage ◽

Psychological Characteristics ◽

Social Solidarity ◽

Psychological States ◽

Precautionary Behavior ◽

Public Health Emergency Preparedness

Background: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness. Methods: this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey. Results: compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine. Conclusions: the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation.

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DEEP SCOPE: A Framework for Safe Healthcare Design

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157780 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7780

Author(s):

Ellen Taylor ◽

Sue Hignett

Keyword(s):

Human Factor ◽

Healthcare Facility ◽

Built Environments ◽

Facility Design ◽

Healthcare Facilities ◽

Healthcare Design ◽

Accident Causation ◽

Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

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Carbapenemase-Producing, Carbapenem-Resistant Acinetobacter baumannii: Summary of CDC Consultations, 2017–2019

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.670 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s151-s152

Author(s):

Lauren Epstein ◽

Alicia Shugart ◽

David Ham ◽

Snigdha Vallabhaneni ◽

Richard Brooks ◽

...

Keyword(s):

Public Health ◽

Acinetobacter Baumannii ◽

Median Number ◽

Skilled Nursing Facilities ◽

Nursing Facilities ◽

Skilled Nursing ◽

Healthcare Facilities ◽

Carbapenem Resistant ◽

Number Of Patients ◽

Single Facility

Background: Carbapenemase-producing carbapenem-resistant Acinetobacter baumannii (CP-CRAB) are a public health threat due to potential for widespread dissemination and limited treatment options. We describe CDC consultations for CP-CRAB to better understand transmission and identify prevention opportunities. Methods: We defined CP-CRAB as CRAB isolates with a molecular test detecting KPC, NDM, VIM, or IMP carbapenemases or a plasmid-mediated oxacillinase (OXA-23, OXA-24/40, OXA-48, OXA-58, OXA-235/237). We reviewed the CDC database of CP-CRAB consultations with health departments from January 1, 2017, through June 1, 2019. Consultations were grouped into 3 categories: multifacility clusters, single-facility clusters, and single cases. We reviewed the size, setting, environmental culturing results, and identified infection control gaps for each consultation. Results: We identified 29 consultations involving 294 patients across 19 states. Among 9 multifacility clusters, the median number of patients was 12 (range, 2–87) and the median number of facilities was 2 (range, 2–6). Among 9 single-facility clusters, the median number of patients was 5 (range, 2–50). The most common carbapenemase was OXA-23 (Table 1). Moreover, 16 consultations involved short-stay acute-care hospitals, and 6 clusters involved ICUs and/or burn units. Also, 8 consultations involved skilled nursing facilities. Environmental sampling was performed in 3 consultations; CP-CRAB was recovered from surfaces of portable, shared equipment (3 consultations), inside patient rooms (3 consultations) and nursing stations (2 consultations). Lapses in environmental cleaning and interfacility communication were common across consultations. Among 11 consultations for single CP-CRAB cases, contact screening was performed in 7 consultations and no additional CP-CRAB was identified. All 4 patients with NDM-producing CRAB reported recent international travel. Conclusions: Consultations for clusters of oxacillinase-producing CP-CRAB were most often requested in hospitals and skilled nursing facilities. Healthcare facilities and public health authorities should be vigilant for possible spread of CP-CRAB via shared equipment and the potential for CP-CRAB spread to connected healthcare facilities.Funding: NoneDisclosures: None

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The Use of Twitter as an Interactive Learning Tool Within a Postgraduate Public Health Course: A Pilot Study

Pedagogy in Health Promotion ◽

10.1177/2373379920978429 ◽

2020 ◽

pp. 237337992097842

Author(s):

Rimante Ronto ◽

Alexandra Bhatti ◽

Josephine Chau

Keyword(s):

Public Health ◽

Online Survey ◽

Learning Experience ◽

Empirical Studies ◽

Teaching Staff ◽

Learning Tool ◽

Interactive Approach ◽

Master Of Public Health ◽

Use Of Social Media ◽

The Impact

Twitter has gained attention in recent years as a tool to use in higher education to enhance students’ learning, engagement, and reflective writing. This study explored public health students’ perceptions on the usefulness of Twitter as a learning tool, engagement with their peers, staff, and the broader public health community. Participants were Master of Public Health students from a public university based in Sydney, Australia. A mixed methods approach was used combining content analysis of tweets, an online survey and two focus groups. Students were asked to engage with Twitter by reflecting on each week’s teaching content and by liking and replying to their peers’ tweets. Participation and engagement in this task were high initially and declined toward the end of semester. Most student tweets aligned with topics taught during the semester. Survey and focus group data indicated most students had positive views on using Twitter and reported finding engagement with Twitter beneficial in obtaining current information on health promotion news and trends, increasing their professional networks and allowing them to connect with their peers and teaching staff. Results indicate Twitter is a promising interactive approach to enhance public health students’ engagement and overall learning experience, as well as being useful for professional networking. Larger scale empirical studies are needed to investigate the impact of the use of social media platforms such as Twitter to various learning outcomes longitudinally and beyond this course.

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Delivery of the National Child Measurement Programme in England

Public Health Nutrition ◽

10.1017/s1368980020004991 ◽

2020 ◽

pp. 1-21

Author(s):

Martin Čadek ◽

Stuart W. Flint ◽

Ralph Tench

Keyword(s):

Public Health ◽

Local Government ◽

Best Practice ◽

Online Survey ◽

The Other ◽

Service Availability ◽

Healthy Weight ◽

Weight Category ◽

Convenience Sampling

Abstract Objective: The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in reception and year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. Design: An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGAs in England and disseminated using non-probability convenience sampling. Setting: LGAs received an anonymous link to the survey. Participants: A total of 92 LGAs participated in the survey. Results: Most LGAs who responded provide result feedback (86%), a proactive follow-up (71%) and referrals to services (80%). Additionally, 65% of the authorities tailor Public Health England specimen result letters to suit their needs, and 84% provide attachments alongside. Out of 71% of LGAs who provide proactive follow-up, 19 (29%) provide the proactive follow-up only to upper weight categories, and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80% of LGAs who indicated that services are available, 32 (43%) targeted solely upper weight categories while the other 42 (57%) offered services across all weight categories. Finally, most LGAs (88%) commission providers to manage various parts of the NCMP. Conclusions: The results show that LGAs in England localise the NCMP. Further guidance regarding standards of best practice would help LGAs to find the most suitable localisation out of various options that exist across other LGAs.

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What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme

Health Research Policy and Systems ◽

10.1186/s12961-020-00671-0 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Peter van der Graaf ◽

Lindsay Blank ◽

Eleanor Holding ◽

Elizabeth Goyder

Keyword(s):

Public Health ◽

Health Research ◽

Collaborative Research ◽

Online Survey ◽

Public Health Practice ◽

Rapid Review ◽

Success Rates ◽

Evaluation Scheme ◽

Health Practitioners ◽

Public Health Practitioners

Abstract Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

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