The role of local context for managers’ strategies when adapting to the COVID-19 pandemic in Norwegian homecare services: a multiple case study

BMC Health Services Research

Research

Olav Røise¹  Siri Wiig²  Camilla Seljemo²  Eline Ree² 

[1] Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway;SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway;

关键词: Managers;    Homecare services;    Local context;    Adaptation;    Strategies;    Resilience;    Pandemic;   

DOI  :  10.1186/s12913-023-09444-1

 received in 2022-11-25, accepted in 2023-04-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic had a major impact on healthcare systems around the world, and lack of resources, lack of adequate preparedness and infection control equipment have been highlighted as common challenges. Healthcare managers’ capacity to adapt to the challenges brought by the COVID-19 pandemic is crucial to ensure safe and high-quality care during a crisis. There is a lack of research on how these adaptations are made at different levels of the homecare services system and how the local context influences the managerial strategies applied in response to a healthcare crisis. This study explores the role of local context for managers’ experiences and strategies in homecare services during the COVID-19 pandemic.MethodsA qualitative multiple case study in four municipalities with different geographic locations (centralized and decentralized) across Norway. A review of contingency plans was performed, and 21 managers were interviewed individually during the period March to September 2021. All interviews were conducted digitally using a semi-structured interview guide, and data was subjected to inductive thematic analysis.ResultsThe analysis revealed variations in managers’ strategies related to the size and geographical location of the homecare services. The opportunities to apply different strategies varied among the municipalities. To ensure adequate staffing, managers collaborated, reorganized, and reallocated resources within their local health system. New guidelines, routines and infection control measures were developed and implemented in the absence of adequate preparedness plans and modified according to the local context. Supportive and present leadership in addition to collaboration and coordination across national, regional, and local levels were highlighted as key factors in all municipalities.ConclusionManagers who designed new and adaptive strategies to respond to the COVID-19 pandemic were central in ensuring high-quality Norwegian homecare services. To ensure transferability, national guidelines and measures must be context-dependent or -sensitive and must accommodate flexibility at all levels in a local healthcare service system.

【 授权许可】

CC BY   
© The Author(s) 2023

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