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COvid Pandemic Institutional maNaGement (COPING)

2021年5月27日 更新者:Hospices Civils de Lyon

Institutional Management and Professional Experience During the Pandemic COVID-19 by Health Care Institutions in the Auvergne-Rhône-Alpes Region: Assessment and Lessons Learned

Covid-19 has increased organizational tensions within health services (lack of resources, difficulties in recruiting healthcare professionals , elderly and polypathological patients, etc.) and tested the reliability of health facilities. This project aims to draw lessons so that hospitals can transform themselves while improving their reliability to face future crises and other exceptional situations.

Research hypothesis:

Crisis management arrangements lack sensitivity to uncertainty, which manifests itself in lower quality of care and efficiency losses for the entire institution.

The virtuous practices implemented during the crisis spontaneously incorporated principles of the highly reliable organization.

The integration of principles from complexity theory into the management of institutions promotes high reliability organization.

Sustaining these virtuous practices in order to anticipate and cope with crises requires the activation of two interconnected levers: a shared vision (by patients, healthcare professionals, ARS, HAS, and the Ministry in the first place) of the meaning of the action taken by hospitals, and the development of a policy enabling hospitals to become both learning and highly reliable.

Main objective:

To evaluate the management process of the Covid-19 epidemic by the university hospitals of the Auvergne-Rhône-Alpes region, and the structures linked to them (establishments in their territory, ARS, user associations), in terms of points of improvement and good practices. This evaluation concerns the preparation, management and exit phases of the crisis.

調査の概要

研究の種類

観察的

入学 (予想される)

20000

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

      • Clermont-Ferrand、フランス、63003
        • 募集
        • CHU Clermont-Ferrand , Pôle de Santé Publique, unité d'Epidémiologie, Economie de la Santé et Prévention
        • コンタクト:
      • Grenoble、フランス、38700
        • 募集
        • CHU Grenoble, Pôle Santé Publique, service de veille sanitaire
        • コンタクト:
      • Lyon、フランス、69002
        • 募集
        • Hospices Civils de Lyon, DOQ-RU
        • コンタクト:
      • Saint-Étienne、フランス、42055

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

はい

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

  • Professionals and members of the institutions' bodies in the 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble
  • Adult patients hospitalized for at least 48 hours during the first wave of the pandemic COVID-19 in the 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble

説明

Inclusion Criteria:

  • Establishments :

    • 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble
    • Establishments in the same territories, public and private
  • Professionals and members of the institutions' bodies:

    • Governance: management and chair of the CME
    • Management (care, communication, medical, technical, logistics, IT, personnel)
    • Clinical and public health cluster governance
    • Medical, paramedical and non-medical staff in the departments most concerned (emergency and EMS reception, intensive care, infectiology, hygiene, virology, imaging, occupational medicine in particular)
    • Organizations representing the personnel
    • Members of the users' representatives committee
  • Adult patients hospitalized for at least 48 hours during the study period (quantitative study by questionnaires).

Exclusion Criteria:

  • none

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
Professional qualitative group
Qualitative analysis of crisis management by interviewing professionals most involved during the crisis in each university hospital.

3 individual interviews with the different categories of professionals most involved during the crisis in each university hospital. In the first phase, the points of improvement identified will be analyzed In the second phase, good practices and innovations will be analyzed. For these first two phases, the duration of one hour was chosen because it is difficult to mobilize the professionals for longer. Individual interviews are preferred, but group interviews are possible with no more than three people so that everyone can express himself or herself. Finally, individual interviews of 15 to 30 minutes will be conducted with some of the people interviewed previously in order to identify the costs of the dysfunctions or problems encountered during the crisis.

Questionnaires with establishments associated with the crisis management, the ARS AuRA and France Assos Santé AuRA.

Analysis of evidence documents in the university hospitals

Professional quantitative group
Quantitative analysis of crisis management using the WHO grid adapted sent to the target persons identified within the establishments

A self-assessment of the three phases of the crisis management process (preparation, crisis management, crisis recovery) will be carried out in the participating establishments using the WHO grid with the target persons identified within the establishments.

This step will use the crisis response assessment tool developed by the WHO following the H1N1 pandemic in 2011. This grid will be adapted beforehand to the COVID-19 situation and to the local organization by the study's scientific committee. The dimensions investigated will be : Command and control, Communication, Safety and security, Triage, Surge capacity, Continuity of essential services; Human resources, Logistics and supply management, Post-disaster recovery.

The grids will be sent to the 4 university hospitals to be filled in with the target audience recommended by the WHO methodological guide.

The results of this self-assessment will be linked to and interpreted with the results of the interviews in phase 1.

Patient quantitative group
Quantitative analysis of crisis management using a questionnaire sent to patients hospitalized in the first wave asking them about their perception of crisis and post-crisis management.

A questionnaire of patients' perceptions on the same perimeter (crisis and post-crisis management, from the point of view of points of improvement and good practices) will be constructed and sent by the management of the establishments to all patients hospitalized for 48 hours or more during the first wave and who have left their email address (methods similar to the e-satis survey). The online questionnaire survey is preferred in order to get away from the emotion and for feasibility reasons. This patient experience questionnaire adapted to COVID will be co-constructed with expert/partner patients and user associations.

Four dimensions will be investigated : The perception of the quality of the information received by the patient, The nature of the information on the specific health protection protocol from which the patient benefited, The patient's consideration of the overall context, during and after, The effects of the health context on the overall management of the patient

Tools development
Development of tools to prepare for situations of uncertainty

Development of tools to prepare for situations of uncertainty : In the third phase of the project, design thinking workshops will be organized (within the HCL) to develop training (in the form of simulation) in order to appropriate virtuous practices in situations of uncertainty. The purpose of these training sessions will be to improve the institution's ability to learn in a situation of uncertainty and thus to develop its reliability.

The aim of these workshops is to provide tools for raising awareness of situations of uncertainty to all hospital staff.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Crisis management process based on a qualitative approach
時間枠:The Qualitative analysis (intervention 1) will take place from September, 2020 to December, 2021
The qualitative evaluation (interviews, document review) will make it possible to identify the points of improvement and virtuous practices implemented in the establishments.
The Qualitative analysis (intervention 1) will take place from September, 2020 to December, 2021
Crisis management process based on a quantitative approach with the professionals (identified within the establishments)
時間枠:The Quantitative analysis for professionals (intervention 2) will be conducted from March, 2021 to June 2021.
The quantitative evaluation will be based on the WHO checklist. This first part will report, for each hospital, the proportion of items validated in each dimension of the WHO checklist (https://www.who.int/publications/i/item/hospital-emergency-response-checklist):
The Quantitative analysis for professionals (intervention 2) will be conducted from March, 2021 to June 2021.
Crisis management process based on a quantitative approach with the patients (hospitalized in the first wave)
時間枠:The Quantitative analysis for patients (intervention 3) will be conducted from March, 2021 to June 2021. The tool development phase (intervention 4) will be carried out from January, 2022 to June, 2022

The second quantitative evaluation will be based on patients' perceptions with a constructed questionnaire on theses perimeters: crisis and post-crisis management, from the point of view of points of improvement and good practices.

This patient experience questionnaire will be adapted to COVID with expert/partner patients and user associations.

The Quantitative analysis for patients (intervention 3) will be conducted from March, 2021 to June 2021. The tool development phase (intervention 4) will be carried out from January, 2022 to June, 2022

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2020年9月1日

一次修了 (予想される)

2021年12月1日

研究の完了 (予想される)

2022年9月1日

試験登録日

最初に提出

2021年5月17日

QC基準を満たした最初の提出物

2021年5月27日

最初の投稿 (実際)

2021年6月1日

学習記録の更新

投稿された最後の更新 (実際)

2021年6月1日

QC基準を満たした最後の更新が送信されました

2021年5月27日

最終確認日

2021年4月1日

詳しくは

本研究に関する用語

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

COVID19の臨床試験

3
購読する