Perceptions of postoutbreak management by management and healthcare workers of a Middle East respiratory syndrome outbreak in a tertiary care hospital: a qualitative study
Identifieur interne : 000435 ( Main/Exploration ); précédent : 000434; suivant : 000436Perceptions of postoutbreak management by management and healthcare workers of a Middle East respiratory syndrome outbreak in a tertiary care hospital: a qualitative study
Auteurs : Bandar Abdulmohsen Al Knawy [Arabie saoudite] ; Hanan M F. Al-Kadri [Arabie saoudite] ; Mahmoud Elbarbary [Arabie saoudite] ; Yaseen Arabi [Arabie saoudite] ; Hanan H. Balkhy [Arabie saoudite] ; Alex Clark [Canada]Source :
- BMJ Open [ 2044-6055 ] ; 2019.
Descripteurs français
- KwdFr :
- Administrateurs d'hôpitaux, Adulte, Adulte d'âge moyen, Arabie saoudite (épidémiologie), Centres de soins tertiaires (organisation et administration), Entretiens comme sujet, Femelle, Flambées de maladies (), Groupes focalisés, Humains, Infections à coronavirus (), Mâle, Personnel hospitalier, Sujet âgé.
- MESH :
- organisation et administration : Centres de soins tertiaires.
- épidémiologie : Arabie saoudite.
- Administrateurs d'hôpitaux, Adulte, Adulte d'âge moyen, Entretiens comme sujet, Femelle, Flambées de maladies, Groupes focalisés, Humains, Infections à coronavirus, Mâle, Personnel hospitalier, Sujet âgé.
- Wicri :
- geographic : Arabie saoudite.
English descriptors
- KwdEn :
- Adult, Aged, Coronavirus Infections (prevention & control), Disease Outbreaks (prevention & control), Female, Focus Groups, Hospital Administrators, Humans, Interviews as Topic, Male, Middle Aged, Personnel, Hospital, Saudi Arabia (epidemiology), Tertiary Care Centers (organization & administration).
- MESH :
- geographic , epidemiology : Saudi Arabia.
- organization & administration : Tertiary Care Centers.
- prevention & control : Coronavirus Infections, Disease Outbreaks.
- Adult, Aged, Female, Focus Groups, Hospital Administrators, Humans, Interviews as Topic, Male, Middle Aged, Personnel, Hospital.
Abstract
This study examines perceptions of the operational and organisational management of a major outbreak of Middle East Respiratory Syndrome (MERS) caused by a novel coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia (KSA). Perspectives were sought from key decision-makers and clinical staff about the factors perceived to promote and inhibit effective and rapid control of the outbreak.
A large teaching tertiary healthcare centre in KSA; the outbreak lasted 6 weeks from June 2015.
Data were collected via individual and focus group interviews with 28 key informant participants (9 management decision-makers and 19 frontline healthcare workers).
We used qualitative methods of process evaluation to examine perceptions of the outbreak and the factors contributing to, or detracting from successful management. Data were analysed using qualitative thematic content analysis.
Five themes and 15 subthemes were found. The themes were related to: (1) the high stress of the outbreak, (2) factors perceived to contribute to outbreak occurrence, (3) factors perceived to contribute to success of outbreak control, (4) factors inhibiting outbreak control and (5) long-term institutional gains in response to the outbreak management.
Management of the MERS-CoV outbreak at King Abdulaziz Medical City-Riyadh was widely recognised by staff as a serious outbreak of local and national significance. While the outbreak was controlled successfully in 6 weeks, progress in management was inhibited by a lack of institutional readiness to implement infection control (IC) measures and reduce patient flow, low staff morale and high anxiety. Effective management was promoted by greater involvement of all staff in sharing learning and knowledge of the outbreak, developing trust and teamwork and harnessing collective leadership. Future major IC crises could be improved via measures to strengthen these areas, better coordination of media management and proactive staff counselling and support.
Url:
DOI: 10.1136/bmjopen-2017-017476
PubMed: 31061009
PubMed Central: 6502063
Affiliations:
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Al-Kadri</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution content-type="department">College of Medicine</institution>,<institution>King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences</institution>,<addr-line content-type="city">Riyadh</addr-line>,<country>Saudi Arabia</country></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Elbarbary, Mahmoud" sort="Elbarbary, Mahmoud" uniqKey="Elbarbary M" first="Mahmoud" last="Elbarbary">Mahmoud Elbarbary</name><affiliation wicri:level="1"><nlm:aff id="aff3"><institution content-type="department">College of Public Health</institution>,<institution>King Abdulla International Research Center and King Saud bin Abdulaziz University for Health Sciences</institution>,<addr-line content-type="city">Riyadh</addr-line>,<country>Saudi Arabia</country></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution content-type="department">Department of Medicine</institution>,<institution>King Abdulaziz Medical City</institution>,<addr-line content-type="city">Riyadh</addr-line>,<country>Saudi Arabia</country></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H" last="Balkhy">Hanan H. Balkhy</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution content-type="department">Department of Pediatrics</institution>,<institution>King Abdullah International Medical Research Centre and King Saud bin Abdulaziz University for Health Sciences</institution>,<addr-line content-type="city">Riyadh</addr-line>,<country>Saudi Arabia</country></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Clark, Alex" sort="Clark, Alex" uniqKey="Clark A" first="Alex" last="Clark">Alex Clark</name><affiliation wicri:level="1"><nlm:aff id="aff5"><institution content-type="department">Faculty of Nursing</institution>,<institution>University of Alberta</institution>,<addr-line content-type="city">Edmonton</addr-line>,<addr-line content-type="state">Alberta</addr-line>,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Coronavirus Infections (prevention & control)</term><term>Disease Outbreaks (prevention & control)</term><term>Female</term><term>Focus Groups</term><term>Hospital Administrators</term><term>Humans</term><term>Interviews as Topic</term><term>Male</term><term>Middle Aged</term><term>Personnel, Hospital</term><term>Saudi Arabia (epidemiology)</term><term>Tertiary Care Centers (organization & administration)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Administrateurs d'hôpitaux</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Arabie saoudite (épidémiologie)</term><term>Centres de soins tertiaires (organisation et administration)</term><term>Entretiens comme sujet</term><term>Femelle</term><term>Flambées de maladies ()</term><term>Groupes focalisés</term><term>Humains</term><term>Infections à coronavirus ()</term><term>Mâle</term><term>Personnel hospitalier</term><term>Sujet âgé</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Saudi Arabia</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Centres de soins tertiaires</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Tertiary Care Centers</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Disease Outbreaks</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Arabie saoudite</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Focus Groups</term><term>Hospital Administrators</term><term>Humans</term><term>Interviews as Topic</term><term>Male</term><term>Middle Aged</term><term>Personnel, Hospital</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Administrateurs d'hôpitaux</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Entretiens comme sujet</term><term>Femelle</term><term>Flambées de maladies</term><term>Groupes focalisés</term><term>Humains</term><term>Infections à coronavirus</term><term>Mâle</term><term>Personnel hospitalier</term><term>Sujet âgé</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Arabie saoudite</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>This study examines perceptions of the operational and organisational management of a major outbreak of Middle East Respiratory Syndrome (MERS) caused by a novel coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia (KSA). Perspectives were sought from key decision-makers and clinical staff about the factors perceived to promote and inhibit effective and rapid control of the outbreak.</p></sec><sec><title>Setting</title><p>A large teaching tertiary healthcare centre in KSA; the outbreak lasted 6 weeks from June 2015.</p></sec><sec><title>Participants</title><p>Data were collected via individual and focus group interviews with 28 key informant participants (9 management decision-makers and 19 frontline healthcare workers).</p></sec><sec><title>Design</title><p>We used qualitative methods of process evaluation to examine perceptions of the outbreak and the factors contributing to, or detracting from successful management. Data were analysed using qualitative thematic content analysis.</p></sec><sec><title>Results</title><p>Five themes and 15 subthemes were found. The themes were related to: (1) the high stress of the outbreak, (2) factors perceived to contribute to outbreak occurrence, (3) factors perceived to contribute to success of outbreak control, (4) factors inhibiting outbreak control and (5) long-term institutional gains in response to the outbreak management.</p></sec><sec><title>Conclusion</title><p>Management of the MERS-CoV outbreak at King Abdulaziz Medical City-Riyadh was widely recognised by staff as a serious outbreak of local and national significance. While the outbreak was controlled successfully in 6 weeks, progress in management was inhibited by a lack of institutional readiness to implement infection control (IC) measures and reduce patient flow, low staff morale and high anxiety. Effective management was promoted by greater involvement of all staff in sharing learning and knowledge of the outbreak, developing trust and teamwork and harnessing collective leadership. Future major IC crises could be improved via measures to strengthen these areas, better coordination of media management and proactive staff counselling and support.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Senga, M" uniqKey="Senga M">M Senga</name></author><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Fowler, Ra" uniqKey="Fowler R">RA Fowler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yaseen, M" uniqKey="Yaseen M">M Yaseen</name></author><author><name sortKey="Arabi, Rf" uniqKey="Arabi R">RF Arabi</name></author><author><name sortKey="Bright, Ra" uniqKey="Bright R">RA Bright</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name 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Broom</name></author><author><name sortKey="Broom, A" uniqKey="Broom A">A Broom</name></author><author><name sortKey="Bowden, V" uniqKey="Bowden V">V Bowden</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Arabie saoudite</li><li>Canada</li></country></list><tree><country name="Arabie saoudite"><noRegion><name sortKey="Al Knawy, Bandar Abdulmohsen" sort="Al Knawy, Bandar Abdulmohsen" uniqKey="Al Knawy B" first="Bandar Abdulmohsen" last="Al Knawy">Bandar Abdulmohsen Al Knawy</name></noRegion><name sortKey="Al Kadri, Hanan M F" sort="Al Kadri, Hanan M F" uniqKey="Al Kadri H" first="Hanan M F" last="Al-Kadri">Hanan M F. Al-Kadri</name><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H" last="Balkhy">Hanan H. Balkhy</name><name sortKey="Elbarbary, Mahmoud" sort="Elbarbary, Mahmoud" uniqKey="Elbarbary M" first="Mahmoud" last="Elbarbary">Mahmoud Elbarbary</name></country><country name="Canada"><noRegion><name sortKey="Clark, Alex" sort="Clark, Alex" uniqKey="Clark A" first="Alex" last="Clark">Alex Clark</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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