Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions

Factors Associated with Healthcare Leaders' Perceived Self-Efficacy During Crises

GOAL

The COVID-19 pandemic exposed a lack of healthcare leadership preparedness for a widespread, persistent emergency. This study aimed to identify factors contributing to perceived leadership self-efficacy to better prepare leaders for future crises.

METHODS

The researcher conducted an online composite survey (n = 96) of factors affecting perceived leadership self-efficacy from an American College of Healthcare Executives group using a quantitative correlational design with multiple regression analysis. Results were examined through the lens of Kolb's experiential learning theory to determine recommended leadership training.

PRINCIPAL FINDINGS

The researcher found that the most significant factors contributing to perceived self-efficacy in leadership were years of experience and skill (β = .004). This was supported by a multiple regression model predicting leadership self-efficacy, F(6, 95) = 9.932, p < .001, and adjusted ΔR2 = .361. An overall moderate effect size supports the practical significance of these results. When given the opportunity to indicate what preparation would be most beneficial, healthcare leaders indicated a desire for more training in communication skills alongside tabletop drills to practice rapid assessment and response techniques.

PRACTICAL APPLICATIONS

As healthcare leaders continue to face unanticipated challenges, their self-perceived ability to handle crises competently is influenced by their years of experience and skill level. Of these two, skill level is practically addressable. Education and leadership development that incorporate evolving methods of training, such as tabletop drills, will improve critical skills, and thus, perceived self-efficacy during times of crisis.

Investigation and Analysis of Disaster Preparedness among Nurses in Chinese Non-First-tier (Inland) Cities: A Case Study from Yongcheng City, Henan Province

OBJECTIVES

Compared with first-tier cities in China that are of abundant funds and resources like legions of high-level hospitals, the degree of nurses' disaster nursing preparedness in non-first-tier cities (inland) is relatively lower. For example, nurses' knowledge reserve of specific disasters is not comprehensive enough. And nurses are diffident when it comes to the skills of handling disaster rescue. Furthermore, their understanding of the roles to take in disaster coordination management is ambiguous. Conquering these challenges could be conducive to the improvement of local medical staffs' confidence and capabilities in disaster relief. Consequently, the objective of this research is to probe for approaches of improving the strategies of disaster nursing in Chinese small cities.

METHODS

In order to ascertain the factors that influence disaster preparedness, a cross-sectional study with SPSS 25.0 data analysis method is adopted. The sample of the study is nursing personnel from 4 comprehensive hospitals at or above the second level in Yongcheng, Henan Province, China, as nurses are first-line responders in disasters and pandemics and the largest group in disaster rescue.

RESULTS

From 813 distributed questionnaires, 784 completed questionnaires were returned, for a response rate of 96.43%. The total average score of the Disaster Preparedness Evaluation Tool is 146.76 ± 34.98, and the average score of all the entries is 3.26 ± 0.45, indicating moderate performance. The results indicate that age affects post disaster management ( P < 0.05), meaning that as age increases, the scores also tend to be higher. Work experience, professional titles, disaster relief experience, and disaster training significantly differ in terms of knowledge, skills, post disaster management, and total scores (P < 0.01). The result of multivariate analysis indicates that titles, disaster relief experiences, and disaster training are the main factors affecting the disaster preparedness of nurses in Chinese non-first-tier (inland) cities( P < 0.05).

CONCLUSIONS

For the sake of upgrading the efficiency of disaster nursing preparedness in Chinese non-first-tier (inland) cities with limited funds and resources, it is very important to formulate training and education methods that are suitable for the local area, conduct characteristic simulation exercises, and expand experience exchange between hospitals. It's certain that the local government will also play an important role in coordinating and organizing the division of labor, resource allocation, and management of hospitals at all levels in different phases of disasters, which can help nursing staff have a clearer understanding of their roles when preparing for disasters.

Drivers and collaborative governance of public health emergency response in the context of digital city

Introduction

With the frequent occurrence of public health events, the government inevitably makes many mistakes in emergency management. In modern emergency management, it is particularly important to promote the diversification of emergency management subjects and improve the government's emergency management ability.

Methods

In order to make up for the deficiency of government's participation in public health emergency management, this paper analyzes the driving factors and driving effects of enterprises' participation in public health emergency response under the background of digital city. A fully explained structural model is used to analyze the relationship between the different drivers. In addition, the spatial and temporal distribution characteristics of public health events were analyzed through spatial auto-correlation. On this basis, the government cooperative governance strategy is discussed.

Results and discussion

The results show that in the context of digital cities, there are 14 driving factors for enterprises to participate in public health emergency response. The most important factors are the company's own development needs, relative technical advantages and so on. The driving efficiency is mainly concentrated in three aspects: psychology, resources and structure. Public health events have periodicity in time distribution and regional differences in spatial distribution. The significance of this study is to help the government improve the emergency management ability from different angles.

How does the COVID-19 pandemic impact medication adherence of patients with chronic disease?: A systematic review

OBJECTIVE

To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence.

METHODS

Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis.

RESULTS

Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth.

DISCUSSION

Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended.

Hospital preparedness for major incidents in Sweden: a national survey with focus on mass casualty incidents

INTRODUCTION

Mass-casualty incidents, MCI, pose a constant threat on societies all over the world. It is essential that hospital organizations systematically prepare for such situations. A method for repeated follow-up and evaluation of hospital disaster planning is much needed.

AIMS

To evaluate Swedish hospitals´ disaster preparedness with focus on MCI through a web-based survey to highlight areas in need of improvement to ensure better preparedness and resilience.

MATERIALS AND METHODS

An online survey was sent to all Swedish emergency hospitals (n = 87, 49 emergency hospitals). One respondent per hospital answered questions about the hospital's disaster planning, training, key functions, and preparedness. The survey was developed based on current knowledge on key areas of interest for all-hazard preparedness, including the WHO's guidelines. The survey was open between September 6th and November 1st, 2021.

RESULTS

39 hospitals (34 emergency hospitals) from 18/21 regions participated. Main findings included marked differences between regions and hospital types regarding contingency plans, organization, formal education for key functions, disaster training and triage systems.

CONCLUSIONS

Generally, Swedish hospitals cover most key areas in disaster preparedness, but no hospital appears to have a full all-hazards coverage, which leaves room for improvement. There are large variations between the different hospitals' preparedness, which need to decrease. Several hospitals expressed a need of national guidelines for developing equivalent contingency plans. The study-method could be used for monitoring compliance with current laws and guidelines.

Attitudes and Response Capacities for Public Health Emergencies of Healthcare Workers in Primary Healthcare Institutions: A Cross-Sectional Investigation Conducted in Wuhan, China, in 2020

OBJECTIVES

Response capacities for public health emergencies (PHEs) amongst healthcare workers play important roles in the prevention and control of PHEs. This study assessed the attitudes and response capacities of PHE workers in primary healthcare (PHC) institutions.

METHODS

An online anonymous questionnaire survey of 803 healthcare workers sampled from 13 PHC institutions in Wuhan, China, was conducted from April to June 2020. The Kruskal-Wallis test and linear regression model were used to analyze the response capacities of PHE workers and associated factors.

RESULTS

The healthcare workers with longer working years, particularly 30 years and above, had higher knowledge (OR = 7.323, p < 0.001) and practical ability scores (OR = 8.012, p < 0.001) when compared to those with less than 5 working years. The nurses had higher practical ability scores (OR = 2.188, p = 0.049), and pharmacists had lower practical ability scores (OR = 0.166, p = 0.007), when compared to doctors. Moreover, the healthcare workers who had never participated in educational activities related to PHE management in the past two years (OR = 0.540, p = 0.038; OR = 0.282, p = 0.001), had not participated in a PHE drill activity (OR = 0.327, p < 0.001; OR = 0.340, p = 0.004), and had never been involved in emergency management of PHEs (OR = 0.254, p < 0.001; OR = 0.174, p < 0.001) had lower knowledge and practical ability scores.

CONCLUSION

The healthcare workers with longer working years had better response capacities, and nurses had better practical abilities when compared to doctors. More emergency management education and chances to be involved in PHE drill activities were encouraged amongst healthcare workers in PHC institutions for better prevention and control of PHEs. Moreover, inter-institution cooperation, a flexible response system, and dynamic adjustment of healthcare workers were suggested during PHEs.

Adaptive leadership of doctors during COVID-19

PURPOSE

This study aims to examine the adaptive leadership of doctors during COVID-19 to understand the leadership competencies required for adaptive events.

DESIGN/METHODOLOGY/APPROACH

Phenomenology-based qualitative design was used. Data were collected from six doctors from the state of Kerala, India using semi-structured interviews.

FINDINGS

Five themes were identified. The first theme, core leadership shows that doctors perceive leaders as educators, learners and social beings. The second theme, adaptive challenges, describes the ambiguous pandemic-related challenges that doctors are facing including, unusual occupational demands, information overload, sociocultural issues and personal intricacies. The third theme reflects that for doctors, adaptive work during the pandemic included - new learning to address unique issues, changing perspectives and establishing and maintaining a safe and engaging workplace environment. The fourth theme describes the adaptive leadership competencies such as regulating distress, providing direction, maintaining disciplined action, fostering collaboration, empowering, understanding organizational linkages, strategic vision and communication skills. The fifth theme elucidates the lacunae in leadership training as perceived by the doctors.

RESEARCH LIMITATIONS/IMPLICATIONS

The findings can help in developing and enhancing competency frameworks for doctors' adaptive leadership.

ORIGINALITY/VALUE

This is one of the earliest studies to systematically examine components of adaptive leadership for doctors during COVID-19 and identify associated competencies.