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Agostini L, Onofrio R, Piccolo C, Stefanini A. A management perspective on resilience in healthcare: a framework and avenues for future research. BMC Health Serv Res 2023; 23:774. [PMID: 37468875 DOI: 10.1186/s12913-023-09701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023] Open
Abstract
Recent major health shocks, such as the 2014-16 Ebola, the Zika outbreak, and, last but not least, the COVID-19 pandemic, have strongly contributed to drawing attention to the issue of resilience in the healthcare domain. Nevertheless, the scientific literature appears fragmented, creating difficulties in developing incremental research in this relevant managerial field.To fill this gap, this systematic literature review aims to provide a clear state of the art of the literature dealing with resilience in healthcare. Specifically, from the analysis of the theoretical articles and reviews, the key dimensions of resilience are identified, and a novel classification framework is proposed. The classification framework is then used to systematize extant empirical contributions. Two main dimensions of resilience are identified: the approach to resilience (reactive vs. proactive) and the type of crisis to deal with (acute shocks vs. chronic stressors). Four main streams of research are thus identified: (i) proactive approaches to acute shocks; (ii) proactive approaches to chronic stressors; (iii) reactive approaches to acute shocks; and (iv) reactive approaches to chronic stressors. These are scrutinised considering three additional dimensions: the level of analysis, the resources to nurture resilience, and the country context. The classification framework and the associated mapping contribute to systematising the fragmented literature on resilience in healthcare, providing a clear picture of the state of the art in this field and drawing a research agenda that opens interesting paths for future research.
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Affiliation(s)
- L Agostini
- Department of Management and Engineering, University of Padova, Stradella San Nicola 3, Padua, Italy.
| | - R Onofrio
- Department of Management, Economics and Industrial Engineering, Politecnico Di Milano, Piazza Leonardo da Vinci, 32, Milano, Italy
| | - C Piccolo
- Department of Industrial Engineering, University of Naples Federico II, C.So Umberto I, 40, Naples, Italy
| | - A Stefanini
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Lungarno Antonio Pacinotti, 43, Pisa, Italy
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Lee GW, Vine K, Atkinson AR, Tong M, Longman J, Barratt A, Bailie R, Vardoulakis S, Matthews V, Rahman KM. Impacts of Climate Change on Health and Health Services in Northern New South Wales, Australia: A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6285. [PMID: 37444133 PMCID: PMC10341403 DOI: 10.3390/ijerph20136285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023]
Abstract
Climate change is exposing populations to increasing temperatures and extreme weather events in many parts of Australia. To prepare for climate challenges, there is a growing need for Local Health Districts (LHDs) to identify potential health impacts in their region and strengthen the capacity of the health system to respond accordingly. This rapid review summarised existing evidence and research gaps on the impact of climate change on health and health services in Northern New South Wales (NSW)-a 'hotspot' for climate disaster declarations. We systematically searched online databases and selected 11 peer-reviewed studies published between 2012-2022 for the Northern NSW region. The most explored health outcome was mental health in the aftermath of floods and droughts, followed by increased healthcare utilisation due to respiratory, cardiovascular and mortality outcomes associated with bushfire smoke or heat waves. Future research directions were recommended to understand: the compounding impacts of extreme events on health and the health system, local data needs that can better inform models that predict future health risks and healthcare utilisation for the region, and the needs of vulnerable populations that require a whole-of-system response during the different phases of disasters. In conclusion, the review provided climate change and health research directions the LHD may undertake to inform future adaptation and mitigation policies and strategies relevant to their region.
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Affiliation(s)
- Grace W. Lee
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Kristina Vine
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
| | - Amba-Rose Atkinson
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- School of Public Health, Faculty of Medicine, the University of Queensland, St. Lucia, QLD 4072, Australia
| | - Michael Tong
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
- College of Health and Medicine, The Australian National University, Canberra, ACT 2601, Australia
| | - Jo Longman
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
- Sydney Environment Institute, University of Sydney, Camperdown, NSW 2006, Australia
| | - Alexandra Barratt
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia;
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
| | - Ross Bailie
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
- School of Medicine, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Sotiris Vardoulakis
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
- College of Health and Medicine, The Australian National University, Canberra, ACT 2601, Australia
| | - Veronica Matthews
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- Healthy Environments And Lives (HEAL) National Research Network, Canberra, ACT 2601, Australia; (M.T.); (R.B.); (S.V.)
| | - Kazi Mizanur Rahman
- University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia; (G.W.L.); (K.V.); (A.-R.A.); (J.L.); (V.M.)
- Sydney Environment Institute, University of Sydney, Camperdown, NSW 2006, Australia
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Salvador Costa MJ, Leitão A, Silva R, Monteiro V, Melo P. Climate Change Prevention through Community Actions and Empowerment: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214645. [PMID: 36429383 PMCID: PMC9690446 DOI: 10.3390/ijerph192214645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/03/2022] [Indexed: 05/27/2023]
Abstract
As society tries to tackle climate change around the globe, communities need to reduce its impact on human health. The purpose of this review is to identify key stakeholders involved in mitigating and adapting to climate change, as well as the type and characteristics of community empowerment actions implemented so far to address the problem. Published and unpublished studies from January 2005 to March 2022 in English and Portuguese were included in this review. The search, conducted on PubMed, CINAHL, Scopus, MEDLINE, Scopus, Web of Science, SciELO, and RCAAP (Repositório Científico de Acesso Aberto de Portugal), followed a three-step search strategy. Data extraction was performed by two independent reviewers, using an extraction tool specifically designed for the review questions. Twenty-seven studies were eligible for inclusion: six used interviews as a qualitative method, three were systematic reviews, three were case study analyses, three used surveys and questionnaires as quantitative methods, two used integrative baseline reviews, and three utilized a process model design. Six studies targeted local, public and private stakeholders. Community settings were the context target of fifteen studies, whereas twelve specifically referred to urban settings. Seven types of community actions were acknowledged across the globe, characterised as hybrid interventions and referring to the leading stakeholders: local governments, non-governmental organizations, civil society, universities, public health, and private sectors.
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Affiliation(s)
- Maria João Salvador Costa
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Alexandra Leitão
- Católica Porto Business School, Research Centre in Management and Economics, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, 3004-011 Coimbra, Portugal
| | - Vanessa Monteiro
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
- Vila Real Community Care Unit 1, 5000-557 Vila Real, Portugal
| | - Pedro Melo
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
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Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Emmerton L, Bereznicki B, Bereznicki L, Mitchell B, Wilson F, Wright B, Wilson K, Weier N, Segrott R, Cleveland R, Jan S, Shan S, Billot L, Armour C. A Targeted Approach to Improve Asthma Control Using Community Pharmacists. Front Pharmacol 2022; 12:798263. [PMID: 35024035 PMCID: PMC8743269 DOI: 10.3389/fphar.2021.798263] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Building on lessons learnt from evidence-based community pharmacy asthma management models, a streamlined and technology supported Pharmacy Asthma Service (PAS) was developed to promote the integration of the service into routine practice. Objective: This study investigates the efficacy of the PAS in improving asthma symptom control and other health outcomes. Methods: A two-arm pragmatic cluster randomized controlled trial was implemented in 95 pharmacies across three Australian States. Participants were adults with poorly controlled asthma as per the Asthma Control Questionnaire (ACQ), with or without allergic rhinitis. Patients within the PAS arm engaged in four consultations with the pharmacist over a 12-month period. An evidence-based algorithm guided pharmacies, via a trial specific software, to deliver a series of interventions targeting three issues underpinning uncontrolled asthma (medication use and adherence, inhaler technique, and allergic rhinitis management) to patient clinical asthma status and patient need. Comparator arm patients received a minimal intervention likened to usual practice involving referral of eligible patients to the GP and two follow-up consultations with their pharmacist to collect comparative data. Results: In total, 143 of 221 PAS patients (65%) and 111 of 160 comparator patients (69%) completed the trial. Improvements in asthma control were achieved in both the PAS (mean difference (MD) in ACQ from baseline = −1.10, p <.0001) and comparator (MD in ACQ from baseline = −0.94, p <.0001) arms at the trial end; however, there were no significant differences between the two arms (MD = −0.16, 95% CI −0.41 to 0.08, p = 0.19). Patients’ quality of life in the PAS arm improved significantly when compared with the comparator arm (MD in Impact of Asthma on Quality-of-Life Questionnaire (IAQLQ) = −0.52, 95% CI −0.89 to −0.14, p = 0.0079). Conclusion: Despite the PAS achieving a greater improvement in patients’ quality of life, the pharmacist-led service and usual practice arm produced comparable improvements in asthma control. These results ask us to reflect on current standards of usual care, as it appears the standard of asthma care in usual practice has evolved beyond what is reported in the literature.
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Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Bandana Saini
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Central Sydney Area Health Service, Sydney, NSW, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Lynne Emmerton
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - Luke Bereznicki
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, Australia
| | | | - Frances Wilson
- Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - Bronwen Wright
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Kiara Wilson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, Australia
| | - Naomi Weier
- The Pharmaceutical Society of Australia, Deakin, ACT, Australia
| | | | - Rhonda Cleveland
- National Asthma Council Australia, South Melbourne, VIC, Australia
| | - Stephen Jan
- The George Institute, Newtown, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Sana Shan
- The George Institute, Newtown, NSW, Australia
| | - Laurent Billot
- The George Institute, Newtown, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Carol Armour
- Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Central Sydney Area Health Service, Sydney, NSW, Australia
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Siman-Tov M, Vanderplanken K, Guha-Sapir D, van Loenhout JAF, Adini B. Does Ethnic Diversity Impact on Risk Perceptions, Preparedness, and Management of Heat Waves? Front Public Health 2021; 9:642874. [PMID: 34409002 PMCID: PMC8365166 DOI: 10.3389/fpubh.2021.642874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/09/2021] [Indexed: 11/18/2022] Open
Abstract
Detrimental health impacts of heatwaves, including excess mortality, are increasing worldwide. To assess risk perceptions, protective knowledge and behaviors concerning heatwaves in Israel, a study was initiated, comparing attitudes of majority (Jewish) and minority (Arab) populations. A quantitative survey was disseminated through an internet panel, to a representative sample of 556 individuals (79% Jews; 21% Arabs). Overall, 74% consider heatwaves a problem, 93% believe that heatwaves' frequencies will increase, 27% are very concerned about the effects of heatwaves. Higher levels of awareness to heatwaves were found among Jewish compared to Arab respondents; 90 vs. 77% (respectively) could name heatwaves' symptoms (p < 0.001); 81 vs. 56% (respectively) reported knowing how to protect themselves (p < 0.001); 74 vs. 47% (respectively) reported knowing what to do when someone suffers from heat stroke (p < 0.001). Arab compared to Jewish respondents presented higher levels of concern about heatwaves' effects (3.22 vs. 3.09 respectively; t −2.25, p = 0.03), while knowledge of protective measures was higher among Jews compared to Arabs (3.67 vs. 3.56 t = 2.13 p = 0.04). A crucial component of enhancing preparedness to heatwaves is empowerment of minority as well as majority groups, to strengthen their capacity to implement protective behavior and elevate their self-belief in their individual ability and fortitude.
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Affiliation(s)
| | - Kirsten Vanderplanken
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Joris A F van Loenhout
- Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Bruria Adini
- Department of Emergency Management and Disaster Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
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