TY - JOUR
T1 - The COVID-19 System Shock Framework
T2 - Capturing Health System Innovation During the COVID-19 Pandemic
AU - Hodgins, Michael
AU - van Leeuwen, Dee
AU - Braithwaite, Jeffrey
AU - Hanefeld, Johanna
AU - Wolfe, Ingrid
AU - Lau, Christine
AU - Dickins, Emma
AU - McSweeney, Joeanne
AU - McCaskill, Mary
AU - Lingam, Raghu
N1 - Funding Information:
Funding and Finance Adequate and well allocated funding has the potential to shore up health systems in the face of shocks and conversely exacerbates the negative impacts of shocks when unpredictable or limited.33 To support the response to COVID-19 the NSW state government established a COVID fund for health services. COVID-19 funding priorities within the Network included assessment clinics, PPE, cleaning, concierge, and the Clinical Communications program, Medtasker. The allocation of COVID-19 funding had a small degree of leniency, with any cost exceeding $10 000 requiring approval from the Ministry of Health. This funding enabled many of the innovations that occurred within the Network and proved a workaround for gaps in funding for necessary services. Additional sources of funding to support innovation included research funding, for instance, a research grant providing funds to support the construction of the e-gate. In March 2020, new COVID-19 telehealth Medicare Benefits Schedule items were introduced that enabled telephone and videoconference consultations to be bulk-billed for patients residing in both metropolitan and rural locations. This allowed equitable access of care for patients and ensured vulnerable staff could continue to work and continue to provide care without be placed at risk.
Publisher Copyright:
© 2022 The Author(s); Published by Kerman University of Medical Sciences.
PY - 2022/10
Y1 - 2022/10
N2 - Background: Coronavirus disease 2019 (COVID-19) has resulted in over 2 million deaths globally. The experience in Australia presents an opportunity to study contrasting responses to the COVID-19 health system shock. We adapted the Hanefeld et al framework for health systems shocks to create the COVID-19 System Shock Framework (CSSF). This framework enabled us to assess innovations and changes created through COVID-19 at the Sydney Children’s Hospitals Network (SCHN), the largest provider of children’s health services in the Southern hemisphere. Methods: We used ethnographic methods, guided by the CSSF, to map innovations and initiatives implemented across SCHN during the pandemic. An embedded field researcher shadowed members of the emergency operations centre (EOC) for nine months. We also reviewed clinic and policy documents pertinent to SCHN’s response to COVID-19 and conducted interviews and focus groups with stakeholders, including clinical directors, project managers, frontline clinicians, and other personnel involved in implementing innovations across SCHN. Results: The CSSF captured SCHN’s complex response to the pandemic. Responses included a COVID-19 assessment clinic, inpatient and infectious disease management services, redeploying and managing a workforce working from home, cohesive communication initiatives, and remote delivery of care, all enabled by a dedicated COVID-19 fund. The health system values that shaped SCHN’s response to the pandemic included principles of equity of healthcare delivery, holistic and integrated models of care, and supporting workforce wellbeing. SCHN’s resilience was enabled by innovation fostered through a non-hierarchical governance structure and responsiveness to emerging challenges balanced with a singular vision. Conclusion: Using the CSSF, we found that SCHN’s ability to innovate was key to ensuring its resilience during the pandemic.
AB - Background: Coronavirus disease 2019 (COVID-19) has resulted in over 2 million deaths globally. The experience in Australia presents an opportunity to study contrasting responses to the COVID-19 health system shock. We adapted the Hanefeld et al framework for health systems shocks to create the COVID-19 System Shock Framework (CSSF). This framework enabled us to assess innovations and changes created through COVID-19 at the Sydney Children’s Hospitals Network (SCHN), the largest provider of children’s health services in the Southern hemisphere. Methods: We used ethnographic methods, guided by the CSSF, to map innovations and initiatives implemented across SCHN during the pandemic. An embedded field researcher shadowed members of the emergency operations centre (EOC) for nine months. We also reviewed clinic and policy documents pertinent to SCHN’s response to COVID-19 and conducted interviews and focus groups with stakeholders, including clinical directors, project managers, frontline clinicians, and other personnel involved in implementing innovations across SCHN. Results: The CSSF captured SCHN’s complex response to the pandemic. Responses included a COVID-19 assessment clinic, inpatient and infectious disease management services, redeploying and managing a workforce working from home, cohesive communication initiatives, and remote delivery of care, all enabled by a dedicated COVID-19 fund. The health system values that shaped SCHN’s response to the pandemic included principles of equity of healthcare delivery, holistic and integrated models of care, and supporting workforce wellbeing. SCHN’s resilience was enabled by innovation fostered through a non-hierarchical governance structure and responsiveness to emerging challenges balanced with a singular vision. Conclusion: Using the CSSF, we found that SCHN’s ability to innovate was key to ensuring its resilience during the pandemic.
KW - COVID-19
KW - Ethnography
KW - Health Management
KW - Health System Change
KW - Health System Shock
UR - http://www.scopus.com/inward/record.url?scp=85140034007&partnerID=8YFLogxK
U2 - 10.34172/ijhpm.2021.130
DO - 10.34172/ijhpm.2021.130
M3 - Article
C2 - 34814662
AN - SCOPUS:85140034007
SN - 2322-5939
VL - 11
SP - 2155
EP - 2165
JO - International Journal of Health Policy and Management
JF - International Journal of Health Policy and Management
IS - 10
ER -
