Volume 13 Issue 4
Aug.  2022
Turn off MathJax
Article Contents
Ingela Wennman, Catharina Jacobson, Eric Carlström, Anders Hyltander, Amir Khorram-Manesh. Organizational Changes Needed in Disasters and Public Health Emergencies: A Qualitative Study among Managers at a Major Hospital[J]. International Journal of Disaster Risk Science, 2022, 13(4): 481-494. doi: 10.1007/s13753-022-00423-4
Citation: Ingela Wennman, Catharina Jacobson, Eric Carlström, Anders Hyltander, Amir Khorram-Manesh. Organizational Changes Needed in Disasters and Public Health Emergencies: A Qualitative Study among Managers at a Major Hospital[J]. International Journal of Disaster Risk Science, 2022, 13(4): 481-494. doi: 10.1007/s13753-022-00423-4

Organizational Changes Needed in Disasters and Public Health Emergencies: A Qualitative Study among Managers at a Major Hospital

doi: 10.1007/s13753-022-00423-4
  • Available Online: 2022-09-09
  • Most hospitals have a contingency plan, based on all-risks and all-hazards assessment principles. However, emerging threats and risks often necessitate a flexible approach to emergency management at several levels of a disaster response system, for example, in hospitals. Sweden, and possibly other countries, has limited possibilities of surge capacity in the management of large-scale disasters and emergencies, which necessitates a local/national partnership and a flexible local disaster and contingency plan. This study evaluates the opinions of a selected managerial group, both at operative and strategic levels, regarding possible changes in a major hospital’s contingency plan during the ongoing COVID-19 pandemic. Semistructured interviews were conducted to explore the elements of surge capacity and an operational tool, consisting of command and control, safety, communication, assessment, triage, treatment, and transport. The results show a need to create feasible management methods that can be evaluated, establish clear leadership, put preparedness as a constant point on the highest managerial agenda, improve external monitoring, and create a regional coordinating center. Furthermore, the results emphasize the significant role played by the incident command system and qualified leadership to facilitate competent and crucial medical decision making, as well as to provide reliable communication, collaboration, and coordination in a multi-agency response system during dynamic and unexpected emergencies. These steps enable a constant connection between reactive contingency plans and the proactivity in continuous risk assessment and enhance the flexibility of the contingency plans.
  • loading
  • Adini, B., D. Laor, and L. Aharonson-Daniel. 2014. Factors affecting preparedness and capacity to manage pandemic influenza:Perceptions of healthcare managers. Public Health 128(8):703-708.
    Al-Sawai, A. 2013. Leadership of healthcare professionals:Where do we stand?. Oman Medical Journal 28(4):285-287.
    Basch, J.M., and K.G. Melchers. 2021. The use of technology-mediated interviews and their perception from the organization's point of view. International Journal of Selection and Assessment 29(3-4):495-502.
    Berlin, J., and E. Carlström. 2015. The three-level collaboration exercise-Impact of learning and usefulness. Journal of Contingency and Crisis Management 23(4):257-265.
    Brenna, C.T.A., and S. Das. 2021. The divided principle of justice:Ethical decision-making at surge capacity. American Journal of Bioethics 21(8):37-39.
    Burkle, M.F. 2019. Challenges of global public health emergencies:Development of a health crisis management framework. The Tohoku Journal of Experimental Medicine 249(1):33-41.
    Carlström, E. 2012. Strategies for change-Adaption to new accounting conditions. Journal of Accounting & Organizational Change 8(1):41-61.
    Choflet, A., T. Packard, and K. Stashower. 2021. Rethinking organizational change in the Covid-19 era. Journal of Hospital Management and Heath Policy 5(2):16.
    Erlingsson, C., and P. Brysiewicz. 2017. A hands-on guide to doing content analysis. African Journal of Emergency Medicine 7(3):93-99.
    Farcas, A., J. Ko, J. Chan, S. Malik, L. Nono, and G. Chiampas. 2021. Use of incident command system for disaster preparedness:A model for an emergency department Covid-19 response. Disaster Medicine and Public Health Preparedness 15(3):e31-e36.
    Fitzgerald, L., and A. McDermott. 2017. Challenging perspectives on organizational change in health care. Milton Park, Abingdon-on-Thames, Oxfordshire, England, UK:Routledge.
    Glantz, V., P. Phattharapornjaroen, E. Carlström, and A. Khorram-Manesh. 2020. Regional flexible surge capacity-A flexible response system. Sustainability 12(15):Article 5984.
    Goniewicz, K., A. Khorram-Manesh, A.J. Hertelendy, M. Goniewicz, K. Naylor, and F.M. Burkle Jr. 2020. Current response and management decisions of the European Union to the Covid-19 outbreak:A review. Sustainability 12(9):Article 3838.
    Goniewicz, K., M. Goniewicz, A. Włoszczak-Szubzda, F.M. Burkle, A. Hertelendy, A. Al-Wathinani, M.S. Molly, and A. Khorram-Manesh. 2021. The importance of pre-training gap analyses and the identification of competencies and skill requirements of medical personnel for mass casualty incidents and disaster training. BMC Public Health 21:Article 114.
    Hinings, C.R., and N. Malholtra. 2008. Changes in institutional fields. In The institutions of the market:Organizations, social systems, and governance, ed. E. Alexander, and B. Nikolaus, 106-130. New York:Oxford University Press.
    Huber, G.P. 2011. Organizations:Theory, design, future. In APA handbook of industrial and organizational psychology, ed. S. Zedeck, 117-160. Washington, DC:American Psychological Association.
    Huber, G.P., and J.M. Bartunek. 2019. Organization change. In Oxford research encyclopedia of psychology. https://doi.org/10.1093/acrefore/9780190236557.013.24
    Ingrassia, P.L., M. Foletti, A. Djalali, P. Scarone, L. Ragazzoni, F.D. Corte, K. Kaptan, and O. Lupescu et al. 2014. Education and training initiatives for crisis management in the European Union:A web-based analysis of available programs. Prehospital and Disaster Medicine 29(2):115-126.
    Khorram-Manesh, A. 2020. Flexible surge capacity-Public health, public education, and disaster management. Health Promotion Perspectives 10(3):175-179.
    Khorram-Manesh, A. 2020. Facilitators and constrainers of civilian-military collaboration:the Swedish perspectives. European Journal of Trauma and Emergency Surgery 46(3):649-656.
    Khorram-Manesh, A., and F.M. Burkle Jr. 2020. Disasters and public health emergencies-Current perspectives in preparedness and response. Sustainability 12(20):Article 8561.
    Khorram-Manesh, A., J. Berlin, and E. Carlström. 2016. Two validated ways of improving the ability of decision-making in emergencies; Results from a literature review. Bulletin of Emergency and Trauma 4(4):186-196.
    Khorram-Manesh, A., F.M. Burkle Jr., P. Phattharapornjaroen, M.A. Marzaleh, M. Al- Sultan, M. Mäntysaari, E. Carlström, and K. Goniewicz et al. 2021. The development of Swedish military healthcare system:Part II-Re-evaluating the military and civilian healthcare systems in crises through a dialogue and study among practitioners. Military Medicine 186(3-4):e442-e450.
    Khorram-Manesh, A., A. Hedelin, and P. Örtenwall. 2009. Regional coordination in medical emergencies and major incidents; plan, execute and teach. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 17(1):Article 32.
    Khorram-Manesh, A., H. Lönroth, P. Rotter, M. Wilhelmsson, J. Aremyr, A. Berner, A.N. Andersson, and E. Carlström. 2017. Non-medical aspects of civilian-military collaboration in the management of major incidents. European Journal of Trauma and Emergency Surgery 43(5):595-603.
    Khorram-Manesh, A., O. Lupesco, T. Friedl, G. Arnim, K. Kaptan, A.R. Djalali, M. Foletti, and P.L. Ingrasia et al. 2016. Education in disaster management:What do we offer and what do we need? Proposing a new global program. Disaster Medicine and Public Health Preparedness 10(6):854-873.
    Khorram-Manesh, A., L.J. Mortelmans, Y. Robinson, F.M. Burkle, and K. Goniewicz. 2022. Civilian-military collaboration before and during Covid-19 pandemic-A systematic review and a pilot survey among practitioners. Sustainability 14(2):Article 624.
    Khorram-Manesh, A., Y. Robinson, K. Boffard, and P. Örtenwall. 2020. The history of the Swedish military healthcare system and its path toward civilian-military collaboration from a total defense perspective. Military Medicine 185(9-10):e1492-e1498.
    Komasawa, N., F. Terasaki, M. Tomioka, R. Saura, and R. Kawata. 2021. The need of collaboration in medical education for worldwide disasters. Disaster Medicine and Public Health Preparedness 15(5):539-539.
    Lowes, A.J., and J.F. Cosgrove. 2016. Prehospital organization and management of a mass casualty incident. BJA Education 16(10):323-328.
    Maiers, C., M. Reynolds, and M. Haselkorn. 2005. Challenges to effective information and communication systems in humanitarian relief organizations. In Proceedings of International Professional Communication Conference, 10-13 July 2005, Limerick, Ireland, 82-91.
    Marshall, B., P. Cardon, A. Poddar, and R. Fontenot. 2013. Does sample size matter in qualitative research? A review of qualitative interviews in research. Journal of Computer Information System 54(1):11-22.
    Morgan, G. 2006. Images of organizations. Thousand Oaks, CA:SAGE.
    Nelson, C., N. Lurie, J. Wasserman, and S. Zakowski. 2007. Conceptualizing and defining public health emergency preparedness. American Journal of public health 97(Suppl. 1):9-11.
    Phattharapornjaroen, P., V. Glantz, E. Carlström, L. Dahlén Holmqvist, and A. Khorram-Manesh. 2020. Alternative leadership in flexible surge capacity-The perceived impact of tabletop simulation exercises on Thai emergency physicians' capability to manage a major incident. Sustainability 12(15):Article 6216.
    Phattharapornjaroen, P., V. Glantz, E. Carlström, L. Dahlén Holmqvist, Y. Sittichanbuncha, and A. Khorram-Manesh. 2021. The feasibility of implementing the flexible surge capacity concept in Bangkok:Willing participants and educational gaps. International Journal of Environmental Research and Public Health 18(15):Article 7793.
    Phattharapornjaroen, P., E. Carlström, and A. Khorram-Manesh. 2022. Developing a conceptual framework for flexible surge capacity based on complexity and collaborative theoretical frameworks. Public Health 208:46-51.
    Pomare, C., K. Churruca, J.C. Long, L.A. Ellis, and J. Braithwaite. 2019. Organizational change in hospitals:A qualitative case-study of staff perspectives. BMC Health Services Research 19:Article 840.
    Rhomberg, L. 2000. A framework for assessing risk to deployed forces. In Strategies to protect the health of deployed U.S. forces:Analytical framework for assessing risks, ed. L. Rhomberg, 44-81. Washington, DC:National Academies Press.
    Scott, W.R., and G.F. Davis. 2007. Organizations and organizing:Rational, natural, and open systems perspectives. Upper Saddle River, NJ:Prentice-Hall.
    Swedish National Constitution (Svensk författningssamling). 2003. The change of law (2003:460) regarding ethical approval of research concerning human (SFS 2008:192 Lag om ändring i lagen (2003:460) om etikprövning av forskning som avser människor). Last modified 4 January 2021. https://www.lagboken.se/Lagboken/start/skoljuridik/lag-2003460-om-etikprovning-av-forskning-som-avser-manniskor/d_181354-sfs-2008_192-lag-om-andring-i-lagen-2003_460-om-etikprovning-av-forskning-som-avser-manniskor. Accessed 10 May 2022.
    van Rossum, L., K.H. Aij, F.E. Simons, N. van der Eng, and W.D. ten Have. 2016. Lean healthcare from a change management perspective:The role of leadership and workforce flexibility in an operating theatre. Journal of Health Organization and Management 30(3):475-493.
    Yi, P., S.K. George, J.A. Paul, and L. Lin. 2010. Hospital capacity planning for disaster emergency management. Socio-Economic Planning Sciences 44(3):151-160.
    WHO (World Health Organization). 2019. Health emergency and disaster risk management framework. https://apps.who.int/iris/bitstream/handle/10665/326106/9789241516181-eng.pdf. Accessed 10 May 2022.
  • 加载中


    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (312) PDF downloads(0) Cited by()
    Proportional views


    DownLoad:  Full-Size Img  PowerPoint