Protecting the healthcare workforce during COVID-19: a qualitative needs assessment of employee occupational health in the US national Veterans Health Administration.
Protecting the healthcare workforce during COVID-19: a qualitative needs assessment of employee occupational health in the US national Veterans Health Administration.
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DOI：
10.1136/bmjopen-2021-049134
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发表时间：
2021-10-04
期刊：
影响因子：
2.9
通讯作者：
Giannitrapani KF
中科院分区：
文献类型：
--
作者：
Brown-Johnson C;McCaa MD;Giannitrapani S;Singer SJ;Lorenz KA;Yano EM;Thanassi WT;DeShields C;Giannitrapani KF
在2019冠状病毒病大流行初期，美国退伍军人健康管理局（VHA）的雇员职业健康（EOH）提供者被要求在协调雇员2019冠状病毒病筛查和上岗检查方面发挥核心作用，这是一项全新的EOH职责。在快速定性需求评估中，我们的目标是确定从该领域学到的知识，以支持EOH提供者在国家医疗保健系统中广泛发挥作用。我们采用了快速定性分析的关键线人采访中的最大变化样本的参数的工作类型，农村与城市和供应商的性别。我们在2020年7月至12月期间采访了21家VHA EOH提供商。该样本代表了来自美国不同地区的15家工厂（大西洋中部的大型、中型和小型工厂;南部的中型工厂;西部和太平洋西北部的大型工厂）。五个相互依存的需求包括：（1）支持员工群体管理的基础设施，包括促进接触者追踪等感染控制措施的工具（例如，面向患者的电子健康记录和协调的数据库）;（2）跨环境的信息共享机制（例如，VHA列表服务器），特别是用于改变政策和协议;（3）使用详细说明将EOH需求与人力资源资本相匹配的充足资源人员配置;（4）连接和资源的地方和国家领导人;和（5）战略，以支持医护人员的心理健康。我们确定的EOH促进者在COVID-19期间承担了新的具有挑战性和动态变化的角色，包括：（A）培训或获得专业知识;（B）现有的信息共享机制;（C）灵活和反应灵敏的人员配置;以及（D）利用以前不属于EOH的其他机构专业知识（例如，牧师支持丧亲）。我们的需求评估强调了在COVID-19期间EOH承担扩大角色的地方和系统层面的障碍和促进者。整合系统内部和系统之间的变化，并与人力资本保持一致，将使EOH为未来的挑战做好准备。
Early in the COVID-19 pandemic, US Veterans Health Administration (VHA) employee occupational health (EOH) providers were tasked with assuming a central role in coordinating employee COVID-19 screening and clearance for duty, representing entirely novel EOH responsibilities. In a rapid qualitative needs assessment, we aimed to identify learnings from the field to support the vastly expanding role of EOH providers in a national healthcare system. We employed rapid qualitative analysis of key informant interviews in a maximal variation sample on the parameters of job type, rural versus urban and provider gender. We interviewed 21 VHA EOH providers between July and December 2020. This sample represents 15 facilities from diverse regions of the USA (large, medium and small facilities in the Mid-Atlantic; medium sites in the South; large facilities in the West and Pacific Northwest). Five interdependent needs included: (1) infrastructure to support employee population management, including tools that facilitate infection control measures such as contact tracing (eg, employee-facing electronic health records and coordinated databases); (2) mechanisms for information sharing across settings (eg, VHA listserv), especially for changing policy and protocols; (3) sufficiently resourced staffing using detailing to align EOH needs with human resource capital; (4) connected and resourced local and national leaders; and (5) strategies to support healthcare worker mental health. Our identified facilitators for EOH assuming new challenging and dynamically changing roles during COVID-19 included: (A) training or access to expertise; (B) existing mechanisms for information sharing; (C) flexible and responsive staffing; and (D) leveraging other institutional expertise not previously affiliated with EOH (eg, chaplains to support bereavement). Our needs assessment highlights local and system level barriers and facilitators of EOH assuming expanded roles during COVID-19. Integrating changes both within and across systems and with alignment of human capital will enable EOH preparedness for future challenges.
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