COvid Pandemic Institutional maNaGement (COPING)

Civil Hospices of Lyon

Status: Unknown

Conditions: Covid19

Treatments: Other: Tools development; Other: Quantitative analysis for Professionals; Other: Quantitative analysis for Patients; Other: Qualitative analysis for professionals

Study type: Observational

Funder types: Other

Identifiers

NCT04908007

69HCL20_0466

Details and patient eligibility

About

Covid-19 has increased organizational tensions within health services (lack of resources, difficulties in recruiting healthcare professionals , elderly and polypathological patients, etc.) and tested the reliability of health facilities. This project aims to draw lessons so that hospitals can transform themselves while improving their reliability to face future crises and other exceptional situations.

Research hypothesis:

Crisis management arrangements lack sensitivity to uncertainty, which manifests itself in lower quality of care and efficiency losses for the entire institution.

The virtuous practices implemented during the crisis spontaneously incorporated principles of the highly reliable organization.

The integration of principles from complexity theory into the management of institutions promotes high reliability organization.

Sustaining these virtuous practices in order to anticipate and cope with crises requires the activation of two interconnected levers: a shared vision (by patients, healthcare professionals, ARS, HAS, and the Ministry in the first place) of the meaning of the action taken by hospitals, and the development of a policy enabling hospitals to become both learning and highly reliable.

Main objective:

To evaluate the management process of the Covid-19 epidemic by the university hospitals of the Auvergne-Rhône-Alpes region, and the structures linked to them (establishments in their territory, ARS, user associations), in terms of points of improvement and good practices. This evaluation concerns the preparation, management and exit phases of the crisis.

Enrollment: 20,000 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Establishments :

  • 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble
  • Establishments in the same territories, public and private

• Professionals and members of the institutions' bodies:

  • Governance: management and chair of the CME
  • Management (care, communication, medical, technical, logistics, IT, personnel)
  • Clinical and public health cluster governance
  • Medical, paramedical and non-medical staff in the departments most concerned (emergency and EMS reception, intensive care, infectiology, hygiene, virology, imaging, occupational medicine in particular)
  • Organizations representing the personnel
  • Members of the users' representatives committee

• Adult patients hospitalized for at least 48 hours during the study period (quantitative study by questionnaires).

Exclusion criteria

• none

Trial design

20,000 participants in 4 patient groups

Professional qualitative group

Description:

Qualitative analysis of crisis management by interviewing professionals most involved during the crisis in each university hospital.

Treatment:

Other: Qualitative analysis for professionals

Professional quantitative group

Description:

Quantitative analysis of crisis management using the WHO grid adapted sent to the target persons identified within the establishments

Treatment:

Other: Quantitative analysis for Professionals

Patient quantitative group

Description:

Quantitative analysis of crisis management using a questionnaire sent to patients hospitalized in the first wave asking them about their perception of crisis and post-crisis management.

Treatment:

Other: Quantitative analysis for Patients

Tools development

Description:

Development of tools to prepare for situations of uncertainty

Treatment:

Other: Tools development