from the editor
from the editor
Addressing Resource Shortfalls Before the Next Outbreak or Pandemic
Still looming large is the specter of the widespread shortfall in personal protective equipment ( PPE ), disinfectants , hand hygiene products , saline , and other patient-care commodities that were in horrifically short supply during the COVID-19 pandemic . The situation became so dire in some healthcare systems that official declarations of crisis were made and clinicians were handcrafting PPE and reusing masks , gowns and gloves . The perfect storm of a fractured supply chain due to halted overseas manufacturing , depleted just-in-time inventory systems , and a lack of readiness at the facility and system levels hit healthcare hard , and what ’ s worse , some of it could have been avoided . As we navel-gaze but don ’ t take decisive action three years later , are we headed for an encore during the next pandemic ?
That critical issue aside , what was the impact of resource shortfalls on frontline clinicians ? Common sense tells us we already know the answer , but recent research by Butler , et al . ( 2023 ) suggest that institutional plans to protect frontline clinicians from the responsibility for allocating scarce resources may be unworkable , especially in a state of chronic crisis . The researchers emphasize that efforts are needed to directly integrate frontline clinicians into institutional emergency responses and support them in ways that reflect the complex and dynamic realities of healthcare resource limitation .
The researchers ’ qualitative inductive thematic analysis was based on interviews with physicians and nurses providing direct patient care at U . S . healthcare institutions during the COVID-19 pandemic . Interviews were conducted between Dec . 28 , 2020 and Dec . 9 , 2021 . Interviews with 23 clinicians ( 21 physicians and two nurses ) who were practicing in California , Idaho , Minnesota , or Texas were included .
Three themes emerged ; the first was isolation . As Butler , et al . ( 2023 ) explain , “ Clinicians had a limited view on what was happening outside their immediate practice setting and perceived a disconnect between official messaging about crisis conditions and their own experience . In the absence of overarching system-level support , responsibility for making challenging decisions about how to adapt practices and allocate resources often fell to frontline clinicians .”
The second theme was in-the-moment decision-making . “ Formal crisis declarations did little to guide how resources were allocated in clinical practice ,” the researchers observe . “ Clinicians adapted practice by drawing on their clinical judgment but described feeling ill equipped to handle some of the operationally and ethically complex situations that fell to them .”
The third theme was waning motivation . “ As the pandemic persisted , the strong sense of mission , duty , and purpose that had fueled extraordinary efforts earlier in the pandemic was eroded by unsatisfying clinical roles , misalignment between clinicians ’ own values and institutional goals , more distant relationships with patients , and moral distress ,” the researchers wrote .
The researchers say their findings “ suggest that institutional plans to protect frontline clinicians from the responsibility for allocating scarce resources may be unworkable , especially in a state of chronic crisis . Efforts are needed to directly integrate frontline clinicians into institutional emergency responses and support them in ways that reflect the complex and dynamic realities of healthcare resource limitation .”
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
Reference : Butler CR , et al . Experiences of US Clinicians Contending With Health Care Resource Scarcity During the COVID-19 Pandemic , December 2020 to December 2021 . JAMA Netw Open . 2023 ; 6 ( 6 ): e2318810 . doi : 10.1001 / jamanetworkopen . 2023.18810 healthcarehygienemagazine
editor & publisher
president & cfo art director customer service manager
Kelly M . Pyrek kelly @ healthcarehygienemagazine . com
A . G . Hettinger , CPA Patti Valdez J . Christine Phillips
Send inquiries to : team @ keystonemediainc . com
Healthcare Hygiene magazine is published monthly by Keystone Media Inc . 8955 Ridgeline Blvd ., Suite 500 , Highlands Ranch , CO 80129 . Free digital subscriptions available at www . healthcarehygienemagazine . com for U . S ., Canada and other foreign subscribers . Copyright © 2023 Keystone Media Inc . All rights reserved . The publisher reserves the right to accept or reject any advertising or editorial material . Advertisers , and / or their agents , assume the responsibility for all content of published advertisements and assume responsibility for any claims against the publisher based on the advertisement . Editorial contributors assume responsibility for their published works and assume responsibility for any claims against the publisher based on the published work . All items submitted to Healthcare Hygiene magazine become the sole property of Keystone Media Inc . Editorial content may not necessarily reflect the views of the publisher . No part of this publication may be reproduced in any form or by any electronic or mechanical means , including information storage and retrieval systems , without permission in writing from the publisher .
6 july 2023 • www . healthcarehygienemagazine . com