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Resilient performance in healthcare during the COVID-19 pandemic (ResCOV): study protocol for a multilevel grounded theory study on adaptations, working conditions, ethics and patient safety.
Dalarna University, School of Health and Welfare, Caring Science/Nursing. Department of Anesthesia and Intensive Care Unit, Falun Hospital, Region Dalarna, Falun.ORCID iD: 0000-0002-0883-4072
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2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 12, article id e051928Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Since early 2020, the COVID-19 pandemic has challenged societies and revealed the built-in fragility and dependencies in complex adaptive systems, such as healthcare. The pandemic has placed healthcare providers and systems under unprecedented amounts of strain with potential consequences that have not yet been fully elucidated. This multilevel project aims to explore resilient performance with the purpose of improving the understanding of how healthcare has adapted during the pandemic's rampage, the processes involved and the consequences on working conditions, ethics and patient safety.

METHODS: An emerging explorative multilevel design based on grounded theory methodology is applied. Open and theoretical sampling is performed. Empirical data are gathered over time from written narratives and qualitative interviews with staff with different positions in healthcare organisations in two Swedish regions. The participants' first-person stories are complemented with data from the healthcare organisations' internal documents and national and international official documents.

ANALYSIS: Experiences and expressions of resilient performance at different system levels and times, existing influencing risk and success factors at the microlevels, mesolevels and macrolevels and inter-relationships and consequences in different healthcare contexts, are explored using constant comparative analysis. Finally, the data are complemented with the current literature to develop a substantive theory of resilient performance during the pandemic.

ETHICS AND DISSEMINATION: This project is ethically approved and recognises the ongoing strain on the healthcare system when gathering data. The ongoing pandemic provides unique possibilities to study system-wide adaptive capacity across different system levels and times, which can create an important basis for designing interventions focusing on preparedness to manage current and future challenges in healthcare. Feedback is provided to the settings to enable pressing improvements. The findings will also be disseminated through scientific journals and conferences.

Place, publisher, year, edition, pages
2021. Vol. 11, no 12, article id e051928
Keywords [en]
covid-19, ethics (see medical ethics), health & safety, human resource management, qualitative research, quality in health care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:du-39051DOI: 10.1136/bmjopen-2021-051928ISI: 000728888800025PubMedID: 34880017Scopus ID: 2-s2.0-85122542619OAI: oai:DiVA.org:du-39051DiVA, id: diva2:1620010
Available from: 2021-12-14 Created: 2021-12-14 Last updated: 2023-08-28Bibliographically approved

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Göras, CamillaKällberg, Ann-Sofie

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