Considering context: Adaptive elements of a simulation program to improve primary care safety during the COVID-19 pandemic in Alberta, Canada - 28/07/22
, Nicole Pinto, MPH a, Myles Leslie, PhD a, b
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Highlights |
• | Globally, primary care (PC) has seen significant disruptions and strain from the COVID-19 pandemic, jeopardizing the ability to provide safe, accessible in-person care. |
• | Our “action research” team from the high-income country (HIC) context of Alberta, Canada, developed an innovative virtual tabletop simulation (TTS) intervention which assisted clinical teams to deliver safe, in-person care during the COVID-19 pandemic. |
• | We examine “adaptive elements” which contributed to our program's success, which were just as important as the technical details of virtual TTS program implementation. |
• | Rather than assuming this innovation developed in a HIC setting should be used to solve low- and middle-income country (LMIC) challenges, we ask whether and how our virtual TTS intervention might be adapted in other settings to improve the safety and accessibility of PC during the COVID-19 pandemic. |
Résumé |
Background |
Globally, primary care (PC) has been central to the COVID-19 response. The pandemic has strained PC systems and introduced novel infection prevention and control (IPC) risks to the provision of safe, accessible in-person care. Specifically, the implementation of IPC guidance developed outside of PC into its operational context has proved challenging.
Methods |
Our team of “action researchers” developed an innovative virtual tabletop simulations (TTS) intervention which assisted PC teams as they adapted, implemented, and integrated IPC guidance into their specific clinical contexts. While we have detailed the “technical” elements of the TTS program elsewhere, this paper examines the specific “adaptive” elements that made this intervention successful in the high-income country context of Alberta, Canada.
Results |
Multiple factors influenced the uptake of this program in our Albertan setting, including: cultural geography; approach to financing and delivering PC; and policies and cultural norms supporting PC integration, medical education and research, and egalitarian teamwork.
Conclusions |
Virtual TTS may provide substantial benefits to IPC and safety improvements in PC settings globally. However, the specific technical and adaptive elements of our Albertan TTS program might, or might not, make these a viable IPC intervention for adapting, spreading, and scaling to other settings.
Le texte complet de cet article est disponible en PDF.Key Words : COVID-19 pandemic response, Quality improvement, Interdisciplinary research, Knowledge translation, Infection prevention and control, Family medicine
Abbreviations : AHS, FFS, HIC, ILI, IPC, LMIC, MoH, PC, PCN, PPE, TTS
Plan
| Funding/support: This work is supported by the Government of Canada, through the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council of Canada (NSERC), the Social Sciences and Humanities Research Council (SSHRC), the Canada Research Coordinating Committee (CRCC) through the New Frontiers in Research Fund (NFRF), the International Development Research Centre (IDRC), and Genome Canada (GC). Funding was supplied through the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding Opportunity (#202002COV, Award #440239). This work was also funded by the WHO (Award #2020/10698115-0). The sponsors had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript. Open access of this article is sponsored by the World Health Organization. |
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| Conflicts of interest: None to report. |
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| Ethics approval and consent to participate: Ethics approval for the full study was granted by the University of Calgary's Conjoint Health Research Ethics Board (CHREB) on March 11, 2020 (REB20-0371) and renewed on March 11, 2021. For this type of study, consent to participate is not required. |
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| Availability of data and materials: No additional data are available. |
Vol 50 - N° 8
P. 885-889 - août 2022 Retour au numéro
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