Clinical trial NCT04908007: COvid Pandemic Institutional maNaGement
Official title: Institutional Management and Professional Experience During the Pandemic COVID-19 by Health Care Institutions in the Auvergne-Rhône-Alpes Region: Assessment and Lessons Learned
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Covid19
Keywords: Covid-19
Institutional management process
Professional experience
Crisis management
Lead sponsor: Hospices Civils de Lyon
Sponsor class: OTHER
First posted: 2021-06-01
Enrollment: 20000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: * Professionals and members of the institutions' bodies in the 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble
* Adult patients hospitalized for at least 48 hours during the first wave of the pandemic COVID-19 in the 4 university hospitals: Lyon, St Etienne, Clermont Ferrand, Grenoble

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Crisis management process based on a qualitative approach
timeFrame: The Qualitative analysis (intervention 1) will take place from September, 2020 to December, 2021
measure: Crisis management process based on a quantitative approach with the professionals (identified within the establishments)
timeFrame: The Quantitative analysis for professionals (intervention 2) will be conducted from March, 2021 to June 2021.
measure: Crisis management process based on a quantitative approach with the patients (hospitalized in the first wave)
timeFrame: The Quantitative analysis for patients (intervention 3) will be conducted from March, 2021 to June 2021. The tool development phase (intervention 4) will be carried out from January, 2022 to June, 2022
Secondary outcomes:
Other outcomes:
Locations:
city: Clermont-Ferrand
country: France
facility: CHU Clermont-Ferrand , Pôle de Santé Publique, unité d'Epidémiologie, Economie de la Santé et Prévention
city: Grenoble
country: France
facility: CHU Grenoble, Pôle Santé Publique, service de veille sanitaire
city: Lyon
country: France
facility: Hospices Civils de Lyon, DOQ-RU
city: Saint-Étienne
country: France
facility: CHU Saint-Etienne , Unité de gestion du risque infectieux
Study officials:
References: