Literature review
Critical evaluation for already published review
Objective:
Clarify and identify problem
Summarize the investigation
Identify relations, inconstancy, contradiction, gab in this literature
Suggest next steps in solving the problem
Health Care Management During Corona
Health care management is at the core of quality care services since it ensures that the organization has adequate resources and efficient allocation to meet the demand for services. Health care managers face the challenge of balancing scarce resources with the increasing demand due to medical problems’ complexity. Furthermore, new issues emerge that increase the pressure on managers to stretch the resources even further. The coronavirus disease 2019 (COVID-19) pandemic occurred and created a new challenge for health care management as hospitals have to use additional financial resources to deal with the new highly infectious disease. The COVID-19 crisis has changed the way hospitals deliver care in the United States and globally. Although the crisis has affected various dimensions of health care management, the most significant challenge has been how to balance the already limited resources to the management of the pandemic and other medical conditions.
The COVID-19 pandemic has affected almost every dimension of health care and creates new challenges and dilemmas for managing hospitals and health care organizations across the country and internationally. Laventhal et al. (2020) elucidate that quandaries among the obstacles are delineating and implementing crisis management standards of care and allocating resources to health care services during the pandemic. The authors add that healthcare organizations experience serious shortages of resources during a pandemic due to the high demand for services. Marron et al. (2020) support the sentiments of Laventhal et al. (2020), claiming that the ongoing pandemic will continue to demand more resources than the United States health care system is capable of providing. From the demand and supply perspective, the former continues to be higher than the demand due to the high rate of infection of the new virus. The pandemic’s impact on the system includes a growth in the number of patients seeking health care services, disruption in the supply chain, and growing mental health concerns.
Research is still limited regarding the actual impact of the loss of capacity, such as surgical services, in the wake of the COVID-19 pandemic. However, current evidence reveals that patients’ medical conditions and associated health will be affected negatively due to the lack of much-needed clinical services. Besides, information is available from normal cancellations of surgeries, which cause negative prognosis, as well as feelings of frustration, anger, and stress (Søreide et al., 2020). Besides, such scarcity or lack of medical services has economic consequences, such as inability to maintain occupancy, sick leave, loss of work, and family life (Weiser et al., 2016). While such adverse effects are common in health care facilities, the management will contend with more due to the shortage created by the COVID-19 pandemic. For example, hospitals have a limited capacity to handle surgeries, meaning that many will be put on hold when the demand increases.
Ongoing studies indicate the extent of stress that health care managers experience in the wake of the COVID-19 pandemic. According to Farrell et al. (2020), health care organizations face a shortage of human resources and supplies as more patients get infected and seek emergency services from available hospitals. Healthcare professionals contend with the increasing demand for their services, forcing them to work long hours amid inadequate medical supplies. Emanuel et al. (2020) take a similar perspective as Farrell et al. (2020), suggesting that the high rate at which people are infected will most definitely overwhelm health care infrastructure and resources. Unfortunately, health care managers will need to provide critical services, creating the need to know how well to allocate and use the limited resources to provide optimal care to the infected persons. Therefore, the health care management amid the COVID-19 pandemic requires greater competence in the management and allocation of resources than during the ordinary times.
The COVID-19 pandemic is a new crisis for the health care system, creating the need for significant changes to address the problem and protect organizations from potential collapse. However, Emanuel et al. (2020) claim that the actual impact of the COVID-19 pandemic on health care management remains uncertain since the crisis is still underway. The author elucidates that the pandemic’s ultimate course and impact remain uncertain, calling for health care management to prepare for any potential outcome. However, the authors conclude that regardless of the uncertainty, emerging viral pandemics “can place extraordinary and sustained demands on public health and health systems and on providers of essential community services” (2049). Kirkpatrick et al. (2020) add that the scarcity of resources will change how health care providers deliver services to their patients in different departments. Since they have to continue providing care to patients, they should learn the effective allocation of resource allocation. Such demands will create the need to ration medical equipment and interventions.
Health care management during the COVID-19 pandemic has changed considerably with attention focused on the limited resources and how to use them optimally to serve the needs of all patients. The crisis and its sequelae have caused challenges relating to triage, allocation, and reallocation amid the shortage (Kirkpatrick et al., 2020). Health care organizations’ ability to continue providing quality care depends on the ability of the management to allocate the limited resources optimally to all services and departments (Maves et al., 2020; Søreide et al., 2020). Although the demand for health care services is likely to increase, health care managers have an ethical responsibility to provide care to patients. However, Søreide et al. (2020) fail to provide a clear direction regarding dealing with the surge in critically ill patients that might overwhelm available services, especially in surgical units, due to the crisis. The level of preparedness among the health are managers for such scenarios remains questionable as the problem continues to affect the country’s health care system and globally.
Regardless of the agreement that resource allocation is a critical skill for health care managers during the COVID-19 pandemic, scholars disagree about the most effective method to use in the allocation process. For example, some health care organizations opted to cancel non‐essential services, such as surgeries, to create room for critical patients to receive life-saving care (Iacobucci, 2020). According to Ferrell et al. (2020), some approaches to resource allocation misguidedly use age as the primary criterion, focusing more on elderly patients. the American Geriatrics Society (AGS) ‘s official statement focuses on such as perspective that considers age as the critical factor to view during a pandemic to allocate resources. However, such a position raises ethical questions due to the potential disadvantage to other patient populations in a health care system then favors older adults in resource allocation decisions (Berlinger et al., 2020). Hospitals should adopt equitable emergency resource allocation approaches to ensure that all patients have a chance of receiving critical care during a pandemic, such as COVID-19 (Ferrell et al., 2020). A clear strategy helps health care managers to focus resources on the right services whenever they experience the resource allocation dilemma.
Despite the disagreement regarding the most effective formula to share and allocate resources, Kirkpatrick et al. (2020) and Laventhal et al. (2020) propose a focus on ethical principles and values when deciding how to use the limited resources to provide optimal care during the crisis. Health care managers should adopt ethical decision-making models when determining which service or department to allot what proportion of the health care budget. Necessary changes are required to ensure the fair and ethical use of available resources to support health care in a highly demanding environment. Vaccaro et al. (2020) suggest the need to maintain practice viability by retaining staff, cutting the cost, and positioning practice for recovery. The authors present the need to ensure that the available resources are equitably allocated to continue providing critical medical services for all patients in need. After all, all patients have the right to receive health care services regardless of the shortage.
Health care management has a new demand to change their resource allocation formula to adapt to the new care providing environment caused by the COVID-19 crisis. Laventhal et al. (2020) allude to the need to understand and adopt disaster planning and resource stewardship in the current health care environment to ensure that all medical needs are met equitably and ethically. Marron et al. (2020) also support the need for ethical relevance in allocating medical resources during the current and future public health crises. Unlike the use of age as the criterion for allocating resources, Laventhal et al. (2020) propose the focus on illness severity as a scoring system when deciding on the services or units to allocate the scarce resources. Managers should adopt real-time dashboards to report the case and the severity of the illness to ensure equitable and ethical distribution of resources (Dong et al., 2020; COVID & Team, 2020). For example, hospitals should record and monitor the severity of cases reported to ensure that the services available are used for the most critical cases. Other potential measures include the rationing of critical and intensive care beds, ventilators, and medications to ensure that they are available for severe cases (Marron et al., 2020; White & Lo, 2020). Such measures are necessary to ensure the effective use of limited resources to serve the increasing needs due to the COVID-19 crisis.
Health care management is critical in health care and in all seasons because of the ongoing demand for health care services. However, the role of the management changes from season to another depending on emerging needs. For example, the COID-19 pandemic outbreak has changed the way health care organizations are managed, especially regarding the allocation of limited resources. Human resources and supplies are strained due to the high infection rate and the criticality of emerging cases. Researchers agree about the need for effective allocation but lack a common model for the ethical distribution of resources. In the current pandemic, ethical health care management is necessary for positive outcomes in the wake of the pandemic that has strained available medical resources.
References
Berlinger, N., Wynia, M., Powell, T., Hester, D. M., Milliken, A., Fabi, R., & Jenks, N. P. (2020). Ethical framework for health care institutions responding to novel Coronavirus SARS-CoV-2 (COVID-19) guidelines for institutional ethics services responding to COVID-19. Safeguarding Communities, Guiding Practice, 2.
COVID, T. C., & Team, R. (2020). Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19)-United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep, 69(12), 343-346.
Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., Jiang, Z., & Tong, S. (2020). Epidemiology of COVID-19 among children in China. Pediatrics, 145(6).
Emanuel, E. J., Persad, G., Upshur, R., Thome, B., Parker, M., Glickman, A., … & Phillips, J. P. (2020). Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med 382, 2049-2055
Farrell, T. W., Ferrante, L. E., Brown, T., Francis, L., Widera, E., Rhodes, R., … & Liu, S. W. (2020). AGS Position Statement: Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond. Journal of the American Geriatrics Society. 68(6), 1136-1142
Iacobucci, G. (2020). Covid-19: all non-urgent elective surgery is suspended for at least three months in England. BMJ: British Medical Journal (Online), 368, 1-6
Kirkpatrick, J. N., Hull, S. C., Fedson, S., Mullen, B., & Goodlin, S. J. (2020). Scarce-resource allocation and patient triage during the COVID-19 pandemic: JACC Review Topic of the Week. Journal of the American College of Cardiology, 76(1), 85-92.
Laventhal, N., Basak, R., Dell, M. L., Diekema, D., Elster, N., Geis, G., … & Macauley, R. (2020). The ethics of creating a resource allocation strategy during the COVID-19 pandemic. Pediatrics, 146(1) 1-7
Marron, J. M., Joffe, S., Jagsi, R., Spence, R. A., & Hlubocky, F. J. (2020). Ethics and resource scarcity: ASCO recommendations for the oncology community during the COVID-19 pandemic. J Clin Oncol, 38(19), 2201-2205.
Marron, J. M., Joffe, S., Jagsi, R., Spence, R. A., & Hlubocky, F. J. (2020). Ethics and resource scarcity: ASCO recommendations for the oncology community during the COVID-19 pandemic. J Clin Oncol, 38(19), 2201-2205.
Maves, R. C., Downar, J., Dichter, J. R., Hick, J. L., Devereaux, A., Geiling, J. A., … & Rubinson, L. L. (2020). Triage of scarce critical care resources in COVID-19: an implementation guide for regional allocation An expert panel report of the Task Force for Mass Critical Care and the American College of Chest Physicians. Chest. 158(1), 212-225
Søreide, K., Hallet, J., Matthews, J. B., Schnitzbauer, A. A., Line, P. D., Lai, P., Otero, J., Callegaro, D., Warner, S. G., Baxter, N. N., Teh, C., Ng-Kamstra, J., Meara, J. G., Hagander, L., & Lorenzon, L. (2020). Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. The British journal of surgery, 10.1002/bjs.11670.
Vaccaro, A. R., Getz, C. L., Cohen, B. E., Cole, B. J., & Donnally III, C. J. (2020). Practice management during the COVID-19 pandemic. The Journal of the American Academy of Orthopaedic Surgeons. 10.5435/JAAOS-D-20-00379
Weiser, T. G., Haynes, A. B., Molina, G., Lipsitz, S. R., Esquivel, M. M., Uribe-Leitz, T., … & Gawande, A. A. (2016). Size and distribution of the global volume of surgery in 2012. Bulletin of the World Health Organization, 94(3), 201.
White, D. B., & Lo, B. (2020). A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. Jama, 323(18), 1773-1774.
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