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Will the “New” Become the “Normal”? Exploring Sustainability of Rapid Health System Transformations

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Organising Care in a Time of Covid-19

Abstract

Health, social, and community care agencies are undergoing rapid changes in response to the COVID-19 pandemic, arguably offering a “window of opportunity” for health system transformation. What is required is theoretical guidance to help determine whether rapid system responses are likely to be sustained as part of broader transformation efforts. We performed a single-phenomenon two theory integration to develop the Rapid and Sustainable Transformation (or RAST) framework, aligning theories from the disaster response and sustainability literature to propose a framework exploring the long-term impact of rapid health system changes and interventions related to COVID-19. In this chapter, the proposed theoretical framework is applied to three cases from Quebec and Ontario in Canada and The Netherlands to examine ongoing efforts to improve health system delivery prior to the pandemic. By applying the framework to these cases, this chapter demonstrates how the framework can help to identify components that require attention for studying sustainability in a disaster response environment. The RAST framework helps advance organizational research around health system transformation by demonstrating how the components of sustainability are interrelated and may be weighed differently in their influence on longer-term transformation.

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References

  • Austin, J. M., & Kachalia, A. (2020). The state of health care quality measurement in the era of COVID-19: The importance of doing better. JAMA, 324(4), 333–334.

    Article  Google Scholar 

  • Best, A., et al. (2012). Large-system transformation in health care: A realist review. Milbank Quarterly, 90(3), 421–456.

    Article  Google Scholar 

  • Bill 188, Economic and Fiscal Update Act, 2020. (2020).

    Google Scholar 

  • Braithwaite, J., et al. (2018). When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Medicine, 16(1), 63.

    Article  Google Scholar 

  • Brundiers, K. (2018). Disasters as opportunities for sustainability: the case of Christchurch, Aotearoa New Zealand. Sustainability Science, 13(4), 1075–1091.

    Article  Google Scholar 

  • Brundiers, K., & Eakin, H. (2018). Leveraging post-disaster windows of opportunities for change towards sustainability: A framework. Sustainability, 10, 1–5.

    Google Scholar 

  • Bryski, K. (2020, August 18). Virtual beats viral. https://infoway-inforoute.ca/en/what-we-do/blog/access-to-care/8585-virtual-beats-viral

  • Canadian Medical Association. (2019). Virtual care in Canada (Discussion Paper). Canadian Medical Association, Ottawa, ON.

    Google Scholar 

  • Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8(1), 117.

    Article  Google Scholar 

  • Côté-Boileau, É., et al. (2019). The unpredictable journeys of spreading, sustaining and scaling healthcare innovations: A scoping review. Health Research Policy and Systems, 17(1), 84.

    Article  Google Scholar 

  • Council, C. (2014). Telemedicine (C.o.P.a.S.o, Ed.). Toronto, ON.

    Google Scholar 

  • Coulibaly, S., & Fortin, B. (2020). COVID-19 et maintien à domicile des aînés (CIRANO Papers).

    Google Scholar 

  • Da Silva, R.B. (2020, July 30). Portrait des CHSLD et enjeux en contexte de pandémie. https://policyoptions.irpp.org/magazines/april-2020/portrait-des-chsld-et-enjeux-en-contexte-de-pandemie/

  • Fleiszer, A. R., et al. (2015). An organizational perspective on the long-term sustainability of a nursing best practice guidelines program: A case study. BMC Health Services Research, 15(1), 535.

    Article  Google Scholar 

  • Gagnon, É., Clément, M., & Bordeleau, L. (2017). Speaking out and being heard residents’ committees in Quebec’s residential long-term care centre. Health Care Analysis, 25(4), 308–322.

    Article  Google Scholar 

  • Greenhalgh, T., et al. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629.

    Article  Google Scholar 

  • Greenhalgh, T., et al. (2012). “If we build it, will it stay?” A case study of the sustainability of whole-system change in London. The Milbank Quarterly, 90(3), 516–547.

    Article  Google Scholar 

  • Hamilton Health Sciences. (2020). Virtual care for long-term care. Hamilton, ON.

    Google Scholar 

  • Hsu, A. T., & Lane, N. (2020). Impact of COVID-19 on residents of Canada’s long-term care homes—Ongoing challenges and policy response (p. 15; I.L.T.C.P. Network, Ed.). Report in LTCcovid.org.

    Google Scholar 

  • Institute of Medicine Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press (US) Copyright 2001 by the National Academy of Sciences. All rights reserved.

    Google Scholar 

  • Klinga, C., et al. (2018). Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care. BMC Health Services Research, 18(1), 400.

    Article  Google Scholar 

  • Kroneman, M., Boerma, W., van den Berg, M., Groenewegen, P., de Jong, J., & van Ginneken, E. (2016). The Netherlands: Health system review. Health Systems in Transition, 18(2), 1–239.

    Google Scholar 

  • Lennox, L. (2020). Sustainability. In P. Nielsen & S. Birken (Eds.), Handbook on implementation science (pp. 333–367). Edward Elgar Publishing.

    Chapter  Google Scholar 

  • Luft, A. (2020, September 17). Quebec coroner orders public inquiry into COVID-19 deaths in long-term care residences. https://montreal.ctvnews.ca/quebec-coroner-orders-public-inquiry-into-covid-19-deaths-in-long-term-care-residences-1.4988171

  • Mayer, K. J., & Sparrowe, R. T. (2013). Integrating theories in AMJ Articles. Academy of Management Journal, 56(4), 917–922.

    Article  Google Scholar 

  • Norris, F. H., et al. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41(1–2), 127–150.

    Article  Google Scholar 

  • Olshansky, R., Hopkins, L. D., & Johnson, L. A. (2012). Disaster and recovery: Processes compressed in time. Natural Hazards Review, 13, 173–178.

    Article  Google Scholar 

  • Ontairo Ministry of Health. (2020). Billing for virtual physician services and technical guidance. Info Bulletin. Ontairo Ministry of Health, Toronto, ON.

    Google Scholar 

  • Ontario Ministry of Health Claims Services Branch. (2019). Virtual care program—Billing amendments to enable direct-to-patient video visits and modernize virtual care compensation. Info Bulletin, Toronto, ON.

    Google Scholar 

  • Ontario Telemedicine Network. (2020a, August 10). Important COVID-19 information and updates.

    Google Scholar 

  • Ontario Telemedicine Network. (2020b). Cyber security advisory—Zoom. Ontario Telemedicine Network, ON.

    Google Scholar 

  • Pierson, S., et al. (2020). Virtual care for long term care—Launching Monday! (S.J.s.H. Hamilton, Ed.). Hamilton, ON.

    Google Scholar 

  • PointClikcCare. (2020). Better collaboration means better care for long-term care residents. Hamilton, ON.

    Google Scholar 

  • Pulejo, M., & Querubín, P. (2020). Electoral concerns reduce restrictive measures during the COVID-19 pandemic (National Bureau of Economic Research Working Paper Series, 2020. No. 27498).

    Google Scholar 

  • Quarshie, A. M., & Leuschner, R. (2018). Cross-sector social interactions and systemic change in disaster response: A qualitative study. Journal of Business Ethics, 150(2), 357–384.

    Article  Google Scholar 

  • Shingler, B., & Montpetit, J. (2020). Quebec finally gets a handle on COVID outbreaks in long-term care, but is it ready for a 2nd wave? CBC News, Montreal.

    Google Scholar 

  • Steele Gray, C., et al. (2018). Using information communication technology in models of integrated community-based primary health care: Learning from the iCOACH case studies. Implementation Science, 13(1), 87.

    Article  Google Scholar 

  • St. Joseph’s Healthcare Hamilton. (2020, August 1). Integrated Comprehensive Care (ICC). https://www.stjoes.ca/hospital-services/integrated-comprehensive-care-icc

  • Sword-Daniels, V. L., et al. (2016). Unpacking long-term disaster recovery processes: A case study of the healthcare system in Montserrat, West Indies. International Journal of Mass Emergencies and Disasters, 34(1), 113–142.

    Google Scholar 

  • Wankah, P., et al. (2018). Reorganising health and social care in Québec: A journey towards integrating care through mergers. London Journal of Primary Care, 10(3), 48–53.

    Article  Google Scholar 

  • Weible, C. M., et al. (2020). COVID-19 and the policy sciences: Initial reactions and perspectives. Policy Sciences, 53(2), 225–241.

    Article  Google Scholar 

  • Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (WHIV). (2019). Enhanced access to primary care: Project evaluation final report (p. 59). Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (WHIV), Toronto, ON.

    Google Scholar 

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Correspondence to Carolyn Steele Gray .

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Steele Gray, C. et al. (2021). Will the “New” Become the “Normal”? Exploring Sustainability of Rapid Health System Transformations. In: Waring, J., Denis, JL., Reff Pedersen, A., Tenbensel, T. (eds) Organising Care in a Time of Covid-19. Organizational Behaviour in Healthcare. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-82696-3_15

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