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Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | COVID-19 | Research

Health workforce strategies in response to major health events: a rapid scoping review with lessons learned for the response to the COVID-19 pandemic

Authors: Alison Coates, Asli-Oubah Fuad, Amanda Hodgson, Ivy Lynn Bourgeault

Published in: Human Resources for Health | Issue 1/2021

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Abstract

Background

The early weeks of the COVID-19 pandemic brought multiple concurrent threats—high patient volume and acuity and, simultaneously, increased risk to health workers. Healthcare managers and decision-makers needed to identify strategies to mitigate these adverse conditions. This paper reports on the health workforce strategies implemented in relation to past large-scale emergencies (including natural disasters, extreme weather events, and infectious disease outbreaks).

Methods

We conducted a rapid scoping review of health workforce responses to natural disasters, extreme weather events, and infectious disease outbreaks reported in the literature between January 2000 and April 2020. The 3582 individual results were screened to include articles which described surge responses to past emergencies for which an evaluative component was included in the report. A total of 37 articles were included in our analysis.

Results

The reviewed literature describes challenges related to increased demand for health services and a simultaneous decrease in the availability of the workforce. Many articles also described impacts on infrastructure that hindered emergency response. These challenges aligned well with those faced during the early days of the COVID-19 pandemic. In the published literature, the workforce strategies that were described aimed either to increase the numbers of health workers in a given area, to increase the flexibility of the health workforce to meet needs in new ways, or to support and sustain health workers in practice. Workforce responses addressed all types and cadres of health workers and were executed in a wide range of settings. We additionally report on the barriers and facilitators of workforce strategies reported in the literature reviewed. The strategies that were reported in the literature aligned closely with our COVID-specific conceptual framework of workforce capacity levers, suggesting that our framework may have heuristic value across many types of health disasters.

Conclusions

This research highlights a key deficiency with the existing literature on workforce responses to emergencies: most papers lack substantive evaluation of the strategies implemented. Future research on health workforce capacity interventions should include robust evaluation of impact and effectiveness.
Appendix
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Footnotes
1
At the time, Healthcare Excellence Canada was working under its previous title of the Canadian Foundation for Healthcare Improvement.
 
Literature
2.
go back to reference Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. 2020;323(16):1545–6.PubMed Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. 2020;323(16):1545–6.PubMed
3.
go back to reference Flores S, Gavin N, Romney M-L, Tedeschi C, Olsen E, Heravian A, et al. COVID-19: New York City pandemic notes from the first 30 days. Am J Emerg Med. 2020;38(7):1534–5.PubMedPubMedCentral Flores S, Gavin N, Romney M-L, Tedeschi C, Olsen E, Heravian A, et al. COVID-19: New York City pandemic notes from the first 30 days. Am J Emerg Med. 2020;38(7):1534–5.PubMedPubMedCentral
4.
go back to reference Bourgeault IL, Maier CB, Dieleman M, Ball J, MacKenzie A, Nancarrow S, et al. The COVID-19 pandemic presents an opportunity to develop more sustainable health workforces. Hum Resour Health. 2020;18(1):83.PubMedPubMedCentral Bourgeault IL, Maier CB, Dieleman M, Ball J, MacKenzie A, Nancarrow S, et al. The COVID-19 pandemic presents an opportunity to develop more sustainable health workforces. Hum Resour Health. 2020;18(1):83.PubMedPubMedCentral
5.
go back to reference Fraher EP, Pittman P, Frogner BK, Spetz J, Moore J, Beck AJ, et al. Ensuring and sustaining a pandemic workforce. N Engl J Med. 2020;382(23):2181–3.PubMed Fraher EP, Pittman P, Frogner BK, Spetz J, Moore J, Beck AJ, et al. Ensuring and sustaining a pandemic workforce. N Engl J Med. 2020;382(23):2181–3.PubMed
7.
go back to reference Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Evidence summaries: the evolution of a rapid review approach. Syst Rev. 2012;1(1):10.PubMedPubMedCentral Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Evidence summaries: the evolution of a rapid review approach. Syst Rev. 2012;1(1):10.PubMedPubMedCentral
8.
go back to reference Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
10.
go back to reference McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;1(75):40–6. McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;1(75):40–6.
11.
go back to reference Coates A, Bourgeault I, Hodgson A. Health workforce innovations in response to major health events: rapid scoping review protocol. 2020 Apr 30 [cited 2021 Oct 19]; Available from: https://osf.io/bajsd/. Coates A, Bourgeault I, Hodgson A. Health workforce innovations in response to major health events: rapid scoping review protocol. 2020 Apr 30 [cited 2021 Oct 19]; Available from: https://​osf.​io/​bajsd/​.
12.
go back to reference Booth CM, Stewart TE. Severe acute respiratory syndrome and critical care medicine: the Toronto experience. Crit Care Med. 2005;33(1 Suppl):S53-60.PubMed Booth CM, Stewart TE. Severe acute respiratory syndrome and critical care medicine: the Toronto experience. Crit Care Med. 2005;33(1 Suppl):S53-60.PubMed
13.
go back to reference Chaple EB, Mercer MA. The Cuban response to the Ebola epidemic in West Africa: lessons in solidarity. Int J Health Serv. 2017;47(1):134–49.PubMed Chaple EB, Mercer MA. The Cuban response to the Ebola epidemic in West Africa: lessons in solidarity. Int J Health Serv. 2017;47(1):134–49.PubMed
14.
go back to reference Charney RL, Armbrecht ES, Kennedy BR, Flood RG. Pandemic influenza extension areas in an urban pediatric hospital. Prehosp Disaster Med. 2012;27(1):75–80.PubMed Charney RL, Armbrecht ES, Kennedy BR, Flood RG. Pandemic influenza extension areas in an urban pediatric hospital. Prehosp Disaster Med. 2012;27(1):75–80.PubMed
15.
go back to reference Chin TWF, Chant C, Tanzini R, Wells J. Severe acute respiratory syndrome (SARS): the pharmacist’s role. Pharmacotherapy. 2004;24(6):705–12.PubMedPubMedCentral Chin TWF, Chant C, Tanzini R, Wells J. Severe acute respiratory syndrome (SARS): the pharmacist’s role. Pharmacotherapy. 2004;24(6):705–12.PubMedPubMedCentral
16.
go back to reference Chou T-L, Ho L-Y, Wang K-Y, Kao C-W, Yang M-H, Fan P-L. Uniformed service nurses’ experiences with the severe acute respiratory syndrome outbreak and response in Taiwan. Nurs Clin North Am. 2010;45(2):179–91.PubMedPubMedCentral Chou T-L, Ho L-Y, Wang K-Y, Kao C-W, Yang M-H, Fan P-L. Uniformed service nurses’ experiences with the severe acute respiratory syndrome outbreak and response in Taiwan. Nurs Clin North Am. 2010;45(2):179–91.PubMedPubMedCentral
17.
go back to reference Considine J, Shaban RZ, Patrick J, Holzhauser K, Aitken P, Clark M, et al. Pandemic (H1N1) 2009 influenza in Australia: absenteeism and redeployment of emergency medicine and nursing staff. Emerg Med Australas. 2011;23(5):615–23.PubMed Considine J, Shaban RZ, Patrick J, Holzhauser K, Aitken P, Clark M, et al. Pandemic (H1N1) 2009 influenza in Australia: absenteeism and redeployment of emergency medicine and nursing staff. Emerg Med Australas. 2011;23(5):615–23.PubMed
18.
go back to reference Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: a phenomenological study. Int J Nurs Stud. 2010;47(5):577–85.PubMedPubMedCentral Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: a phenomenological study. Int J Nurs Stud. 2010;47(5):577–85.PubMedPubMedCentral
19.
go back to reference Crawford JM, Stallone R, Zhang F, Gerolimatos M, Korologos DD, Sweetapple C, et al. Laboratory surge response to pandemic (H1N1) 2009 outbreak, New York City metropolitan area, USA. Emerg Infect Dis. 2010;16(1):8–13.PubMedPubMedCentral Crawford JM, Stallone R, Zhang F, Gerolimatos M, Korologos DD, Sweetapple C, et al. Laboratory surge response to pandemic (H1N1) 2009 outbreak, New York City metropolitan area, USA. Emerg Infect Dis. 2010;16(1):8–13.PubMedPubMedCentral
20.
go back to reference Cruz AT, Patel B, DiStefano MC, Codispoti CR, Shook JE, Demmler-Harrison GJ, et al. Outside the box and into thick air: implementation of an exterior mobile pediatric emergency response team for North American H1N1 (swine) influenza virus in Houston, Texas. Ann Emerg Med. 2010;55(1):23–31.PubMed Cruz AT, Patel B, DiStefano MC, Codispoti CR, Shook JE, Demmler-Harrison GJ, et al. Outside the box and into thick air: implementation of an exterior mobile pediatric emergency response team for North American H1N1 (swine) influenza virus in Houston, Texas. Ann Emerg Med. 2010;55(1):23–31.PubMed
21.
go back to reference Albahari A, Schultz CH. A qualitative analysis of the spontaneous volunteer response to the 2013 Sudan floods: changing the paradigm. Prehosp Disaster Med. 2017;32(3):240–8.PubMed Albahari A, Schultz CH. A qualitative analysis of the spontaneous volunteer response to the 2013 Sudan floods: changing the paradigm. Prehosp Disaster Med. 2017;32(3):240–8.PubMed
22.
go back to reference Broz D, Levin EC, Mucha AP, Pelzel D, Wong W, Persky VW, et al. Lessons learned from Chicago’s emergency response to mass evacuations caused by Hurricane Katrina. Am J Public Health. 2009;99(8):1496–504.PubMedPubMedCentral Broz D, Levin EC, Mucha AP, Pelzel D, Wong W, Persky VW, et al. Lessons learned from Chicago’s emergency response to mass evacuations caused by Hurricane Katrina. Am J Public Health. 2009;99(8):1496–504.PubMedPubMedCentral
23.
go back to reference Buajaroen H. Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand. Australas Emerg Nurs J. 2013;16(3):116–22.PubMed Buajaroen H. Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand. Australas Emerg Nurs J. 2013;16(3):116–22.PubMed
24.
go back to reference Comeau OY, Heffernan JM, Sheaffer JL, Sayles FM II. Rising to the challenge. Crit Care Nurs Q. 2014;37(3):336–43.PubMed Comeau OY, Heffernan JM, Sheaffer JL, Sayles FM II. Rising to the challenge. Crit Care Nurs Q. 2014;37(3):336–43.PubMed
25.
go back to reference Connelly M. IMERT deployment to Baton Rouge, Louisiana in response to Hurricane Katrina, September 2005. Disaster Manag Response. 2006;4(1):4–11.PubMed Connelly M. IMERT deployment to Baton Rouge, Louisiana in response to Hurricane Katrina, September 2005. Disaster Manag Response. 2006;4(1):4–11.PubMed
26.
go back to reference Currier M, King DS, Wofford MR, Daniel BJ, Deshazo R. A Katrina experience: lessons learned. Am J Med. 2006;119(11):986–92.PubMed Currier M, King DS, Wofford MR, Daniel BJ, Deshazo R. A Katrina experience: lessons learned. Am J Med. 2006;119(11):986–92.PubMed
27.
go back to reference Bailey JH, Deshazo RD. Providing healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning. Am J Med Sci. 2008;336(2):124–7.PubMed Bailey JH, Deshazo RD. Providing healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning. Am J Med Sci. 2008;336(2):124–7.PubMed
28.
go back to reference D’Amore AR, Hardin CK. Air Force expeditionary medical support unit at the Houston floods: use of a military model in civilian disaster response. Mil Med. 2005;170(2):103–8.PubMed D’Amore AR, Hardin CK. Air Force expeditionary medical support unit at the Houston floods: use of a military model in civilian disaster response. Mil Med. 2005;170(2):103–8.PubMed
29.
go back to reference Deal BJ, Fountain RA, Russell-Broaddus A, Stanley-Hermanns M. Challenges and opportunities of nursing care in special-needs shelters. Disaster Manag Response. 2006;4(4):100–5.PubMed Deal BJ, Fountain RA, Russell-Broaddus A, Stanley-Hermanns M. Challenges and opportunities of nursing care in special-needs shelters. Disaster Manag Response. 2006;4(4):100–5.PubMed
30.
go back to reference Edwards TD, Young RA, Lowe AF. Caring for a surge of Hurricane Katrina evacuees in primary care clinics. Ann Fam Med. 2007;5(2):170–4.PubMedPubMedCentral Edwards TD, Young RA, Lowe AF. Caring for a surge of Hurricane Katrina evacuees in primary care clinics. Ann Fam Med. 2007;5(2):170–4.PubMedPubMedCentral
31.
go back to reference Grover JM, Smith B, Williams JG, Patel MD, Cabanas J, Brice JH. Novel use of telemedicine by hurricane evacuation shelters. Prehosp Emerg Care. 2020;24(6):804–12.PubMed Grover JM, Smith B, Williams JG, Patel MD, Cabanas J, Brice JH. Novel use of telemedicine by hurricane evacuation shelters. Prehosp Emerg Care. 2020;24(6):804–12.PubMed
32.
go back to reference Klein KR, Nagel NE. Mass medical evacuation: Hurricane Katrina and nursing experiences at the New Orleans airport. Disaster Manag Response. 2007;5(2):56–61.PubMed Klein KR, Nagel NE. Mass medical evacuation: Hurricane Katrina and nursing experiences at the New Orleans airport. Disaster Manag Response. 2007;5(2):56–61.PubMed
33.
go back to reference Lawlor J, Franklin RC, Aitken P, Hooke B, Furyk J, Johnson A. Perceptions of the utility and acceptability of an emergency child minding service for health staff. Disaster Med Public Health Prep. 2014;8(6):485–8.PubMed Lawlor J, Franklin RC, Aitken P, Hooke B, Furyk J, Johnson A. Perceptions of the utility and acceptability of an emergency child minding service for health staff. Disaster Med Public Health Prep. 2014;8(6):485–8.PubMed
34.
go back to reference Parak BE, Hodge NS, Eccleston SD. Implementing a fast-track team triage approach in response to Hurricane Maria. Am J Nurs. 2019;119(10):58–64.PubMed Parak BE, Hodge NS, Eccleston SD. Implementing a fast-track team triage approach in response to Hurricane Maria. Am J Nurs. 2019;119(10):58–64.PubMed
35.
go back to reference Read DJ, Holian A, Moller C-C, Poutawera V. Surgical workload of a foreign medical team after Typhoon Haiyan. ANZ J Surg. 2016;86(5):361–5.PubMed Read DJ, Holian A, Moller C-C, Poutawera V. Surgical workload of a foreign medical team after Typhoon Haiyan. ANZ J Surg. 2016;86(5):361–5.PubMed
36.
go back to reference Taylor IL. Hurricane Katrina’s impact on Tulane’s teaching hospitals. Trans Am Clin Climatol Assoc. 2007;118(w2t, 7507559):69–78.PubMedPubMedCentral Taylor IL. Hurricane Katrina’s impact on Tulane’s teaching hospitals. Trans Am Clin Climatol Assoc. 2007;118(w2t, 7507559):69–78.PubMedPubMedCentral
37.
go back to reference Waisman Y. Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences. Eur J Emerg Med. 2003;10(2):124–9.PubMed Waisman Y. Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences. Eur J Emerg Med. 2003;10(2):124–9.PubMed
38.
go back to reference Weeks SM. Mobilization of a nursing community after a disaster. Perspect Psychiatr Care. 2007;43(1):22–9.PubMed Weeks SM. Mobilization of a nursing community after a disaster. Perspect Psychiatr Care. 2007;43(1):22–9.PubMed
39.
go back to reference Wyte-Lake T, Griffin AR. Supporting staff through a complete hospital evacuation and extended displacement period. J Healthc Manag. 2018;63(3):195–209.PubMed Wyte-Lake T, Griffin AR. Supporting staff through a complete hospital evacuation and extended displacement period. J Healthc Manag. 2018;63(3):195–209.PubMed
40.
go back to reference Amat Camacho N, Karki K, Subedi S, von Schreeb J. International emergency medical teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–4.PubMed Amat Camacho N, Karki K, Subedi S, von Schreeb J. International emergency medical teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–4.PubMed
41.
go back to reference Burnweit C, Stylianos S. Disaster response in a pediatric field hospital: lessons learned in Haiti. J Pediatr Surg. 2011;46(6):1131–9.PubMed Burnweit C, Stylianos S. Disaster response in a pediatric field hospital: lessons learned in Haiti. J Pediatr Surg. 2011;46(6):1131–9.PubMed
42.
go back to reference Catlett CL, Kirsch TD, Scheulen JJ, Cole G, Kelen GD. Maximizing utility of a deployable medical team from an academic medical center to a disaster. World Med Health Policy. 2011;3(4):4. Catlett CL, Kirsch TD, Scheulen JJ, Cole G, Kelen GD. Maximizing utility of a deployable medical team from an academic medical center to a disaster. World Med Health Policy. 2011;3(4):4.
43.
go back to reference Chaudhary P, Vallese G, Thapa M, Alvarez VB, Pradhan LM, Bajracharya K, et al. Humanitarian response to reproductive and sexual health needs in a disaster: the Nepal Earthquake 2015 case study. Reprod Health Matters. 2017;25(51):25–39.PubMed Chaudhary P, Vallese G, Thapa M, Alvarez VB, Pradhan LM, Bajracharya K, et al. Humanitarian response to reproductive and sexual health needs in a disaster: the Nepal Earthquake 2015 case study. Reprod Health Matters. 2017;25(51):25–39.PubMed
44.
go back to reference Fredricks K, Dinh H, Kusi M, Yogal C, Karmacharya BM, Burke TF, et al. Community health workers and disasters: lessons learned from the 2015 earthquake in Nepal. Prehosp Disaster Med. 2017;32(6):604–9.PubMed Fredricks K, Dinh H, Kusi M, Yogal C, Karmacharya BM, Burke TF, et al. Community health workers and disasters: lessons learned from the 2015 earthquake in Nepal. Prehosp Disaster Med. 2017;32(6):604–9.PubMed
45.
go back to reference Kondo H, Koido Y, Kawashima Y, Kohayagawa Y, Misaki M, Takahashi A, et al. Consideration of medical and public health coordination—experience from the 2016 Kumamoto, Japan earthquake. Prehosp Disaster Med. 2019;34(2):149–54.PubMed Kondo H, Koido Y, Kawashima Y, Kohayagawa Y, Misaki M, Takahashi A, et al. Consideration of medical and public health coordination—experience from the 2016 Kumamoto, Japan earthquake. Prehosp Disaster Med. 2019;34(2):149–54.PubMed
46.
go back to reference Lane DA. Medical support to Sri Lanka in the wake of tsunamis: planning considerations and lessons learned. Mil Med. 2006;171(10 SUPPL.):19–23.PubMed Lane DA. Medical support to Sri Lanka in the wake of tsunamis: planning considerations and lessons learned. Mil Med. 2006;171(10 SUPPL.):19–23.PubMed
47.
go back to reference Manning C, Millar S, Newton T, Webb S. After the wave—the Centrelink Social Work response offshore. J Soc Work Disabil Rehabil. 2006;5(3/4):81–95.PubMed Manning C, Millar S, Newton T, Webb S. After the wave—the Centrelink Social Work response offshore. J Soc Work Disabil Rehabil. 2006;5(3/4):81–95.PubMed
48.
go back to reference Roshchin GG, Mazurenko OV. Ukranian’s Disaster Medicine Team Mission to India following the earthquake of 2001. Prehosp Disaster Med. 2002;17(3):163–6.PubMed Roshchin GG, Mazurenko OV. Ukranian’s Disaster Medicine Team Mission to India following the earthquake of 2001. Prehosp Disaster Med. 2002;17(3):163–6.PubMed
49.
go back to reference Waxman BP, Guest GD, Atkinson RN. Disaster preparedness and humanitarian aid—the medical response to the Indian Ocean disaster: lessons learnt, recommendations and RACS actions. ANZ J Surg. 2006;76(1–2):1–3.PubMed Waxman BP, Guest GD, Atkinson RN. Disaster preparedness and humanitarian aid—the medical response to the Indian Ocean disaster: lessons learnt, recommendations and RACS actions. ANZ J Surg. 2006;76(1–2):1–3.PubMed
50.
go back to reference Gupta N, Balcom SA, Gulliver A, Witherspoon RL. Health workforce surge capacity during the COVID-19 pandemic and other global respiratory disease outbreaks: a systematic review of health system requirements and responses. Int J Health Plan Manag. 2021. https://doi.org/10.1002/hpm.3137.CrossRef Gupta N, Balcom SA, Gulliver A, Witherspoon RL. Health workforce surge capacity during the COVID-19 pandemic and other global respiratory disease outbreaks: a systematic review of health system requirements and responses. Int J Health Plan Manag. 2021. https://​doi.​org/​10.​1002/​hpm.​3137.CrossRef
51.
go back to reference Jnr BA. Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst. 2020;44(7):132. Jnr BA. Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst. 2020;44(7):132.
Metadata
Title
Health workforce strategies in response to major health events: a rapid scoping review with lessons learned for the response to the COVID-19 pandemic
Authors
Alison Coates
Asli-Oubah Fuad
Amanda Hodgson
Ivy Lynn Bourgeault
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00698-6

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