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      Temporary healthcare services for crisis response: organization and management of a mass vaccination center

      case-report
      John Ovretveit , Mikael Ohrling
      Journal of Health Organization and Management
      Emerald Publishing
      Primary care, COVID-19 vaccination, Implementation, Organization, Management, Health information technology, Patient portal

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          Abstract

          Purpose

          Scientific description of the organization and management of a temporary large scale healthcare (T-LSHc) vaccination clinic and evidence-based guidance for future temporary healthcare (T-Hc) services.

          Design/methodology/approach

          Mixed-methods rapid feedback case study, using interviews, document analysis and quantitative data, with both data collection and analysis guided by a research-informed systems program theory of the clinic.

          Findings

          Private contractors were not willing to bid for contracts to set up and close a T-LSHc vaccination clinic in 2022, although they had done so earlier in the year. The public health system was able successfully to set up and run the clinic itself for 2 months, serving 3,000 people a day at its peak. Part of the success was because a dedicated unit to set up and run T-Hc services had been created in 2020. The Stockholm organization model differed from the Milan model by using information technology to reduce the need for a large number of on-site doctors.

          Research limitations/implications

          There may be recall bias in interview data as interviews were carried out four months after the closing of the clinic. The conclusions apply to clinically simple but managerially complex T-Hc services but are limited to public healthcare systems operating in a similar context to that of the case study service. The study contributes to the new science of healthcare crisis organization and management and fills gaps in knowledge in disaster medicine for enduring and fluctuating health crises. The findings show the importance of a capacity to establish and manage T-Hc, and of the specialist management and HIT competence that health systems will need to build to meet the crises that threaten our health, both now and in the future.

          Practical implications

          Public healthcare systems can provide clinically simple and managerially complex T-Hc services quickly and successfully if they have experience and capacity to plan and set up such services, skilled operational managers respected by staff, staff who can be redeployed, and suitable health information technology.

          Social implications

          The need for healthcare services to respond to crises is likely to increase in the future. Information for creating the service may be limited at first and changing. The exact nature of the health threat may be uncertain, as may the demand and needs of subpopulations and individuals. The study findings can help to respond quickly to reduce morbidity illness and death through creating and organizing temporary large-scale public healthcare services when existing services cannot be reorganized to meet the scale of the need.

          Originality/value

          This article is the first detailed empirical description and analysis of a large-scale temporary healthcare service operated by the primary care division of an integrated public healthcare system, with research informed guidance for future services of this type in similar contexts. This article compares two organization models of T-LSHc services, and contributes to an emerging subdiscipline of the organization and management of disaster and crisis healthcare.

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          Most cited references12

          • Record: found
          • Abstract: found
          • Article: found

          Planning for a COVID-19 Vaccination Program

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            • Abstract: not found
            • Book: not found

            Markets and hierarchies: Analysis and antitrust implications

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              Mass-Vaccination Sites — An Essential Innovation to Curb the Covid-19 Pandemic

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                Author and article information

                Contributors
                Journal
                JHOM
                10.1108/JHOM
                Journal of Health Organization and Management
                JHOM
                Emerald Publishing
                1477-7266
                04 August 2023
                16 October 2023
                : 37
                : 4/5
                : 443-462
                Affiliations
                [1] LIME, MMC; , Karolinska Institute; , Stockholm, Sweden
                [2] Region Stockholm; , Stockholm, Sweden
                [3] Karolinska Institute; , Stockholm, UK
                Author notes
                John Ovretveit can be contacted at: jovretbis@aol.com
                Article
                707612 JHOM-12-2022-0375.pdf JHOM-12-2022-0375
                10.1108/JHOM-12-2022-0375
                4f1d3b71-2ddc-45d4-a8b5-3a041b5438e3
                © Emerald Publishing Limited
                History
                : 21 December 2022
                : 26 February 2023
                : 30 June 2023
                Page count
                appendices: 1, Figures: 2, Tables: 3, Equations: 0, References: 20, Pages: 20, Words: 9534
                Categories
                case-report, Case study
                cat-HSC, Health & social care
                , Healthcare management
                Custom metadata
                Yes
                Yes
                Journal
                included

                Health & Social care
                Health information technology,Primary care,COVID-19 vaccination,Implementation,Organization,Management,Patient portal

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