Slack in the infrastructure of intensive care units : resilience management in the postpandemic era
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/263090 |
Resumo: | Background Although slack is an asset to resilient hospitals, it is usually explicitly discussed only in terms of the quantity and quality of beds and staff. This paper expands this view by addressing slack in four infrastructures of intensive care units (ICUs) (physical space, electricity supply, oxygen supply, and air treatment) during the COVID pandemic. Methods The study occurred in a leading private hospital in Brazil, aiming at the identification of slack in four units originally designed as ICUs and two units adapted as ICUs. Data collection was based on 12 interviews with healthcare professionals, documents, and comparison between infrastructures and regulatory requirements. Results Twenty-seven instantiations of slack were identified, with several indications that the adapted ICUs did not provide infrastructure conditions as good as the designed ones. Findings gave rise to five propositions addressing: relationships intra and inter infrastructures; the need for adapted ICUs that match as closely as possible the designed ICUs; the consideration of both clinical and engineering perspectives in design; and the need for the revision of some requirements of the Brazilian regulations. Conclusions Results are relevant to both the designers of the infrastructures and to the designers of clinical activities as these must take place in fit-for-purpose workspaces. Top management might also benefit as they are the ultimate responsible for decision-making on whether or not to invest in slack. The pandemic dramatically demonstrated the value of investing in slack resources, creating momentum for this discussion in health services. |
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Marczyk, Carlos Emílio StiglerSaurin, Tarcísio AbreuBulhões, Iamara RossiPatriarca, RicardoBilotta, Federico2023-08-03T03:32:55Z20231472-6963http://hdl.handle.net/10183/263090001172840Background Although slack is an asset to resilient hospitals, it is usually explicitly discussed only in terms of the quantity and quality of beds and staff. This paper expands this view by addressing slack in four infrastructures of intensive care units (ICUs) (physical space, electricity supply, oxygen supply, and air treatment) during the COVID pandemic. Methods The study occurred in a leading private hospital in Brazil, aiming at the identification of slack in four units originally designed as ICUs and two units adapted as ICUs. Data collection was based on 12 interviews with healthcare professionals, documents, and comparison between infrastructures and regulatory requirements. Results Twenty-seven instantiations of slack were identified, with several indications that the adapted ICUs did not provide infrastructure conditions as good as the designed ones. Findings gave rise to five propositions addressing: relationships intra and inter infrastructures; the need for adapted ICUs that match as closely as possible the designed ICUs; the consideration of both clinical and engineering perspectives in design; and the need for the revision of some requirements of the Brazilian regulations. Conclusions Results are relevant to both the designers of the infrastructures and to the designers of clinical activities as these must take place in fit-for-purpose workspaces. Top management might also benefit as they are the ultimate responsible for decision-making on whether or not to invest in slack. The pandemic dramatically demonstrated the value of investing in slack resources, creating momentum for this discussion in health services.application/pdfengBMC health services research. London. Vol. 23 (2023), Article 579, 13 p.Unidades de terapia intensivaEngenharia de resiliênciaInfraestruturaCOVID-19 (Doença)SlackIntensive care unitsResilience engineeringInfrastructureSlack in the infrastructure of intensive care units : resilience management in the postpandemic eraEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001172840.pdf.txt001172840.pdf.txtExtracted Texttext/plain72929http://www.lume.ufrgs.br/bitstream/10183/263090/2/001172840.pdf.txt1f8b32709ee682df251dd738603f2a26MD52ORIGINAL001172840.pdfTexto completo (inglês)application/pdf1285472http://www.lume.ufrgs.br/bitstream/10183/263090/1/001172840.pdf72ced9285bead7a62da0537a8b96e2caMD5110183/2630902023-08-04 03:32:23.139397oai:www.lume.ufrgs.br:10183/263090Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-08-04T06:32:23Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
title |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
spellingShingle |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era Marczyk, Carlos Emílio Stigler Unidades de terapia intensiva Engenharia de resiliência Infraestrutura COVID-19 (Doença) Slack Intensive care units Resilience engineering Infrastructure |
title_short |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
title_full |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
title_fullStr |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
title_full_unstemmed |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
title_sort |
Slack in the infrastructure of intensive care units : resilience management in the postpandemic era |
author |
Marczyk, Carlos Emílio Stigler |
author_facet |
Marczyk, Carlos Emílio Stigler Saurin, Tarcísio Abreu Bulhões, Iamara Rossi Patriarca, Ricardo Bilotta, Federico |
author_role |
author |
author2 |
Saurin, Tarcísio Abreu Bulhões, Iamara Rossi Patriarca, Ricardo Bilotta, Federico |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Marczyk, Carlos Emílio Stigler Saurin, Tarcísio Abreu Bulhões, Iamara Rossi Patriarca, Ricardo Bilotta, Federico |
dc.subject.por.fl_str_mv |
Unidades de terapia intensiva Engenharia de resiliência Infraestrutura COVID-19 (Doença) |
topic |
Unidades de terapia intensiva Engenharia de resiliência Infraestrutura COVID-19 (Doença) Slack Intensive care units Resilience engineering Infrastructure |
dc.subject.eng.fl_str_mv |
Slack Intensive care units Resilience engineering Infrastructure |
description |
Background Although slack is an asset to resilient hospitals, it is usually explicitly discussed only in terms of the quantity and quality of beds and staff. This paper expands this view by addressing slack in four infrastructures of intensive care units (ICUs) (physical space, electricity supply, oxygen supply, and air treatment) during the COVID pandemic. Methods The study occurred in a leading private hospital in Brazil, aiming at the identification of slack in four units originally designed as ICUs and two units adapted as ICUs. Data collection was based on 12 interviews with healthcare professionals, documents, and comparison between infrastructures and regulatory requirements. Results Twenty-seven instantiations of slack were identified, with several indications that the adapted ICUs did not provide infrastructure conditions as good as the designed ones. Findings gave rise to five propositions addressing: relationships intra and inter infrastructures; the need for adapted ICUs that match as closely as possible the designed ICUs; the consideration of both clinical and engineering perspectives in design; and the need for the revision of some requirements of the Brazilian regulations. Conclusions Results are relevant to both the designers of the infrastructures and to the designers of clinical activities as these must take place in fit-for-purpose workspaces. Top management might also benefit as they are the ultimate responsible for decision-making on whether or not to invest in slack. The pandemic dramatically demonstrated the value of investing in slack resources, creating momentum for this discussion in health services. |
publishDate |
2023 |
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2023-08-03T03:32:55Z |
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2023 |
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Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/263090 |
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eng |
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BMC health services research. London. Vol. 23 (2023), Article 579, 13 p. |
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