Table 2 Resilience of health care facilities in COVID-19: challenges and solutions
Themes | Challenges | Solutions |
|---|---|---|
Leadership and management | • Fragmented management system • Person-centered decision-making • Inadequate coordination • Lack of a unified command structure • Lack of a preventive approach • Insufficient management commitment • Incompetent managers • Poor leadership • Incompatible network structure • Poor organizing | • Development of incident command system (ICS) protocols • Community-based crisis management • Evidence-based management • Effective operational command • • Good governance • Enhancing managers’ risk perception • Developing a resilient mindset in students • Internal and external coordination • Prioritizing prevention at the national level |
Planning | • Lack of a national plan • Poor case detection program • Lack of strategic and operational plans • Lack of using key indicators • Lack of different scenarios | • Appointing competent managers • Holding practical courses • Documenting and building on past experiences • Changing the management structure • Developing strategic and operational plans • Reforming the command-control structure and coordination in the country • Formulating a comprehensive plan and a national crisis management structure |
Organizational culture | • Negative attitude of managers and employee • Organizational resistance • Organizational inertia • Poor resilience culture • Insufficient teamwork | • Promoting the right mindset in managers and employee • Understanding resilience • Changing managers’ attitudes • Creating everyday flexibility • Encouraging creative and innovative ideas • Effective conflict management |
Organizational learning | • Inadequate training of managers and employee • Inadequate exercises • Failure to measure effectiveness • Failure to build on experiences and lessons learned | • Regular theoretical and practical training • Systematic academic education Documenting and building on experiences |
Employee management | • Ineffective employee selection and recruitment process • Insufficient awareness among employee • Low employee competence and skill • Unpreparedness of employee • Insufficient support for employee | • Continuous training • Changing the behavior of managers and employee • Training to recognize the work process • Employee empowerment • Financial incentives • Increasing employee motivation and satisfaction • Providing family support for employee |
Customer management | • Lack of community-based management • Inadequate training; Lack of public empowerment • Lack of effective communication between the health system and the public • Lack of belief in public participation in health programs • Declining social capital • Insufficient involvement of non-governmental organizations | • Motivating people • Giving people responsibility • Building trust • Effective communication with people and non-governmental organizations • Making use of people’s capacities • Transparent job descriptions • International communications • Conducting exercises and drills • Childhood education • Effective communication • Effective organization of people • Community-based management |
Resource management | • Inadequate resources (especially financial and physical resources) • Inefficient information system • Economic instability • Lack of a central portal • Low capability of the integrated health system | Increasing public health expenditure per capita • Working toward lifting sanctions • Capacity building across the country • Improving economic stability • Having a unified information system • Educating employees • Developing a central portal for data management • Upgrading integrated health system programs |
Process management | • Poor structure of the health system • Lack of a system for managing work processes • Insufficient evaluation and monitoring | • Self-organization at the time of crisis • Processes reengineering • Eliminating bureaucracy • Monitoring and evaluation systems • Promoting everyday resilience • Self-evaluation |