Abstract

The purpose of the article is to illustrate how implementation science concepts and methods can be applied by researchers and implementers to understand and assist emergency management in a large primary and community healthcare organization. The article refers to a single-case implementation action evaluation of an emergency management system in a healthcare organization. It describes the methods used in this study and findings to explain how a joint healthcare and university research team were able to use the science and methods both to help implementation and contribute to science. We report two sets of findings. First, findings about implementation of emergency management to illustrate how the investigation adapted implementation science and concepts to achieve the objectives evaluation. We discovered that implementation science provides useful concepts to understand contextual factors and adds to knowledge about organizational change and emergency management in the uncertain and evolving situation we encountered. The second set of findings are the strengths and limitations of both implementation science and the action evaluation methods we used to achieve the dual objectives of practical help with implementation and to contribute to science. The article uses the first implementation action evaluation study of the response of large public primary and community healthcare organization to a pandemic to illustrate how implementation science can be applied. This type of study was able to improve implementation of the response as well as contribute to scientific knowledge about emergency healthcare management and organization.

Highlights

  • IntroductionDuring 2020 and 2021, Stockholm region healthcare rapidly implemented many changes to healthcare service delivery to respond to the SARS COV-2 pandemic

  • Background to Applying Implementation Science inStockholm HealthcareDuring 2020 and 2021, Stockholm region healthcare rapidly implemented many changes to healthcare service delivery to respond to the SARS COV-2 pandemic

  • From documents that included minutes of each emergency management group meeting (n = 84); a diary made by the principle investigator and first author, that summarizes national and regional directives, guidance and changes made from public agencies and from regular regional guidance issued to healthcare providers; and plans for an emergency response (Engström & Ohrling, 2019)

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Summary

Introduction

During 2020 and 2021, Stockholm region healthcare rapidly implemented many changes to healthcare service delivery to respond to the SARS COV-2 pandemic. In early March 2020, we formed a research team to document and evaluate the management and organizational changes made by one organization within the region to respond to the pandemic. This was the single organization that managed all the public primary and community healthcare (P&CHc) services in Stockholm, called the Stockholm County Healthcare Area, or SLSO in Swedish. The municipalities are small independent local authorities and separate from the Region Stockholm county government

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