Feasibility of Emergency Department-Initiated HIV Pre-Exposure Prophylaxis.

Introduction: Pre-exposure prophylaxis (PrEP) for HIV-using antiretroviral medication in non-infected individuals to prevent HIV-has immense potential to slow the spread of the virus. However, uptake has been insufficient, and stark racial disparities exist in both HIV acquisition and PrEP usage, making PrEP access a health equity issue. A promising venue to engage high-risk populations in PrEP care is the emergency department (ED); however, existing ED PrEP initiatives have been costly or have had limited success.

Formal and informal hospital emergency management practices: managing for safety and performance amid crisis.

Although formal preparedness for unexpected crises has long been a concern of health care policy and delivery, many hospitals struggled to manage staff and equipment shortages, precarious finances, and supply chain disruptions among other difficulties during the Coronavirus disease pandemic. Our purpose was to analyze how hospitals used formal and informal emergency management practices to maintain safe and high-quality care while responding to crisis. We conducted a qualitative study based on 26 interviews with hospital leaders and emergency managers from 12 US hospitals, purposively sampled to vary along geographic location, urban/rural delineation, size, resource availability, system membership, teaching status, and performance levels among other characteristics.

Organizational learning in surgery in Tanzania's health system: a descriptive cross-sectional study.

Organizational learning is critical for delivering safe, high-quality surgical care, especially in low- and middle-income countries (LMICs) where perioperative outcomes remain poor. While current investments in LMICs prioritize physical infrastructure, equipment, and staffing, investments in organizational learning are equally important to support innovation, creativity, and continuous improvement of surgical quality. This study aims to assess the extent to which health facilities in Tanzania's Lake Zone perform as learning organizations from the perspectives of surgical providers.

A practical tool for managing change: cross-sectional psychometric assessment of the safe surgery organizational readiness tool.

Background: Strengthening health systems through planned safety and quality improvement initiatives is an imperative to achieve more equitable, resilient, and effective care. And yet, years of organizational behavior research demonstrate that change initiatives often fall short because managers fail to account for organizational readiness for change. This finding remains true especially among surgical safety and quality improvement initiatives in low-income countries and middle-income countries.

Assessing health care leadership and management for resilience and performance during crisis: The HERO-36.

Background: Whereas organizational literature has provided much insight into the conceptual and theoretical underpinnings of organizational leadership and management during emergencies, measures to operationalize related effective practices during crises remain sparse.

Purpose: To address this need, we developed the Healthcare Emergency Response Optimization survey, which set out to examine the leadership and management practices in health care organizations that support resilience and performance during crisis.

Methodology: We administered an online survey in April to May 2022 to health care administrators and frontline staff intimately involved in their hospital's emergency response during the COVID-19 pandemic, which included a sample of 379 respondents across nine rural and urban hospitals (response rate: 44.

Research capacity, motivators and barriers to conducting research among healthcare providers in Tanzania's public health system: a mixed methods study.

Background: Building health research capacity in low- and middle-income countries is essential to achieving universal access to safe, high-quality healthcare. It can enable healthcare workers to conduct locally relevant research and apply findings to strengthen their health delivery systems. However, lack of funding, experience, know-how, and weak research infrastructures hinders their ability.

Centralization and democratization: Managing crisis communication in health care delivery.

Background: Communication is an essential organizational process for responding to adversity. Managers are often advised to communicate frequently and redundantly during crises. Nonetheless, systematic investigation of how information receivers perceive organizational communication amid crises has remained lacking.

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned.

Background: A well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource-constrained settings.

How psychological safety and feeling heard relate to burnout and adaptation amid uncertainty.

Background: Psychological safety-the belief that it is safe to speak up-is vital amid uncertainty, but its relationship to feeling heard is not well understood.

Purpose: The aims of this study were (a) to measure feeling heard and (b) to assess how psychological safety and feeling heard relate to one another as well as to burnout, worsening burnout, and adaptation during uncertainty.

Methodology: We conducted a cross-sectional survey of emergency department staff and clinicians (response rate = 52%; analytic N = 241) in July 2020.

Moving Forward from COVID-19: Organizational Dimensions of Effective Hospital Emergency Management.

Federal investment in emergency preparedness has increased notably since the 9/11 attacks, yet it is unclear if and how US hospital readiness has changed in the 20 years since then. In particular, understanding effective aspects of hospital emergency management programs is essential to improve healthcare systems' readiness for future disasters. The authors of this article examined the state of US hospital emergency management, focusing on the following question: During the COVID-19 pandemic, what aspects of hospital emergency management, including program components and organizational characteristics, were most effective in supporting and improving emergency preparedness and response? We conducted semistructured interviews of emergency managers and leaders at 12 urban and rural hospitals across the country.

Patterns of Technology Use Among Patients With Head and Neck Cancer and Implications for Telehealth.

Objective: To describe baseline technology use within the head and neck cancer (HNC) population prior to the COVID-19 pandemic.

Study Design: Cross-sectional analysis of National Health Interview Survey (NHIS) data.

Setting: The NHIS is a survey of population health administered in person annually to a nationally representative sample of noninstitutionalized US residents via a complex clustered sampling design.

Masked and distanced: a qualitative study of how personal protective equipment and distancing affect teamwork in emergency care.

Background: Newly intensified use of personal protective equipment (PPE) in emergency departments presents teamwork challenges affecting the quality and safety of care at the frontlines.

Objective: We conducted a qualitative study to categorize and describe barriers to teamwork posed by PPE and distancing in the emergency setting.

Methods: We conducted 55 semi-structured interviews between June 2020 and August 2020 with personnel from two emergency departments serving in a variety of roles.

Development and content validation of the Safe Surgery Organizational Readiness Tool: A quality improvement study.

Background: Recent efforts to increase access to safe and high-quality surgical care in low- and middle-income countries have proven successful. However, multiple facilities implementing the same safety and quality improvement interventions may not all achieve successful outcomes. This heterogeneity could be explained, in part, by pre-intervention organizational characteristics and lack of readiness of surgical facilities.

Gene drives as a response to infection and resistance.

Vector-borne infectious diseases continue to be a major threat to public health. Although some prevention and treatment modalities exist for these diseases, resistance to such modalities, exacerbated by global climate change, remains a fundamental challenge. Developments in genomic engineering technologies present a new front in battling vector-borne illnesses; however, there is a lack of consensus over the scope and consequences of these approaches.