A ground-breaking study conducted by Lucy Mwangi, a post-doctoral research fellow at the Aga Khan University Medical College, East Africa, reveals that strong hospital leadership is essential for the successful implementation of pandemic preparedness and response strategies in healthcare facilities.
The study, titled "Role of hospital leadership in pandemic preparedness: Experience at a tertiary hospital in Kenya during the COVID-19 pandemic" was recently published in the BMJ Leader Journal.
The study focuses on the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi (AKUH, N) in response to the COVID-19 pandemic in 2020. It evaluates the hospital's pandemic preparedness across four key areas: leadership, governance and incident management structures; coordination and partnerships; communication strategies and framework to resolve ethical dilemmas.
According to Lucy Mwangi, the lead researcher, “The first leadership meeting for pandemic preparedness and response planning began in January 2020, following the WHO announcement of a cluster of pneumonia cases caused by COVID-19.”
To ensure a swift and coordinated response, AKUH, N established three levels of governance – the task force, operations and implementation teams. The task force, headed by the hospital's CEO, played a pivotal role in command and control during the pandemic. Daily meetings were held to review information, make recommendations, and allocate resources effectively.
A comprehensive response plan was developed and executed based on the anticipated number of COVID-19 patients in the country and within the facility.
“The response plan addressed continuous education and training, movement control and screening procedures, testing and treating capacity and support measures for the healthcare workers and staff including psychological support,” added Lucy.
The study also identified potential risks like staff infections, supply shortages, patient surges, misinformation, and myths, with mitigation strategies deployed accordingly.
Over 600 staff members received training on prevention control, personal safety, departmental preparedness and crisis management. The study further revealed that technology training was essential as healthcare processes became more digitalised and telehealth services were enhanced.
The hospital's ability to expand beyond regular operations was evaluated, resulting in entire wards being converted into COVID-19 units, and intensive care unit (ICU) beds being designated for COVID-19 patients. Additionally, a field hospital with a capacity of up to 100 beds was set up for non-critical COVID-19 patients, thanks to support from donor partners.
Throughout the pandemic, AKUH, N adhered to Ministry of Health directives and maintained a reporting system to contribute to the national COVID-19 data.
“We hope the experiences from this study will contribute to future pandemic preparedness and management plans, especially in low and middle-income countries. Overall, hospital leadership should be alert and highly supportive during future pandemics with elaborate plans that guarantee constant communication, up-to-date knowledge sharing, adequate resourcing and attention to the well-being of their employees,” says Lucy.
The study concludes that pandemic preparedness is an ongoing process requiring dynamic leadership within a complex healthcare system, underlining the critical role of hospital leadership in guiding such efforts.
