Study protocol: maintaining preventive care during public health emergencies through effective coordination

Area of Science:

• Healthcare Management
• Preventive Medicine
• Health Services Research

Background:

• COVID-19 significantly disrupted essential preventive care, including routine health screenings.
• This disruption led to excess mortality not directly caused by COVID-19.
• Screening rate variations across facilities highlight workflow vulnerabilities in screening and referral processes.

Purpose of the Study:

• To investigate the impact of the COVID-19 pandemic on screening rates within the VA healthcare system.
• To compare healthcare facilities with high, low, and variable screening performance.
• To identify specific process and coordination strategies that mitigate care interruptions.

Main Methods:

• Qualitative study using interviews and focus groups with healthcare personnel and patients across 10 VA medical centers.
• Sites selected based on rurality, initial COVID-19 caseload, and screening performance indicators.
• Analysis guided by the multi-team systems (MTS) model, employing process mapping and thematic analysis of coordination patterns, barriers, and facilitators.

Main Results:

• The study will identify specific points of vulnerability in screening and referral workflows.
• It aims to pinpoint coordination processes that, when optimized, yield the highest value in maintaining screening continuity.
• Findings will illuminate how information exchange and collective problem-solving impact clinical performance during disruptions.

Conclusions:

• Understanding screening process susceptibilities is crucial for mitigating pandemic-related care interruptions.
• The study will inform the multi-team systems literature by detailing coordination mechanisms linked to performance.
• Results offer actionable insights for enhancing resilience in screening programs during future public health crises.