The impact of the COVID-19 pandemic response on the health workforce in rural and regional Australia: Lessons learned.

Abstract

Background/aim: Delivery of healthcare in rural and regional areas is challenged by geographic spread, low population density and limited infrastructure. During the COVID-19 global pandemic, emergency powers were enacted to slow the transmission of the virus. This research explored the impact of the COVID-19 pandemic emergency response on regional and rural healthcare workforces, identified lessons learned, and informed recommendations for healthcare policy. Population/setting: The study included health service staff in executive-level, clinical leadership, and administration roles. Methods: One regional and one rural health service in Victoria were purposively selected as case sites. In-depth individual interviews were conducted with key leaders from each site to explore the impact of organisational initiatives implemented to support the healthcare workforce during the COVID-19 pandemic. Interview data were inductively coded and analysed thematically. Results/findings: Across the two organisations, 33 health service staff participated in an interview. Six major themes were identified: Working towards a common goal, Delivery of care, Education and training, Organisational governance and leadership, Personal and psychological impacts, and Working with the Local Community. Collectively, the themes comprised 17 sub-themes. The sub-themes of ‘Working towards a common goal’ were collaboration, communication, teamwork, and trust and respect. The theme ‘Delivery of care’ included the pandemic response and maintaining business as usual as sub-themes. The ‘Education and training’ theme included sub-themes: upskilling the workforce, education and training requirements, and undergraduate students. The sub-themes of ‘Organisational governance and leadership’ were leadership, governance, and managing the workforce. The theme ‘Personal and psychological impacts’ comprised personal impacts and psychological impacts as sub-themes. Sub-themes of the ‘Working with the local community’ theme were community leaders, local risk areas, and vulnerable populations. A conceptual model was developed to reflect the themes across all healthcare system levels. Conclusion: Understanding the context was key to a nuanced response, and accommodating the need for flexibility in responses was necessary to ensure the healthcare system could continue to perform and meet the routine needs of its community while also responding to the pandemic emergency. Translational impact/implications for future practice: The findings led to 11 recommendations relating to practice, education, policy and research, spanning the rural and regional health system's micro, meso and macro levels.