The health system values that shaped SCHN’s response to the pandemic included principles of equity of healthcare delivery, holistic and integrated models of care, and supporting workforce wellbeing. Responses included a COVID-19 assessment clinic, inpatient and infectious disease management services, redeploying and managing a workforce working from home, cohesive communication initiatives, and remote delivery of care, all enabled by a dedicated COVID-19 fund. Results: The CSSF captured SCHN’s complex response to the pandemic. We also reviewed clinic and policy documents pertinent to SCHN’s response to COVID-19 and conducted interviews and focus groups with stakeholders, including clinical directors, project managers, frontline clinicians, and other personnel involved in implementing innovations across SCHN. An embedded field researcher shadowed members of the emergency operations centre (EOC) for nine months. Methods: We used ethnographic methods, guided by the CSSF, to map innovations and initiatives implemented across SCHN during the pandemic. This framework enabled us to assess innovations and changes created through COVID-19 at the Sydney Children’s Hospitals Network (SCHN), the largest provider of children’s health services in the Southern hemisphere. ![]() We adapted the Hanefeld et al framework for health systems shocks to create the COVID-19 System Shock Framework (CSSF). ![]() The experience in Australia presents an opportunity to study contrasting responses to the COVID-19 health system shock. Background: Coronavirus disease 2019 (COVID-19) has resulted in over 2 million deaths globally.
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