COVID-19 outbreak management response for residential aged care facilities in Western Sydney: A Donabedian health evaluation

Abstract

The COVID-19 pandemic had significant impacts on the residential aged care sector, whereby outbreaks were the cause of disproportionate morbidity and mortality among the high-risk resident population. The first outbreaks in New South Wales residential aged care facilities (RACF) occurred in mid-2020, however it was not until the widespread permeation of the COVID-19 Delta variant in July 2021 that RACF outbreaks accelerated exponentially. Many areas, like Western Sydney, became epicentres for both community and RACF outbreaks of COVID-19, and this necessitated commensurately aggressive public health and outbreak management responses. Outbreak management teams (OMTs) ? a multidisciplinary coordination of aged care workers, nurses, infection control professionals, public health physicians and specialists ? became central to the pandemic response in Western Sydney RACFs. This study explored the OMT response to COVID-19 outbreaks in Western Sydney RACFs during the initial Delta variant COVID-19 outbreak (June?October 2021), as well as its long-term impact over the subsequent course of pandemic as new variants emerged. Guided by the Donabedian framework, this study employed a cross-sectional, mixed-methods design to define and evaluate the structure, processes, and outcomes of the OMT response. We synthesize comprehensive clinical, epidemiological, and administrative datasets collected from facilities during the RACF outbreaks together with in-depth interviews from the facility managers and OMT members who were directly involved. Our findings provide critical insight into the capabilities, capacities, and challenges of deploying OMTs in aged care settings during pandemics and how this powerful model of care can be better utilized to prepare for future emergencies.