Perceived Barriers in Delivering Optimal Healthcare Services in a Dedicated COVID-19 Hospital: Perspectives of Health-Service Providers.

Background The coronavirus disease 2019 (COVID-19) pandemic challenged the healthcare infrastructure, with health-service providers (HSPs) offering unconditional and unprejudiced service to admitted patients. During the first wave, due to the novelty of the disease and the lack of clarity regarding its transmission in the initial phases of the evolution of the disease, the predominant fear was of contracting the disease while caring for patients. With the prevailing uncertainty in knowledge and management, this study was planned to identify the barriers to delivering optimal healthcare to COVID-19 patients. Methodology A cross-sectional study was conducted among HSPs working in the first phase of a dedicated 500-bed government COVID-19 hospital at Kalinga Institute of Medical Sciences using an online questionnaire with the following five aspects: workplace guidelines and support, protective equipment, access to information regarding updates on the epidemic, overall self-reported stress and workplace stress about self-infection with COVID-19 and family being infected, and demographics. All HSPs aged 18 years or above, who were working either on a full- or a part-time basis, were able to understand the English language, and who were working in the COVID-19 hospital and gave digital informed consent (via Google Forms) were included in the study. All data were collected, coded, tabulated, and analyzed using Google Forms in an Excel format and Epi Info software version 7.2.5.0. Results Of the 144 respondents contacted, 132 completed the survey, with a participation rate of 91.67%. About 52.27% of respondents were aged 21-30 years, 68.18% were females, and 56.06% were nurses. Challenges faced were "working in a new context" (40.91%), "the uncertainty and fear of being infected and infecting others"(31.06%), and "exhausted by the workload and protective gear" (18.94%). Moreover, 64.12% were aware of a workplace policy. Only 0.75% felt that their workload needed to be reduced; 2.27% felt the need for a penalty policy for hiding travel history, lack of quarantine compliance, avoiding the accumulation of face masks, and price inflation of face masks. The overall self-reported stress level was significantly associated with a lack of awareness of workplace policies and the fear of getting infected. Furthermore, 93.94% reported that they had an adequate supply of personal protective equipment. As high as 81.06% of the HSPs were "worried about being infected from COVID-19 during work," and 94.69% were "worried about their family being infected from COVID-19 due to their working in COVID-19 hospitals." Conclusions HSPs' perception of barriers in providing healthcare gave an insight into the problems being faced and helped improve the quality of services. The study highlighted the need of increasing awareness regarding the existing workplace policies among HSPs to promote preparedness during crisis management.