How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic

OBJECTIVE: To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic. DESIGN: Critical interpretive synthesis (CIS) of qualitative research. PARTICIPANTS: Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic. RESULTS: 134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments. CONCLUSIONS: The findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.