Department of Surgery, St Mark!s Hospital, Watford Road, Harrow, HA1 3UJ, UK; Department of Surgery and Cancer, Imperial College London, Paddington, London, W2 1NY, UK; Chartered Management Institute, 77 Kingsway, London, WC2B 6SR, UK.
Department of Surgery and Cancer, Imperial College London, Paddington, London, W2 1NY, UK.
Int J Surg. 2021 Jul;91:105987. doi: 10.1016/j.ijsu.2021.105987. Epub 2021 Jun 4.
Multiple industries and organisations are afflicted by and respond to institutional crises daily. As surgeons, we respond to crisis frequently and individually such as with critically unwell patients or in mass casualty scenarios; but rarely, do we encounter institutional or multi-institutional crisis with multiple actors as we have seen with the COVID-19 pan-demic. Businesses, private industry and the financial sector have been in a more precar-ious position regarding crisis and consequently have developed rapid response strate-gies employing foresight to reduce risk to assets and financial liquidity. Moreover, large nationalised governmental organisations such as the military have strategies in place ow-ing to a rapidly evolving geopolitical climate with the expectation of immediate new chal-lenges either in the negotiating room or indeed the field of conflict. Despite both nation-alised and privatised healthcare systems existing, both appeared ill-prepared for the COVID-19 global crisis.
A narrative review of the literature was undertaken exploring the approach to crisis man-agement and models used in organisations exposed to institutional crises outside the field of medicine.
There are many parallels between the organisational management of private business institutions, large military organisations and surgical organisational management in healthcare. Models from management consultancies and the armed forces were ex-plored discussed and adapted for the surgical leader providing a framework through which the surgical leader can bring about an successful response to an institutional crisis and ensure future resilience.
We believe that healthcare, and surgeons (as leaders) in particular, can learn from these other organisations and industries to engage appropriate generic operational plans and contingencies in preparation for whatever further crises may arise in the future, both near and distant. As such, following a review of the literature, we have explored a number of models we believe are adaptable for the surgical community to ensure we remain a dy-namically responsive and ever prepared profession.
多个行业和组织每天都受到机构危机的影响并作出应对。作为外科医生，我们经常单独应对危机，例如处理病情危急的患者或大规模伤亡情况；但我们很少像在 COVID-19 大流行期间那样，遇到涉及多个行为体的机构或多机构危机。企业、私营行业和金融部门在危机方面处于更加不稳定的地位，因此制定了快速应对策略，运用前瞻性思维降低资产和财务流动性风险。此外，由于地缘政治气候瞬息万变，预期谈判室或冲突现场会立即出现新挑战，大型国有化政府组织（如军队）也制定了战略。尽管存在国有化和私有化的医疗保健系统，但两者似乎都对 COVID-19 全球危机准备不足。
对文献进行了叙述性综述，探讨了暴露于医学领域之外的机构危机中的组织管理方法和使用的模型。
私营企业机构、大型军事组织和医疗保健中的外科组织管理之间存在许多相似之处。探讨了来自管理咨询公司和武装部队的模型，并对其进行了调整，以适应外科领导者，为外科领导者提供了一个框架，通过该框架，外科领导者可以成功应对机构危机并确保未来的恢复力。
我们认为，医疗保健，特别是外科医生（作为领导者）可以从这些其他组织和行业中吸取教训，采用适当的通用运营计划和应急计划，为未来可能出现的任何其他危机做好准备，无论是近期还是远期。因此，在对文献进行审查后，我们探讨了一些我们认为适合外科界的模型，以确保我们保持动态响应和随时准备的专业精神。
