Lloyd-Smith McKenzie
Faculty of Management, Cass Business School, London, UK.
BMJ Lead. 2020 Sep 28;4(3):109-112. doi: 10.1136/leader-2020-000245. Epub 2020 May 18.
The global healthcare sector is currently in the midst of the COVID-19 pandemic, a 'low-chance, high-impact' event which will require healthcare systems, and the organisations within them, to maintain organisational resilience in order to respond effectively. However, contrary to the instinctive reaction to tighten control, the quality of response depends on healthcare systems' capacity to loosen control and, subsequently, enhance improvisation. Three factors critical to enhancing an organisation's capacity for improvisation are highlighted; increasing autonomy, maintaining structure and creating a shared understanding. By drawing on the case of Christchurch Hospital's response to a major earthquake, this paper demonstrates the vital role that improvisation can play within a clinical setting, when responding to a low-chance, high-impact event.
全球医疗保健行业目前正处于新冠疫情之中，这是一个“低概率、高影响”的事件，它要求医疗保健系统及其内部的组织保持组织韧性，以便有效应对。然而，与收紧控制的本能反应相反，应对的质量取决于医疗保健系统放松控制并随后加强即兴发挥的能力。文中强调了提高组织即兴发挥能力的三个关键因素：增加自主性、维持结构和形成共同理解。通过借鉴克赖斯特彻奇医院应对一场大地震的案例，本文展示了在应对低概率、高影响事件时，即兴发挥在临床环境中可以发挥的重要作用。
