Schlinkert Caroline, Muns Laura, van Tuyl Lilian, Wagner Cordula
Nivel (Netherlands institute for health services research), Otterstraat 188, 3513CR, Utrecht, The Netherlands.
VUmc University Medical Centre, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
BMC Health Serv Res. 2024 Jul 16;24(1):817. doi: 10.1186/s12913-024-11197-4.
Resilience is an organizational capacity in day-to-day practice and crisis situation performance. A one of a kind crisis for hospitals is the COVID-19 pandemic. The long duration and magnitude of this crisis offers the opportunity to gain insight into the complexity of crisis management and organizational resilience of hospitals. This interview study therefore explored the organizational resilience of Dutch hospitals during the first 14 months of the COVID-19 pandemic. Nine board members of nine Dutch hospitals were interviewed by means of a semi-structured interview that was built on thirteen indicators of organizational resilience. The results showed that board members considered their hospitals as resilient on almost all indicators. Their judgments varied about how prepared and ready for future crises they considered their hospital. According to board members, hospitals are mainly prepared for "acute" short-term crises, thanks to good crisis leadership, open communication and strong networks. A crisis as long as the COVID-19 pandemic was unprecedented and therefore more difficult to deal with. In between the infection waves, work processes were reflected upon to learn, anticipate and respond more smoothly to successive waves. However, the enduring nature of the COVD-19 crisis presented complex organizational challenges. Crisis operations were eventually scaled down and hospitals had to manage the crisis and regular care as two companies side by side. Each crisis manifests differently. Fostering trust in healthcare staff and allowing them to act autonomously during crises, while diligently monitoring external influences and potential future crises, are therefore paramount in developing organizational adaptive capacities.
韧性是日常实践和危机情况下组织的一种能力。医院面临的一种独特危机是新冠疫情。这场危机的持续时间之长和规模之大，为洞察医院危机管理的复杂性和组织韧性提供了契机。因此，这项访谈研究探讨了新冠疫情头14个月期间荷兰医院的组织韧性。通过基于组织韧性的13项指标进行的半结构化访谈，对9家荷兰医院的9名董事会成员进行了访谈。结果显示，董事会成员认为他们的医院在几乎所有指标上都具有韧性。他们对于自己的医院为未来危机做了多大程度的准备以及应对能力如何，看法不一。董事会成员表示，由于出色的危机领导力、开放的沟通和强大的网络，医院主要为“急性”短期危机做好了准备。像新冠疫情这样长时间的危机是前所未有的，因此更难应对。在感染浪潮之间，对工作流程进行反思，以便更顺利地学习、预测和应对后续浪潮。然而，新冠危机的持久性带来了复杂的组织挑战。危机行动最终缩减规模，医院不得不像管理两家并行的公司一样，同时应对危机和常规医疗。每次危机的表现都不同。因此，在培养医护人员的信任并让他们在危机期间自主行动的同时，认真监测外部影响和潜在的未来危机，对于发展组织适应能力至关重要。
