School of Management, University of los Andes, Bogotá, Colombia.
PLoS One. 2024 Sep 26;19(9):e0311023. doi: 10.1371/journal.pone.0311023. eCollection 2024.
This paper examines the role of temporality in the negotiation of unplanned adaptive tasks that were part of the health system response to the Covid-19 pandemic in Colombia. While research has been carried out on the temporal aspects of emergency preparedness, we argue that there is an empirical gap concerning how health care organizations responded with temporal urgency to Covid-19. The dataset (118 interviews) from which a subset of interviews were analysed for this paper was collected during the first wave of the pandemic in Colombia in 2020. Interviewees included representatives of national and regional governments, public hospitals and private clinic managers, clinicians, including physicians and nurses, laboratory directors, and academics. Narratives of two tasks are presented: reconfiguring clinical laboratories to expand the testing capacity for Covid-19 and increasing intensive care unit capacity for patients hospitalized with Covid-19. Through thematic analysis of the navigation of these tasks, the concept of "temporal shifts", which signifies how organizations use time as a resource (analogous experiences, future projections) to negotiate unplanned service changes, is developed. This study highlights how powerful stakeholders deploy past and future projections to influence others´ perceptions in the negotiation of temporal shifts: a type of change that differs from the incremental and planned types described in previous organizational literature on temporality. This shift was initiated by rapid task delegation via organizational hierarchy, but accomplished through pressured, improvised actions at the operational level. The policy and practice implications we suggest relate to addressing social and organizational effects, including consequences for stakeholder engagement and staff wellbeing, generated by organizational leaders making decisions under "time stress".
本文探讨了临时性在协商非计划性适应任务中的作用，这些任务是哥伦比亚卫生系统应对新冠疫情的一部分。虽然已经有关于应急准备的时间方面的研究，但我们认为，关于医疗保健组织如何以时间紧迫性应对新冠疫情，存在经验上的差距。本文分析的数据集（118 次访谈）是在 2020 年哥伦比亚新冠疫情第一波期间收集的。受访者包括国家和地区政府、公立医院和私立诊所管理者、临床医生，包括医生和护士、实验室主任和学者的代表。呈现了两个任务的叙述：重新配置临床实验室以扩大新冠病毒检测能力，以及增加因新冠病毒住院患者的重症监护病房容量。通过对这些任务的主题分析，发展了“时间转移”的概念，它表示组织如何将时间用作资源（类似经验、未来预测）来协商非计划性服务变更。本研究强调了强大的利益相关者如何利用过去和未来的预测来影响他人在时间转移协商中的看法：这是一种与之前关于时间性的组织文献中描述的增量和计划性变更不同的变更类型。这种转变是通过组织层次结构的快速任务委托发起的，但通过在操作层面上的紧迫、即兴行动来完成。我们提出的政策和实践意义涉及解决社会和组织影响，包括组织领导者在“时间压力”下做出决策所产生的利益相关者参与和员工福利的后果。
