Organizational resilience in emergency healthcare: Lessons from the COVID-19 pandemic in five Danish hospitals.

The COVID-19 pandemic created significant challenges for healthcare professionals and the provision of hospital care, leading to immense stress and rapidly changing conditions. Hospitals had to constantly adapt their organizational structures and strategies to manage the crisis. This study examines the organizational responses of Danish emergency hospitals during the first COVID-19 surge, focusing on resilience in anticipation, coping, and learning. We conducted a study involving interviews with healthcare professionals and managers from the five emergency hospitals in the Central Denmark Region. The interview guides were based on multi-contingency theory for organizational design, with open-ended discussions to compare key organizational components across hospitals. Topics covered included hospital configuration, task design, resources, information systems, leadership, and coordination during the first surge. Interviews were cross-validated with administrative documents. Results showed that hospitals responded differently to national and regional directives, continuously adjusting their governance structures and strategies to meet the demands for new procedures and information sharing. The ability to introduce, learn from, and adapt organizational changes as the pandemic unfolded was crucial to building resilience. This study provides insights into organizational resilience in healthcare and highlights practical lessons for managing future crises.