The aim of this paper is to analyze COVID-19 crisis management from the perspective of organizational resilience. An empirical study was conducted from April to June 2020 in one French hospital in Paris. The study focused on the organizational changes implied by the 'all COVID-19 strategy', the success factors facilitating the organizational resilience, and the difficulty factors. We show that organizational resilience in this case was based on a link between the anticipation and adaptation processes. This capacity for resilience can also be organized using an original structure that connects strategic decisions with the reality on the ground, takes account of the demands and constraints of operational actors, and offers them the necessary support. The description and analysis of real work carried out by operational actors illustrates the contribution made by expertize to organizational resilience, and the social dynamics of the adaptation process. Finally, the emotional aspects, rarely featured in the literature, are highlighted as an intrinsic element of a crisis. The results will provide evidence to help better understand crisis management and feedback to strengthen the management of future crises.
The COVID crisis has put hospitals under great stress over the past 2 years and some institutions came close to their breaking points. This has often forced decision makers and the entire institutions to change their practices and the organization of the hospitals in order to continue operating despite limited resources. It has also led some hospitals to develop and implement organizational innovations. This article is based on a qualitative case study analyzing the case of a crisis unit that has implemented various innovative medical and organizational actions in order to manage the flow of resuscitation Covid patients in a large group of hospitals in Paris. This team has implemented a new evaluation scale of resuscitation needs in order to better manage quantitatively and qualitatively the patients’ flow; it has defined medical criteria to select the patients eligible for transfer; it has organized one hundred patients transfers to other hospitals’ intensive care units, in and out of the region, involving private hospitals and private ambulances for a new collaboration. The case allows us to understand innovation in the midst of an extreme situation, when material and human resources are highly constrained, and with very strong time pressure. We highlight the importance of implementing flexible organizational processes and staffing the crisis team with physicians and nurses with specific and complementary skills and experience in flow management and crisis situations.
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