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Journal Articles Health Services Management Research Year : 2023

Organizational innovation under constraints: the case of Covid patients’ flow management in a Parisian hospital

Abstract

The COVID crisis has put hospitals under great stress over the past 15 months 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 lead 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 developed 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 ambulance for a new collaboration. The case allows 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 organizational processes managed in a flexible way and the key role of tactical physician incorporated into the crisis management team, who mobilized the specific skills of their medical specialty, which met the needs of the situation.
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Dates and versions

hal-04248797 , version 1 (18-10-2023)

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Marie-Léandre Gomez, Marie Kerveillant, Nicolas Lot, Matthieu Langlois, Mathieu Raux. Organizational innovation under constraints: the case of Covid patients’ flow management in a Parisian hospital. Health Services Management Research, 2023, 36 (2), pp.137-144. ⟨10.1177/09514848221115243⟩. ⟨hal-04248797⟩
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