Managers' Experience of the Response of the Health System to the Covid-19 Pandemic for Inpatient Geriatric Care: Lessons About Organisation and Resilience.

backgroundEffective management of crises is a major challenge for healthcare organisations and their managers. Research suggests that to respond to evolving and unpredictable crises, such as the Covid-19 pandemic, an organisation needs the capability to continually adapt to the changing situation using relevant knowledge. However, there are few empirical studies using an organisational resilience perspective to understand how a health system responds to this type of crisis. This study aimed to describe managers' perspectives on what influenced the response to the Covid-19 pandemic in the Region Stockholm healthcare system for older people.

methodsData collection was conducted through in-depth semi-structured interviews with assistant managers (n = 3) and managers of inpatient geriatric services outside of acute care hospitals (n = 8), managers of three acute care hospitals (n = 3); and the crisis management team for geriatric services (n = 3). Data was analysed using qualitative content analysis.

resultsCrisis management of geriatric care in the Stockholm healthcare system during the Covid-19 pandemic's first 15 months was influenced by a combination of service specific aspects, 'Internal flexible responses', collaborative aspects, 'Coordination within the system', and governance aspects 'Adaptive steering'.

conclusionsThis study contributes to empirical knowledge about organisational resilience. Managers' responses are facilitated when the governance allow them more flexibility in their internal responses and enable their cross-organisational collaboration. A coordinating function across healthcare services is an important enabler in a crisis when the function has well-established, trustful prior collaborations with the services.