«Alle mann på dekk!»: Konkurrerende beredskapslogikker i organisering og ledelse av pandemihåndtering i sykehusene

Lars Erik Kjekshus

doi:10.7577/nat.4967

Authors

Lars Erik Kjekshus https://orcid.org/0000-0002-0122-0625

DOI:

https://doi.org/10.7577/nat.4967

Keywords:

Beredskap, krisehåndtering, ,meningsdannelse, organisering, sykehus

Abstract

Hospitals had to adapt quickly when the COVID-19 pandemic occurred in January 2020. This article analyses the organization of the crisis management of the pandemic at Oslo University Hospital (OUS). The analysis is based on theories that organization is processes of formation of meaning, and especially in the face of unexpected events. Crises stress tests the organization and can highlight important decision patterns and otherwise hidden underlying logics. Theories of emergency preparedness and management of crises distinguish between anticipation versus resilience. In the analyses of the OUS case, we identify two different emergency preparedness logics, planned and ad hoc emergency preparedness logic, which create tension in priorities and the choice of problems and solutions. The analysis is based on 19 in-depth interviews in three clinics at OUS between December 2020 and November 2021, as well as internal audits and documents from OUS and published works. The analysis shows that hospitals are plastic, flexible, and loosely coupled organizations, which are particularly suitable in crises, but which are challenging in normal operations. To learn from crisis management and develop robust hospitals for the future, a greater awareness of the relationship between the different emergency preparedness logics and sensemaking in crises is needed.

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