Innovation, Collective Intelligence and Resiliency in Healthcare Organizations E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Resilience in healthcare organizations is a complex issue, involving all stakeholders in the healthcare field. It is a highly topical issue, even more so in the wake of the recent health crisis. This book explores the impact of collective intelligence on the resilience of these organizations, and the role played by innovation. Health organizations comprise the structures and systems involved in treating patients, as well as healthcare professionals with medical, social or medico-social expertise, along with institutional and administrative players in the field. Innovation, Collective Intelligence and Resiliency in Healthcare Organizations alternates between theoretical readings and illustrative case studies. Their diversity is the result of their contributors: university researchers, institutional players from healthcare authorities, practicing caregivers in hospital structures or healthcare coordination support systems, and managers of healthcare structures and systems.
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Seitenzahl: 492
Veröffentlichungsjahr: 2024
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Table of Contents
Cover
Table of Contents
Title Page
Copyright Page
Foreword: Building Meta-Resiliencein Healthcare Organizations
References
Foreword: Resiliency
List of Acronyms
About the Authors
Introduction
References
PART 1: Organizational Resilience in the Healthcare Field
Introduction to Part 1
1 Resilience in Healthcare Organizations: Bibliometric Analysis
1.1. Context and issues
1.2. Literature review
1.3. Lessons learned
1.4. References
2 Response to Exceptional Health Situations at the Meso-Level: CPTSs in the Covid-19 Crisis
2.1. Context and questions
2.2. Conceptual framework
2.3. Case studies
2.4. Lessons learned
2.5. References
3 Dynamic Capabilities and Resilience of a Health Organization: The Case of an EHPAD-Medicalized Retirement Home
3.1. Background context and questions
3.2. Conceptual framework
3.3. Case studies
3.4. Lessons learned
3.5. References
4 The Health Pathway: A Resilient Model for Transforming the Governance of Health Authorities?
4.1. Background context and questions
4.2. Conceptual framework
4.3. Case studies
4.4. Lessons learned
4.5. References
PART 2: Collective Intelligence and the Resilience of Healthcare Organizations
Introduction to Part 2
5 Co-creation, Co-production and Collective Intelligence in Digitized Healthcare Policies
5.1. Context and issues
5.2. Theoretical and conceptual overview
5.3. Literature review
5.4. Lessons learned
5.5. Appendix
5.6. References
6 The Patient Educator: A Profession, A Political Mandate or A Social Mandate?
6.1. Background context and questions
6.2. Conceptual framework
6.3. Illustrations
6.4. Lessons learned
6.5. References
7 The Emergence of an Innovative and Resilient Organization of Healthcare Actors: The
Alliance Santé de Seine-et-Marne
7.1. Background context and questions
7.2. Illustrations
7.3. Lessons learned
7.4. Acknowledgments
8 The Alliance Manager: A Key Actor in Healthcare Coordination Systems
8.1. Background context and questions
8.2. Case studies
8.3. Lessons learned
8.4. References
PART 3: Innovation and Resilience of Healthcare Organizations
Introduction to Part 3
9 Social Innovation through Design in Hospitals: Challenges and Proposals for Conditions of Success
9.1. Background context and questions
9.2. Conceptual framework
9.3. Case studies
9.4. Lessons learned
9.5. References
10 Article 51: Innovative Experiments to Help the French Healthcare System?
10.1. Background context and questions
10.2. Conceptual framework
10.3. Case studies
10.4. Lessons learned
10.5. References
11 Innovation and Training for Healthcare Professionals: Impact on the Structural Resilience of Organizations
11.1. Background context and questions
11.2. Illustrations
11.3. Lessons learned
11.4. References
12 Analysis of Two Innovative Working Methods at the Ile-de-France RHA
12.1. Background context and questions
12.2. Case Studies
12.3. Lessons learned
Appendix: Brief Descriptions of Organizations
List of Authors
Index
Other titles from ISTE in Innovation, Entrepreneurship and Management
End User License Agreement
List of Tables
Chapter 1
Table 1.1. The most cited articles (developed by the authors)
Table 1.2. The most cited journals (developed by the authors)
Table 1.3. The most cited authors (developed by the authors)
Table 1.4. The most cited researchers by countries (developed by the authors)
Table 1.5. Clusters obtained from the analysis of keyword sharing (developed b...
Chapter 3
Table 3.1. A collection of conversations illustrating the observations at the ...
Chapter 5
Table 5.1. Findings from the literature review by category, N = 38
Chapter 8
Table 8.1. Description of the different systems in 2019 before the introductio...
Table 8.2. Skills and competencies of an alliance manager of DAC coordination ...
Chapter 9
Table 9.1. Summary of success factors
Chapter 10
Table 10.1. Points to watch and mechanisms to use in building innovation space...
List of Illustrations
Chapter 1
Figure 1.1. Number of publications by year (developed by authors)
Figure 1.2. Top 10 areas of publications on resilience in organizations (devel...
Figure 1.3. Top six organizations engaged in research on resilience in organiz...
Figure 1.4. Top seven countries of authors by number of publications (develope...
Figure 1.5. Dynamics of the number of publications and citations by years (dev...
Figure 1.6. Clusters of resilience in organizations (developed by the authors)
Figure 1.7. Resilience in healthcare organizations (developed by the authors)
Figure 1.8. Innovations in resilient organizations (developed by the authors)
Figure 1.9. Evolution in resilience in organizations (developed by the authors...
Chapter 10
Figure 10.1. The relationship between the patient, healthcare and the PTA–PAG....
Chapter 12
Figure 12.1. The Deming wheel
Guide
Cover Page
Table of Contents
Title Page
Copyright Page
Foreword: Building Meta-Resiliencein Healthcare Organizations
Foreword: Resiliency
List of Acronyms
About the Authors
Introduction
Begin Reading
Appendix: Brief Descriptions of Organizations
List of Authors
Index
Other titles from ISTE
WILEY END USER LICENSE AGREEMENT
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Health and Innovation Set
coordinated byCorinne Grenier
Volume 4
Innovation, Collective Intelligence and Resiliency in Healthcare Organizations
Edited by
Aline Courie-Lemeur
First published 2023 in Great Britain and the United States by ISTE Ltd and John Wiley & Sons, Inc.
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms and licenses issued by the CLA. Enquiries concerning reproduction outside these terms should be sent to the publishers at the undermentioned address:
ISTE Ltd27-37 St George’s RoadLondon SW19 4EUUK
www.iste.co.uk
John Wiley & Sons, Inc.111 River StreetHoboken, NJ 07030USA
www.wiley.com
© ISTE Ltd 2023The rights of Aline Courie-Lemeur to be identified as the author of this work have been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.
Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s), contributor(s) or editor(s) and do not necessarily reflect the views of ISTE Group.
Library of Congress Control Number: 2023943293
British Library Cataloguing-in-Publication DataA CIP record for this book is available from the British LibraryISBN 978-1-78630-844-3
Foreword by Annie BartoliBuilding Meta-Resilience in Healthcare Organizations
If there is one environment in which the need for resilience seems instantaneously paramount, it is that of health institutions. At first glance, this seems obvious, since the ability of health organizations and professionals to cope with difficulties is implicitly considered to be the keystone and the safety net for the functioning of modern civilizations. Therefore, in order to help individuals to overcome pathologies or painful episodes in their lives, for organizations and their members to be able to overcome sometimes devastating crises or destabilizing changes, for societies to be able to recover after shocks, ruptures or tragedies, the support of resilient health systems, capable of helping people and structures to continue to live and progress, constitutes a necessary and almost unavoidable condition.
Is it not, in essence, a question of meta-resilience, that is to say a capacity placed “alongside”, or even at a higher level, in order to contribute to the resilience of others?
This, however, may be a false sense of the obvious, about which too little analysis has been conducted to date. Beyond the political will and the resources allocated, which are certainly necessary but not sufficient, what else can promote the organizational resilience of health systems? How far should we go in the search for this resilience without risking creating perverse effects, excesses or blockages in the modes of operation, which could then become counterproductive? How can we build organizations that are not only resilient but also efficient, that is, capable of enabling societies to overcome crises, while remaining adapted to routine activities?
It is these fundamental questions that the beautiful book, coordinated by Aline Courie-Lemeur, attempts to respond to with as much ambition as it has humility. The organizational resilience that is at the heart of this book is certainly not, in and of itself, a new concept, but here it has been updated, contextualized and communicated through theoretical and practical interpretations, as a result of analyses carried out in context of health systems.
The concept of organizational resilience was studied in the 1980s by Karl Weick (1987) in relation to the principles of organizational reliability. For him, it was a matter of building a system of organized actions and maintaining that system in the face of difficult situations, with reference to situations of organizational shock that were likely to be destabilizing. In the logic of this researcher, who is also known for his contributions to the management of organizations through meaning, the resilience of systems is not limited to the addition of individual resilience but is based, above all, on organized and sustainable cohesion, in order to be able to survive and progress in the event of a major contingency. In his work with Sutcliffe and Obstfeld (1999), Weick thus analyzes the processes of managing the unexpected, the need for which may arise either in visibly manifest forms or, conversely, in a more subtle manner.
It is true that the unexpected, whether it be a violent crisis or an epiphenomenon with cascading consequences, has become a type of new normal, which paradoxically leads to the need to prepare for it through learning and action processes that are both structured and flexible. The challenges to be faced have been particularly highlighted in the health and medico-social fields in many countries in recent years, especially when organizational resilience was praised, even advocated, by the World Health Organization (WHO), which described resilience as “the ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions” (WHO 2022).
Such incentives, which aim to ensure the health security of populations while preserving the economic and social systems of countries, can only find their coherence by being applied at different complementary levels: at the “macro” level of nations or supranations, at the “meso” level of territories and organizations and at the “micro” level of communities and individuals. In the field of health, perhaps even more so than elsewhere, these registers interact, thus creating systemic complexity and increased challenges for knowledge as well as for action. Aline Courie-Lemeur and the many contributors to the book help us to understand what the hidden face of this much-needed resilience might be. Their combined work leads to the identification of certain interrelated factors that may well be the keys to its development. Innovation, in the broadest sense of the term, and collective intelligence, as a stimulated approach, are among these factors, which have become crucial in times of crisis.
Now, as we know, crisis is as much a danger as an opportunity. The term continues to be polysemous and ambiguous, recalling its plural origins: on the one hand, there is the Latin meaning of the word “crisis”, which can be associated with the serious and paroxysmal moments of pathological situations, while on the other hand, the Greek krisis instead indicates a delicate period of transformation with more or less favorable consequences. However, times of crisis stimulate emergency action, creativity and innovation, leading to different and sometimes more united thinking, and can therefore become an opportunity for strengthening. Everything then depends on the strategic capacity to transform the threat into an opportunity (Ansoff 1977), or what Altintas (2020) calls the dynamic resilience capacity of the organization.
The public management literature of the early 21st century tended to focus on the economic or geopolitical dimensions of crisis situations (Bartoli and Blatrix 2012), while today the global pandemic of Covid-19 has brought health crises and the importance of considering “one health” – human, animal and environmental – back to the forefront (Zinsstag et al. 2020). As a result, health seems to have returned to being seen by many as a common or collective good, leading, fortunately, to its professionals and institutions being seen more as socio-organizational resources that need to be respected and preserved.
It is in this troubled and fragile context that the viewpoints exchanged by international researchers and professionals from healthcare institutions, cleverly brought together in this book, are timely. The authors highlight and significantly update certain conditions for success, such as the process of decommissioning, the co-construction of organizational innovations, formal and informal leadership and the coordinated commitment of actors. All of this can lead to collective forms of knowledge and know-how that guarantee better coherence of analysis and action processes and, as this judicious work demonstrates, a better organizational resilience for our health systems, which are very precious and yet remain highly vulnerable.
This book reveals reflective and distanced, as well as pragmatic and operational ways to innovate in this direction and consolidate in a sustainable way the meta-resilience of health organizations, placed at the service of the resilience of others, whatever its form or its scope of action may be.
The collective intelligence of the authors, presented in this work coordinated by Aline Courie-Lemeur, whether they are researchers, practitioners or institutions, can only help us progress in this direction!
Annie BARTOLI
Université Paris-Saclay, UVSQ, Larequoi, Versailles, France
Georgetown University, Washington, DC, USA
References
Altintas, G. (2020). La capacité dynamique de résilience : l’aptitude à faire face aux évènements perturbateurs du macro-environnement.
Management et Avenir
, 115, 113–133.
Ansoff, H.I. (1977). The changing shape of the strategic problem.
Journal of General Management
, 4(4), 42–58.
Bartoli, A. and Blatrix, C. (2012). Des sciences modestes de l’action publique ? Politiques et management publics face à la crise.
Revue politiques et management public
, 29(3), 289–304.
Weick, K.E. (1987). Organizational culture as a source of high reliability.
California Management Review
, 29(2), 112–127.
Weick, K.E., Sutcliffe, K.M., Obstfeld, D. (1999). Organizing for high reliability: Processes of collective mindfulness.
Research in Organizational Behavior
, 21, 81–123.
WHO (2022). Urban planning for resilience and health: Key messages. Summary report on protecting environments and health by building urban resilience. Report, WHO European Centre for Environment and Health [Online]. Available at:
https://www.who.int/europe/publications/i/item/WHO-10665-355760
[Accessed April 15, 2022].
Zinsstag, J., Schelling, E., Waltner-Toews, D., Whittaker, M.A., Tanner, M. (2020).
One Health, une seule santé : théorie et pratique des approches intégrées de la Santé
. Éditions Quae, Versailles.
Foreword by Yves CharpakResiliency
When I was asked to write the foreword to this book, I accepted without really imagining where it would take me.
I was flattered by the offer, which referred to my varied career path, which started out first as a junior general practitioner, then as a researcher in clinical epidemiology and evaluator of healthcare technologies and practices, then as a consultant and owner of a private evaluation consultancy firm, while keeping the “spirit of science” in my work with nearly all possible actors in the healthcare field. Particularly since the late 1980s, I have been working on “care networks”, from perinatal care to addiction, via public–private collaboration projects, linking city and hospital, general practitioners and specialists, and so on.
My various past activities in academic and professional societies, in public health, epidemiology, and in expert bodies (Haut Conseil de la santé publique, Haut Conseil pour l’avenir de l’assurance maladie, etc.), made reading the contributions in this book a pleasure and a lesson, showing strong commitments to bringing organizations to life, finding solutions to external difficulties (Covid-19 among others), common to healthcare operators as well as to administrative bodies. In addition, these contributions naturally led to a better understanding of the concept of resiliency of which I have never been a specialist and which revealed itself to be a framework that has accompanied me throughout my career.
To ask someone who is not an expert on the subject to write a foreword is to ask them to immerse themselves in what is to be found in the book, and to discover the authors’ expertise in the visible and less visible dynamics of the ongoing transformation of healthcare organizations in response to the unavoidable changes in healthcare problems and the responses to be provided.
This book offers a tremendous variety of insights, experiences and proposals for making organizations as resilient as possible; in particular, by being able to respond to the unexpected and to crises in an effective way, particularly by drawing on what happened during the Covid-19 crisis, and also by suggesting numerous ways in which the same organizations can be better prepared to face future difficulties and crises in order to mitigate their impact. We learn about the need for professionals to develop resiliency skillsets and about the need to organize the management of institutions to facilitate collective resiliency, to set up organizational collaborations between actors, and to build alliances, particularly at the local level.
I suppose it is implicit that the institutional resilience capacity is only beneficial if it leads to a better collective handling of problems, and not just to “surviving”. This is because the “common good” is often at odds with individual or institutional logics. The possible opposition between the resilience of a business unit and a political strategy for the common good made me recall the response of a friend, in charge of communications in a large foreign chemical group, to whom I asked how they managed their crises. He replied: “We haven’t had any crises since internal management and communication processes were put in place so that everyone ‘knows what to do’ when there’s a problem”. He meant that the organization was 100% resilient in protecting itself, but not exactly that it was resilient in preventing mishaps. However, I believe that the resiliency desired by society is that which enables us to better deal with problems, including through changes that may impact organizations and individuals when necessary.
But once I had been invited to delve into the book, there was also the risk that the second part of my career and my expertise, focused on health and not just on care, might lead me to wander onto other paths. My experiences at the WHO, in international affairs at the Institut Pasteur, at the prospective blood transfusion organization (EFS), in professional public health societies in France and Europe, and now my status of elected municipal official, make me read the book slightly outside the box, with the subtle nuance that it describes essential experiences in the organization of care rather than “health”. And the nuance is not just semantic.
To put it plainly, how can we enter into direct interaction, particularly at the local level, with all the actors who contribute to people’s health – and not just to healthcare – in order to ensure good health, clear policies to protect health upstream of disease, prevent chronic illnesses and the consequences of today’s unavoidable threats to health: the environment, social inequalities, diet, lifestyles, urban planning and housing, mobility, etc.?
The actors involved in healthcare issues, particularly at the local level, are not just those involved in providing care.
Should the examples of coordination still being used experimentally in the healthcare sector not be extended as far as possible to other health providers and operators? Could these alliances be extended beyond care? For a future book, perhaps?
Yves CHARPAK
Public health physician, epidemiologist, evaluator,
President of the Charpak Foundation:
l’esprit des sciences (the Spirit of Sciences), and local elected official
List of Acronyms
ANAP: Agence nationale de l’appui à la performance is the French national agency for supporting the performance of health and medico-social establishments.
APRN: advanced practice registered nurse is commonly referred to as an IPA or Infirmier en pratiques avancées in French.
ARM: see MRA.
ARS: see RHA.
ATIH: Agence technique de l’information sur l’hospitalisation is the French technical agency responsible for handling data and information regarding hospitalizations.
CAQES: Contrat d’amélioration de la qualité et de l’efficience des soins is a contract defining the quality of care and commitments to improving efficiency in France.
CECICS: Cellule d’expertise et de coordination des patients insuffisants cardiaques sévères is the expertise and coordination unit for patients with severe heart failure in France.
CHF: congestive heart failure is commonly known as ICC (Insuffisance cardiaque chronique) in French.
CLIC: Centre local d’information et de coordination is a local data and coordination center for health and social issues in France.
CME: Commission médicale d’établissement is the medical committee of a healthcare institution in France.
CPAM: Caisse primaire d’assurance maladie is France’s primary health insurance fund.
CPOM: Contrat pluriannuel d’objectifs et de moyens is a French multi-year contract outlining the objectives and resources allocated.
CPTS: Communauté professionnelle territoriale de santé is a territorial health professional community in France.
CRS: the Comprehensive Rehabilitation Services program serves people who have experienced traumatic injuries. These are commonly referred to by their acronym SSR (Soins de suite et de réadaptation) in French.
CTA: Coordination territoriale d’appui is a local coordination support system in France.
DAC: Dispositif d’appui à la coordination is a coordination support organization in France.
DCGDR: Direction de la coordination et de la gestion du risque (structure régionale de l’assurance maladie) is the department for risk management and coordination in France (whose mandate is the regional structure of health insurance).
DD: Délégations départementales – échelons départementaux de l’AR délégations départementales are departmental delegations/branches of the RHA (ARS) in France.
DDASS: Direction départementale des affaires sanitaires et sociales is the French departmental directorate for health and social affairs.
DLU: Dossier de liaison d’urgence is a French emergency liaison record.
DREES: Direction de la recherche, des études, de l’évaluation et des statistiques is the French directorate for research, studies, evaluations and statistics.
EHPAD: Établissement d’hébergement pour personnes âgées dépendantes is the French abbreviation for an accommodation facility for dependent elderly people.
EMS: emergency medical services in France is commonly referred to by its abbreviation SAMU (Service d’aide médicale urgente).
ES: see HCF.
ETP: see TPE.
FIQCS: Fonds d’intervention pour la qualité et la coordination des soins is an intervention fund for the quality and coordination of care in France.
GHT: Groupement hospitalier territorial ou de territoire is a local (territorial) hospital group in France.
GHU: Groupement hospitalo-universitaire is a university hospital group in France.
HAD: see HaH.
HaH: Hospitalization at Home, in French known as HAD (Hospitalisation à domicile).
HAS: Haute Autorité de santé is the French National Authority for Health.
HCAAM: Haut Conseil pour l’avenir de l’assurance maladie is the French High Council for the Future of Health Insurance.
HCF: a healthcare facility is commonly known as an ES (Établissement de santé) in French.
HPST: Loi du 21 juillet 2009 portant réforme de l’Hôpital et relative aux patients, à la santé et aux territoires is the Law of July 21, 2009 reforming the hospital as it relates to patients, health and territories.
HR: human resources is commonly known in French as RH (Ressources humaines).
HSTS: health system transformation strategies are commonly referred to by their acronym STSS (Stratégie de transformation du système de santé) in French.
ICC: see CHF.
IDE: see SRN.
IDF: Ile-de-France is the region in north-central France surrounding the nation’s capital, Paris.
IPA: see APRN.
LFFS: Loi de financement de la Sécurité sociale is the French Social Security Financing Act.
MAIA: method of action for the integration of healthcare and support services in the field of Autonomy.
MRA: is a “medical regulatory assistant”. These are commonly referred to as ARM (Assistant de régulation médicale) in French.
OSNP: see UCP.
PAERPA: Parcours de santé des personnes âgées en risque de perte d’autonomie is a scheme in France whose mandate is to assist “elderly people at risk of loss of autonomy”.
PME: see SME.
PRADO: Programme de retour à domicile is a return home program in France.
PRS: see RHP.
PTA: Plateforme territoriale d’appui is a local support platform in France.
RH: see HR.
RHA: Regional Health Agency, or Agence régionale de santé (ARS) in France, an autonomous, regional public institution placed under the supervision of the Ministry of Health.
RHP: Regional Health Project, in French these are commonly referred to as PRS (Projet régional de santé).
SAMU: see EMS.
SAS: Service d’accès aux soins is France’s access to care service.
SME: small and medium-sized enterprises are commonly referred to as PME (Petite moyenne entreprise) in French.
SNDS: Système national des données de santé is France’s national health data system.
SRN: state-registered nurse is commonly known as an IDE (Infirmier diplômé d’État) in French.
STSS: see HSTS.
TMHP: territorial mental health projects.
TPE: see VSE.
TPE: therapeutic patient education is commonly known as Éducation thérapeutique du patient (ETP) in French.
UCP: unscheduled or urgent care practitioner is commonly referred to as an OSNP (Opérateur de soin non programmé) in French.
UNCAM: Union nationale des caisses d’assurance maladie is France’s national union of health insurance funds.
URPS: Union régionale des professionnels de santé is France’s regional union of health professionals.
VSE: very small enterprises are commonly referred to in French by their acronym TPE (Toute petite entreprise).
About the Authors
Annie BARTOLI is a professor of management sciences at the ISM-IAE of the UVSQ, Université Paris-Saclay, and director of the Larequoi Management Research Laboratory. She is also a research professor at Georgetown University, Washington, USA, where she co-directs teaching and research programs in international and intercultural management. One of her major fields of expertise is public and non-market management, with works on local governments and the health sector. Among her numerous national and international publications, Le grand livre du management public, published for its 5th edition in 2022 (with C. Blatrix), is a notable reference in the public management field. In addition, she is also editor-in-chief of the scientific journal Gestion et Management Public (GMP).
Sophie BATAILLE is an emergency physician, coordinator of the Cardiology Health Data Warehouse of the Ile-de-France Regional Health Agency (RHA) since 2000, and cardiology referent at the Ile-de-France RHA since 2015.
Élise BLÉRY is a general practitioner, as well as a medical adviser for health insurance. Since 2010, she has been in charge of supporting hospital structures in their efforts to improve performance and the relevance of care, and promoting innovations in healthcare.
Laëtitia BOREL is a doctoral student in management sciences at the Larequoi Laboratory, attached to the University of Versailles Saint-Quentin-en-Yvelines. Her research focuses more specifically on the management of healthcare organizations, in line with her professional background. For the past 10 years, she has been involved in several health coordination organizations in the Ile-de-France region. She is currently a project manager for a national public health agency.
Emmanuelle CARGNELLO-CHARLES is a senior lecturer at the University of Pau and Pays de l’Adour (LiREM laboratory). Her research interests are in the field of health management, more specifically in management control and finance.
Laurent CENARD has a state diploma in nursing with an AED in Public Health and a DESS-MBA in Business Management from the IAE Paris. He has held numerous management positions in non-profit organizations in the healthcare field. These roles have made him a privileged observer of organizational innovations, particularly coordination mechanisms between the city and the hospital. He is currently working at the Fondation Santé Service (“Health Service Foundation”), as director of the home hospitalization unit. He is also an associate member of Larequoi, the Management Research Laboratory of the University of Versailles Saint-Quentin-en-Yvelines.
Yves CHARPAK is a doctor specialized in public health and in clinical epidemiology and evaluation. He is President of the Charpak Foundation, l’esprit des sciences (“the spirit of science”) and also a local elected official in Larchant. He is a member of the board of the association Élus Santé publique et territoires (ESPT, “Elected public health and territories”) and a member of the board of the Société française de santé publique, SFSP (“French Public Health Society”). He worked as a researcher in an Inserm team, then in the evaluation company EVAL, at the WHO regional office for Europe, at the Pasteur Institute and then at the Établissement français du sang, EFS (“French Blood Establishment”). He was a member of the Haut Conseil de la santé publique, HSCP (“High Council for Public Health”) and the Haut Conseil pour l’avenir de l’assurance maladie, HCAAM (“High Council for the Future of Health Insurance”).
Olena Yuriivna CHYGRYN has a PhD in economics and is associate professor in the Department of Marketing, Sumy State University, Ukraine. Her research interests include green marketing, green competitiveness, corporate governance and alternative energy economics1. She is author of more than 100 scientific articles (including two monographs, 10 sections of collective monographs and more than 40 articles in scientific journals – 14 are indexed by Scopus, seven by Thompson Reuters) and more than 50 publications in the abstract collections of international scientific conferences.
Aline COURIE-LEMEUR is a senior lecturer qualified to lead research in management sciences at the Larequoi Laboratory and at the ISM-IAE of the University of Versailles Saint-Quentin-en-Yvelines. Her research focuses on the strategic management of inter-organizational collaborations in the healthcare field and, more specifically, on the issues of consensus and leadership. She is a specialist in organizational innovation.
Cécile DEZEST is a doctoral student of management science at the University of Pau and Pays de l’Adour (LiREM laboratory). She works on the theme of health management and on the management of projects under Article 51 of the French Social Security Financing Act 2018.
Isabelle FRANCHISTEGUY-COULOUME is a senior lecturer in management sciences, authorized to direct research at the IUT of Bayonne and the Basque Country, Université de Pau and Pays de l’Adour (LiREM laboratory). Her research is in the field of health management, with a focus on strategic management and human resources management.
Sylvain GAUTIER is a public health physician at the University of Versailles Saint-Quentin-en-Yvelines. He has a degree in law and health policy from the University of Paris Descartes and Sciences-Po. He is a doctoral student in epidemiology in the “primary care and prevention” research team of UMR 1018, Inserm. His thesis focuses on the localized structuring of primary healthcare, in particular within the framework of CPTS (Communautés professionnelles territoriales de santé) local professional health communities.
Liliia Mykolaivna KHOMENKO is a doctoral student in the Department of Marketing at Sumy State University in Ukraine2.
Vincent MABILLARD is an assistant professor at the Solvay Brussels School of Economics and Management, Université libre de Bruxelles, where he teaches the management and communication of public organizations. His research focuses on the dynamics of transparency and accountability, as well as on localized marketing and communication of public organizations. He is active in an international project on the digitization of processes and services in the healthcare sector.
Hélène MARIE is director of the Seine-et-Marne Departmental Delegation of the Ile-de-France Regional Health Agency (RHA). Trained at the École des hautes études en santé publique, EHESP (“School of Advanced Studies in Public Health”), she has held several positions in the design, implementation and evaluation of public policies. At the CNSA and in ministerial offices, she contributed to the development of planning tools and strategies for strengthening the pathway approach in the medico-social field. A stint in the associative sector allowed her to support the operational implementation of projects to support people. As an agent working in the deconcentrated services of the State and then in the RHA, she implemented public health policies by developing strong partnership logics with the interlocutors of the territories. She has held the position of director of the Seine-et-Marne Delegation of the Ile-de-France RHA since 2016 and has developed several work groups with her team.
Michel MARTY is a doctor at the Ile-de-France regional medical service department (general health insurance scheme) in charge of establishments (health and medico-social) and healthcare pathways.
Jan MATTIJS is a professor at the Solvay Brussels School of Economics and Management, Université libre de Bruxelles, where he teaches organizational change and the conduct of business intervention projects. His research interests include organizational theory, administrative reform and public performance in sectors such as justice, social security and non-market organizations. Socio-material devices and the effects of technology on work and organization are emerging as new topics. He is also interested in the corporeal roots of management in order to articulate personal and social development in the face of the challenges of our time.
Benoît NAUTRE has a doctorate in management science from the IAE in Nantes, a DEA in information systems and strategy from the IAE in Nantes, is a research professor at the MCA-IAE at the University of Clermont Auvergne and is a hospital director.
Béatrice PIPITONE is in charge of the Dispositifs d’appui à la coordination, DAC (“Coordination Support Systems”) mission in the Innovation Department of the Ile-de-France Regional Health Agency (RHA) and deputy head of the Parcours et offre de soins (“Care Pathways and Services”) at the Seine-et-Marne Departmental Delegation. Through her experience as a consultant in public action on health issues at the European level, and then in supporting organizational change in the health and medico-social sector in France, she has supported the deployment of numerous innovative public health measures and approaches aimed at improving the healthcare pathways of vulnerable, disabled, chronically ill, deprived and/or elderly people, in particular for the Ministry of Health and Social Cohesion, the CNSA, and several RHA and MDPH. She has been working for 4 years at the Ile-de-France RHA headquarters on the DAC deployment mission and joined the Seine-et-Marne Departmental Delegation part-time in April 2021.
Charlotte ROUDIER-DAVAL is a health geographer. She is currently a project manager in the innovation department on Article 51 and the improvement of pathways at Ile-de-France RHA.
Marianne SARAZIN is a doctor specializing in public health, with a degree in research on “prevention to optimize care”, and a doctorate in life sciences from the Engineering and Health Center of the École nationale supérieure des mines de Saint-Étienne, on the modeling of predictive scores for aging. She is currently in charge of the département d’information médicale (“hospital databases management”) for the Groupe mutualiste de Saint-Étienne after having worked for 12 years in the Firminy hospital media information department. As of 2013, she has also been an associate in the I4S Department of the Engineering and Health Center, specializing in the optimization of healthcare organization and, since 2006, she has been the regional manager of the Sentinelles network, UMRS 1136 Inserm, specializing in the modeling of epidemics.
Jihane SEBAI is a senior lecturer at the ISM-IAE of the University of Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay. She is a researcher in the Larequoi Management Laboratory. Her research focuses on public management, strategic management, health management, health democracy, coordination structures, integration of care, mental health and more. His publications are available on Cairn and various academic databases.
Bérangère L. SZOSTAK is a university professor at the ISM-IAE of the University of Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay. She is a full researcher at the Larequoi Laboratory. Her specialty is the strategic management of innovation and organizational creativity in various organizations (SMEs, cultural and creative industries, social economy organizations, hospitals, etc.). His contributions concern the development of creativity, particularly through design thinking. Her work has been published in journals such as M@n@gement, Revue française de gestion, Revue internationale de la PME, Revue d’Économie Industrielle, Journal of Innovation Economics & Management and European Journal of Innovation Management. She is the author of Innovation and Creativity in SMEs: Challenges, Evolutions and Prospects (ISTE-Wiley, 2019) in collaboration with C. Gay.
Fatima YATIM is a senior lecturer specializing in the management of healthcare organizations. She is a member of the Équipe pédagogique nationale santé-solidarité au Laboratoire interdisciplinaire de recherches en sciences de l’action (“National Health and Solidarity Teaching Team at the Interdisciplinary Research Laboratory in Action Sciences”) at CNAM in Paris. Her work focuses on three main themes: health technologies, health democracy and patient engagement, and coordination and care pathways.
Notes
1
ORCID:
https://orcid.org/0000-0002-4007-3728
.
2
ORCID:
https://orcid.org/0000-0001-5690-1105
.
Introduction
This book attempts to explore, with humility, the complex issue of resilience in healthcare organizations and to draw lessons from the recent health crisis. As with all “boundary objects” (Trompette and Vinck 2009) located at the intersection of several fields, which encompass various dimensions and are multiple and multifaceted in nature, analyzing them through a single lens is far from judicious and, even worse, may result in a loss of meaning and lead to misinterpretations.
To guard against this, we seek to avoid simplicism that is incompatible with the problem of resilience in the field of health and instead try to approach it in a simplistic approach (Berthoz 2009). This work is complementary to all the approaches challenging the duality between “everything regulated by policies” and “let us do the groundwork” (Grenier 2014), pleading for the adoption of a co-construction approach involving all stakeholders, imperative to building structurally resilient health organizations.
In order to achieve this, we set ourselves goals and took certain precautions. In terms of objectives, this book aims to explore how collective intelligence can promote the structural resilience of healthcare organizations and how innovation can contribute to it. To avoid the bias of a single and mono-dimensional interpretation, we include in health organizations all the structures and devices involved in the care of patients (hospital structures, coordination support structures and devices, medical, social and medico-social structures, health authorities, etc.). We consider “health professionals” to be all caregivers with medical, social or medico-social expertise, institutions, administration and organization professionals, as well as all the actors involved in the care of patients and the management of health organizations.
The diversity in profiles of the contributors to this work also reflects this position, drawing on French and international university researchers, institutional actors from health authorities, medical practitioners within hospital structures or in health coordination, leaders of health structures and devices.
We also consolidate this position through the forms of the contributions, alternating between theoretical readings and illustrative case studies.
This book is divided into three parts, each comprising four chapters.
The first part focuses on the notion of organizational resilience in the healthcare field and seeks to identify its contours and specificities. It is based on intersecting contributions from two international researchers, a hospital researcher-practitioner, a hospital researcher-manager, and a researcher working in a French national public health agency.
The second part focuses on the interaction between collective intelligence and resilience in health organizations. It works to show the dynamic relationship between them by combining two theoretical readings, one by two international university researchers and the other by a French university researcher, as well as two case studies, one by institutional leaders of the health authority and the other by a leader in a regional health structure.
The third part addresses the relationship between innovation and the resilience of health organizations. It seeks to explore their virtuous interactions based on two theoretical analyses by university researchers who specialize in health management, as well as two case studies, the first laid out by institutional leaders working as a health authority in health insurance, and the other by a hospital researcher and practitioner.
In addition to a standardized structuring of all the contributions, to ensure overall coherence throughout the book and better readability, we have ensured that each contribution illustrates a lesson learnt.
We would like to thank Mrs. Annie Bartoli and Mr. Yves Charpak for their salient forewords and the honor they have bestowed upon this book. Their perception, sharpened by their distinguished careers, transcends this book.
This book humbly aspires to contribute to strengthening organizational resilience in the field of health, in particular through multiple innovations and with thanks to the anchoring of collective intelligence in institutional routines and health organizations, in a context where crises, alas, are no longer the exception.
References
Berthoz, A. (2009).
La simplexité
. Odile Jacob, Paris.
Grenier, C. (2014). Proposition d’un modèle d’espaces favorables aux habiletés stratégiques.
Journal de gestion et d’économie médicales
, 32(1), 3–10.
Trompette, P. and Vinck, D. (2009). Retour sur la notion d’objet-frontière.
Revue d’anthropologie des connaissances
, 3(1), 5–27.
Note
Introduction written by Aline COURIE-LEMEUR.
PART 1Organizational Resilience in the Healthcare Field
Introduction to Part 1
This section explores the notion of organizational resilience in the healthcare field, approached as a problem common to all health organizations. On the one hand, it concerns the position of health authorities and the way they relate to the health workers, and on the other hand, the local structuring of care, perceived as an ecosystem. Therefore, the way in which healthcare organizations use internal resources during a crisis is a major issue for them. The authors have profiles either as foreign researchers, or as researchers and practitioners within French healthcare organizations, resulting in complementary approaches and analyses that transcend one another.
In Chapter 1, Olena Yuriivna Chygryn and Liliia Mykolaivna Khomenko conduct a bibliometric analysis of the international scientific literature on resilience in organizations and, in particular, on what can be implemented in health organizations. This research also includes publications on the themes of collective intelligence, innovation, collaboration and the participatory approach in the healthcare field. The main objective of this study is to obtain an overview of existing scientific research on resilience in healthcare organizations, identify modern research topics and anticipate future research topics. For example, it highlights researchers’ findings on multiple outcomes: first, that a transformational leadership style has a statistically significant positive impact on perceived organizational stability; second, that elected officials are more likely to build organizational resilience than designated officials; furthermore, that resilience through mediation may function as a psychological shield that would mitigate burnout; and that the organizational characteristics that indicate resiliency within healthcare organizations are obligation-driven: ability to improvise, reciprocity within the community, leadership of actors during transformations, hope and optimism, and financial transparency. The main areas of modern and future research emphasize the themes of social capital, coaching and communication in health organizations.
In Chapter 2, Sylvain Gautier focuses on the positioning of CPTS (Communautés professionnelles territoriales de santé) local professional health communities1 at the meso-level between clinical integration and systemic integration. He focuses his attention on the organizational and professional dimensions accompanying this positioning in order to better specify the challenges of a local structuring of care with resilient contours. By structuring primary care in a local manner, and by entrusting the actors within this care with local public health missions through the CPTS, the resilience of the health system as a whole is strengthened. It concludes with the fundamental issues and principles of action that underpin structurally resilient community organizations. The obligations of the CPTS must be expanded to first respond more effectively to serious health crises such as Covid-19. And second, to ensure that primary care professionals are genuinely involved in these new public health services, which are far removed from their existing skills. To do this, they need to be trained in crisis management during their studies. Finally, to preserve the flexibility of CPTSs and guarantee the autonomy and empowerment of the healthcare professionals working within them.
In Chapter 3, Benoît Nautre looks at the ways in which a healthcare organization such as an Établissement d’hébergement pour personnes âgées dépendantes, EHPAD (“Residential facility for dependent elderly people”) will, in the face of a crisis situation such as that of Covid-19, mobilize previously untapped internal resources to initially absorb and improvise in the face of turbulence, and then rapidly engage in a structured organizational learning process. He distinguishes between resilience and dynamic resilience capacities: he associates the former with improvisational actions facing a crisis situation, and the latter with post-crisis learning that goes beyond a return to the initial state. He identifies two indispensable conditions for the development of dynamic resilience capabilities: the first is linked to the presence of internal leaders capable of imposing themselves through innovation, while the second depends on the intensity of the external turbulence to encourage the transformation of existing routines.
In Chapter 4, Laëtitia Borel focuses on the health pathway paradigm, which consists of implementing a resilient, decompartmentalized health organization that promotes cooperation between health actors within the framework of a localized approach, derived from the innovative model of local self-organization. It focuses mainly on its impact on the renewal of the role of health authorities, and in particular the Regional Health Agencies (RHAs), located at the interface of national health policies and the territories. From a position of regulator, the RHA must evolve toward a position of partner guardianship. She uses the DAC (Dispositif d’appui à la coordination) coordination support system as a case study to highlight the importance of the RHA establishing a close relationship with local healthcare actors, as well as to give a detailed knowledge of the local ecosystem, in order to be able to occupy this border post. She concludes that it is necessary to question the representations of each person, through the construction of a common cultural meeting zone, on the basis of the collective organizational learning necessary for the construction of a sustainable, resilient health system.
Notes
Introduction written by Aline COURIE-LEMEUR.
1
Acronyms are expanded upon in further detail at the end of the book in the Appendix and/or the List of Acronyms.
1Resilience in Healthcare Organizations: Bibliometric Analysis
The main direction of this chapter is a bibliometric analysis of the scientific literature on resilience in organizations and, particularly, what can be implemented in healthcare organizations. The main purpose of this chapter is to gain a comprehensive view of relevant research on resilience in healthcare organizations, identify modern research and predict future research. Achieving this goal involves the following tasks: analysis of publication trends, fields of application, countries engaged in the most research on resilience in organizations and organizations that fund such research; analysis of the influence of publications, authors, and articles; analysis of directions (clusters) of modern research on resilience in organizations; and forecasting future research directions. In addition, in this chapter the place of publications on collective intelligence, innovation, collaboration and the participatory approach in healthcare, based on the existing database of publications, was determined.
1.1. Context and issues
Interest in resilience in organizations in general and healthcare organizations in particular increases annually. There is a lot of research on resilience in organizations in business economics, engineering, psychology, environmental sciences ecology, public administration, public environmental occupational health, computer science, science technology, and others.
Resilience in organizations has been studied by researchers worldwide, particularly Chaskalson (2019), Malinen, Prayag and others. Each of them has more than three research studies on this topic. More works on resilience in organizations focus on management, organizational resilience, performance, impact and models.
Review articles about resilience in organizations focus on cyber resilience, elements of supply chain resilience, group resilience in organizations and diverse perspectives about resilience enhancement. In addition, interventions implemented by highly resilient organization, organizational and team factors that can strengthen team resilience, the concept of organizational resilience and indicators for the evaluation of community resilience.
However, the issue of resilient organizational structures in healthcare is insufficiently represented in the scientific literature. Aspects of collective intelligence in the health system are also insufficiently covered in the research. There is a small amount of research on some aspects of resilient organizational structures in healthcare, including innovation, collaboration and the participatory approach.
There are several studies on innovation in healthcare organizations. Researchers have studied micro-level processes in organizational innovation; the processes of creating working conditions in hospitals with the use of innovative technologies and methods; critical practices in decision-making to improve managerial innovation; the relationship between innovation and efficiency in healthcare facilities; the relationship between the organizational climate, the organization’s openness to innovation and innovative behavior at work. There is also research on how knowledge-based activities are designed to foster innovation and create value, and how learning is related to innovation.
Fewer studies on collaboration in healthcare organizations have been found. These studies focus on assessing interprofessional and inter-organizational cooperation, elements of organizational culture as resources that help them cooperate with health professionals. In addition, they studied the role of collaboration in the rapid spread and successful implementation of transformational redevelopment, return to work programs and the partnership challenges IT leaders in healthcare face.
The only publication on the participatory approach in healthcare organizations relates to patient education implementation to become patient partners in care.
The main direction of this chapter is a bibliometric analysis of the scientific literature on resilience in organizations and, particularly, what can be implemented in healthcare organizations. It helps to get a holistic view of relevant research on selected topics; explore trends, areas of application, countries and funding organizations; determine the most influential journals, articles and authors; and analyze the direction of previous and projected future research. This study explores the influence of journals, authors and articles; text analysis; and literature visualization.
The main purpose of this chapter is to gain a comprehensive view of relevant research on resilience in healthcare organizations, identify modern research and predict future research.
Achieving this goal involves the following tasks:
analysis of publications trends, fields of application, countries engaged in the most research on resilience in organizations and organizations that fund such research;
analysis of the publications, authors and articles influence;
analysis of directions (clusters) of modern research on resilience in organizations;
forecast of future research directions.
In addition, in this study, it is advisable to determine the place of publications on collective intelligence, innovation, collaboration and participatory approach in healthcare based on the existing database of publications.
1.2. Literature review
1.2.1. Methodology
Web of Science data were used to analyze trends and citations from existing publications on resilience in organizations. This choice has been associated with the widespread use of this database in modern research.
The literature on resilience in organizations was selected and identified by keywords. In particular, the search was carried out on request: resilience AND organizations. The selection was made only in the titles of publications. This made it possible to obtain the most relevant publications on the selected topic.
Based on Web of Science data, 232 publications were found on resilience in organizations. Article titles, authors, journal titles, year of publication, number of citations and keywords were used for further analysis.
The dynamics of publications by year was studied. Key areas of research on resilience in organizations were identified: the organizations most engaged in research on resilience in organizations, and the authors of countries most involved in research on resilience in organizations.
The dynamics of citations by year of selected publications were analyzed. Based on the number of citations, the most influential publications, journals, authors and their countries of affiliation were identified in terms of resilience in organizations.
Based on keywords, the hierarchical cluster analysis was performed. Visualization of scientific literature topics was carried out with the VOSviewer program. Based on the keywords (more than four repetitions), clusters on resilience in organizations were identified.
Based on the keywords, the research evolution on resilience in organizations was analyzed, and the current and future research topics were identified.
1.2.2. Results
Based on Web of Science data, 232 publications on resilience in organizations were found. More than 50% of these works were published during 2016–2019, indicating a rapidly growing interest in this topic (Figure 1.1).
Figure 1.1.Number of publications by year (developed by authors)
As can be seen from Figure 1.1, 61% of the works were published during 2018–2021. These works relate to 63 areas of research. The top 10 areas of research are presented in Figure 1.2.
Figure 1.2.Top 10 areas of publications on resilience in organizations (developed by the authors)
More works were related to business economics (26.3%), engineering (16.8%), psychology (15.5%), environmental sciences ecology (8.6%) and public administration (6.9%). Less than 6.5% of works were related to environmental and occupational public health and other healthcare directions.
More than 400 organizations conduct research on resilience in organizations. The 10 organizations that conduct the most research on this topic are presented in Figure 1.3.
Most research was conducted by the State University System of Florida (USA), the University of Canterbury (New Zealand), the University of London (England), the University of Birmingham (England), University of California System (USA) and the University of Florida (USA).
Together, they conducted 34 studies on resilience.
Seventy-four organizations fund research on resilience. At the same time, the National Science Foundation and the European Commission only funded three studies. Another six organizations funded two studies, and others funded only one study.
Figure 1.3.Top six organizations engaged in research on resilience in organizations by number of publications (developed by the authors)
Figure 1.4.Top seven countries of authors by number of publications (developed by the authors)
Authors from 55 countries are involved in research on resilience in organizations. Figure 1.4 presents the authors of seven countries who have published 10 or more works.
Five percent of works have been published by authors from the United States, UK, Australia, Germany and France.
To understand the most influential authors, publications and works, we will analyze citations. An analysis of citations showed that all 232 publications on resilience in healthcare organizations had 2,283 citations, their H-Index is 23 and all publications were cited 9.8 times on average.
The number of publications and citations is shown in Figure 1.5.
Figure 1.5.Dynamics of the number of publications and citations by years (developed by the authors)
As can be seen from Figure 1.5, 45% of citations fall in years 2016–2021 (128–473 citations per year), which may indicate the relevance of this topic.
In this study, 232 papers on resilience in organizations were found. Table 1.1 presents information on the 10 most cited publications.
As can be seen from Table 1.1, half of the most cited works were published during 2010–2013. The articles published in 1997 have the largest number of citations (277). More than half of the works are published in editions belonging to the first or second quartile. Two articles published in 2013 and 2016 have the highest average citation rate, which indicates their relevance and influence in this area.
Table 1.1.The most cited articles (developed by the authors)
Author
Publication
Category quartile
Year of publication
Total number of citations
Average citation rate
Cicchetti, D. & Rogosch, F.
Development and Psychopathology
Q1
1997
277
11.08
Grossman, G.
American Naturalist
Q1/Q2
1982
162
4.05
Lee, A., Vargo, J. & Seville, E.
Natural Hazards Review
Q2/Q3
2013
159
17.67
Boin, A. & Van Eeten, M.
Public Management Review
Q1/Q2
2013
97
10.78
Kefi, S. et al.
PLOS Biology
Q1
2016
90
15
Salanova, M. et al.
Group & Organization Management
Q2/Q3
2012
76
7.6
Peterson, G.D.
Climatic Change
Q1/Q2
2000
67
3.05
Gordon, T. et al.
Canadian Journal of Physiology and Pharmacology
Q3/Q4
2004
58
3.22
Chaskalson, M.
Mindful Workplace: Developing Resilient Individuals and Resonant Organizations with MBSR
-
2011
57
5.18
Bowles, S. & Bates, M.
Military Medicine
Q3
2010
52
4.33
Table 1.2.The most cited journals (developed by the authors)
Publication
Number of publications
Total number of citations
Development and Psychopathology
1
277
American Naturalist
1
162
Natural Hazards Review
1
159
Public Management Review
1
97
PLOS Biology
1
90
