Lessons of Human Centered Management Culture Transformation in a Crisis

The analysis conducted by our multidisciplinary team allowed us to learn from this experience that organizational aspects proved to be central to expedite management during the COVID-19 emergency, ensuring quality of service and safety for patients and especially for healthcare providers. The disruptive pandemic forced a learning on the job approach as the only way available to deal with unexpected and unprecedented shocks. Best practices quickly shared with other hospitals and at international level through fast-track publications were coupled with lessons learned from less-than-ideal flows subject to continuous assessment and improvement, which were delivered onsite and online (Garcia Vazquez et al., 2020).

At the time of writing this chapter, the emergency seems partially under control largely due to the effects of enforced non-medical pharmaceutical intervention such as social distancing and the closure of schools and non-essential businesses. Our experience of the MHA during the COVID-19 emergency has helped to identify challenges and learning lessons that allow us to share observations and offer some solutions.

The healthcare ecosystem stands now as a more open system where different stakeholders are cooperating more closely. Managers, clinical staff, patients, entrepreneurs, NGOs and volunteers’ associations had to work together to overcome the crisis. The active collaboration fostered and facilitated mutual support and exchange of tools and methodologies. The ability to translate knowledge played a central role in the process. Most realize that only when knowledge is translated effectively, the transfer of relevant information is optimized and sharing is possible and effective. Resilience and agility appear mandatory features aligned with principles of Human Centered Management and the delivery of services in organizations adjusting and reshaping culture under the COVID-19 crisis. That is, resilience in terms of getting strong to bounce back, and agility to overcome disruptions and to move on with the new normal dealing with high uncertainty about the future (Cobianchi et al., 2020).

The crisis pressed healthcare personnel to work under new operative strategies never used before. They had to work on co-production of services and increasing patient’s engagement as pillars of an upcoming and reshaping healthcare ecosystem. Patients in particular and citizens, in general, lost autonomy as they had to follow recommendations provided by health authorities and clinical staff; with high awareness that their responsibility and collective sacrifice was playing an essential role in problem-solving leading to individual and collective wellbeing as a central feature of the healthcare system that is achieved only if everybody cooperates.

Although the COVID-19 pandemic stands as an epidemiological issue, in reality, many different specializations overlap and had to cooperate.

Virology, medicine, psychology, management, accounting, computer engineering, data management, supply chain, communication and public relations are some of the subjects involved. Hard and technical skills matter, but Soft Skills have been critically important to overcome recurrent situations as people involved in the production of services have to rely more on leadership, change management, teamwork, resilience, agility, communication and ICT skills to help patients (Lepeley, 2021a; 2021b; Yule & Smink, 2020). Training and new techniques, methods and management were increasingly needed. And regardless of the level of education, all individuals had new things to learn either on the job or in a physical or virtual classroom (Garcia Vazquez et al., 2020).

Technology is helpful when people can manage it properly to optimize use because the healthcare system relies heavily on big data analytics. The coronavirus emergency generated massive amount of information that when well managed could lead to practical solutions (Lan et al., 2020) with the aid of artificial intelligence tools (machine/deep learning). Technologies and web-based solutions such as social media channels can represent successful ways to communicate with patients and families.

Sharing is caring. Best practices and lesson learned must be shared, to allow other organizations and institutions to quickly apply successful solutions and avoid mistakes. Rewarding processes can help better management of staff and patients, enhancing quality and safety standards and fostering the wellbeing of all.

Under the lens of Human Centered Management framework and the call for people’s wellbeing, several new challenges emerged.

Unmet medical needs arise for several non-COVID-19 patients, who could not get care because their inpatient or outpatient services were suspended. Some of their diseases may have got worse over time (e.g., untreated cancer), some other pathologies could not be diagnosed on time because of the delay in carrying on the necessary tests (e.g., blood collection or screening procedures), leading to the worst prognosis and a more challenging care pathway. Moreover, the dread of COVID-19 induced people with urgent diseases to postpone the request of care. As an example, one of the authors of this chapter (LC) in his surgical activity experienced the death of some patients due to acute peritonitis because of untreated appendicitis. Despite the pain, patients delayed the surgery and avoided to go to the hospital fearing they could be infected with COVID-19.

Most healthcare professionals involved in the emergency had to spend several months under stressful working schedule, performing different tasks they were trained or educated for and often far from their dear ones at home. Furthermore, many of them had to assist patients - not only physically but also psychologically - who died alone without family or friends, and they could solely rely on the consolation of the medical staff looking after them.

The post-COVID-19 pandemic inevitably leads to a new design of the entire healthcare system, which we think should consider the above-mentioned lessons learned. Emergencies such as the COVID-19 may happen again in the future and the healthcare system needs to be prepared. A call for a more comprehensive implementation of Human Centered Management principles and quality and safety standards emerges, to ensure the wellbeing of all the people involved.

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