David Larivière
Director of the Robert Schuman Hospital of the Metz Private Hospital Group
Doctor DBA, Business Science Institute
(DBA thesis supervised by Pr. Cloutier)
Introduction
What is the managerial mechanism for moving from individual resilience (reaction to a crisis) to collective resilience (anticipation of the crisis)? What is the missing link between individual and collective resilience in a hospital context? To what extent can the simple awareness of the risk of the structure's disappearance constitute a fundamental factor of organizational resilience?
Impacts and key research findings
Two models for mobilizing teams in hospitals are highlighted:
in the private sector, the risk of the disappearance of an organization constitutes a real lever for mobilizing the resilience of teams. In the private sector, the risk of the disappearance of an organization is a real lever for mobilizing the resilience of teams. Based on the meaning given to the measures envisaged and a more marked form of authority, due in particular to the direct contractual link between management and its employees, collective resilience is omnipresent in private hospital management.
In the public sector, the mobilization of teams in the management of change is based more on internal communication and informing teams of the issues and risks to be avoided. These approaches are part of a more collective contractual relationship, based on financial support for projects led by medical teams. The mobilization of a collective resilience is confronted with a feeling of immortality expressed by the teams, due to their status as public employees. The involvement of hospital teams in the co-construction of development and change projects is a prerequisite for the success of these initiatives.
The role of management is to work permanently to build individual preventive resilience, a form of theoretical bridge between individual resilience (capacity to react) and collective resilience (capacity to anticipate the structure), and to keep teams under tension in the permanent organizational transformation.
It then focuses on :
the analysis of environmental constraints and risk anticipation;
the definition of the strategy necessary for (1) the survival of the organization and (2) its development;
the meaning given to the initiated projects and communicating with the teams;
supporting technological and managerial innovation by giving more room to middle managers and promoting initiative and participative management;
the establishment of strong partnerships with establishments whose action is complementary and a source of consolidation of strategic positions on a market.
Theoretical foundations of the research
This research is in line with Weick's work on the mechanisms of resilience in management. Indeed, while the literature on change management is rich, few works have made the link between resilience and management. My reflection therefore consisted in evaluating the mechanisms of crisis anticipation, particularly around the theory of collective resilience and the impacts of learning in highly reliable organizations (Altintas and Royer, 2009).
Methodology
The methodological framework used in this study is based on a Group Concept Mapping (GCD) approach. This methodological approach, introduced by Trochim (1989), is based on a mixed bottom-up approach, allowing statistical quantification of qualitative data. By mobilizing the experience of hospital managers in the field and hospital directors, the GCC allowed me to evaluate priorities and possible solutions, as well as to articulate recommendations.
The Professors' opinion
Prof. Lemay notes from the outset that this is a very good thesis with interesting results for hospital administrations in all countries (Prof. Lemay, rapporteur).
Prof. Sébastien Liarte agrees with the great qualities of the work and underlines the great coherence of the question, the methodology and the results leading to a very fluid argumentation and developments (Prof. Liarte, rapporteur).
To go further
Altintas G. & Royer I. (2009). Renforcement de la résilience par un apprentissage post-crise : une étude longitudinale sur deux périodes de turbulence, M@n@gement, 12(4), p. 266-293.
Cloutier M., Larivière D. et Tremblay G., La cartographie des concepts en groupe : étapes de réalisation et conversations orientées terrain, dans Chevalier F., Cloutier M. et Mitev N. (2018). Les méthodes de recherche du DBA, EMS Editions, 2018.
Larivière D., Résilience hospitalière, Une capacité collective face aux enjeux sanitaires, Gestions hospitalières, Décembre 2020, p.600-603.
Larivière D., La gestion de la crise de la COVID-19 à l’Hôpital : la résilience adaptative au service de la survie de l’organisation, dans M. Kalika, L’impact de la crise sur le management, EMS Editions, Octobre 2020.
Weick K.E. (1993). The collapse of sensemaking in organizations: The Mann Gulch disaster,Administrative Science Quarterly, 38 (4), p. 628-652.
Article translated from French with https://www.deepl.com/translator
Presentation of the article in video, by David Larivière