Why resilience in health care systems is more than coping with disasters: implications for health care policy

Health care systems need to be resilient to deal with disasters like the global spread of the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) on top of serving the changing needs of a multi-morbid, ageing and often dispersed population. This paper identifies, discusses and augments critical dimensions of resilience retrieved from the academic literature. It pulls together an integrated concept of resilience characterised by organisational capabilities. Our concept does not focus on the micro-level like most resilience literature in health care but addresses the system level with many stakeholders involved. Distinguishing exogenous shocks to the health care system into adverse events and planned innovations provides the basis for our conclusions and insights. It becomes apparent only when dealing with planned interventions that transformative capabilities are indispensable to cope with sudden increases in health care pressures. Due to the current focus on absorptive and adaptive resilience, organisations over-rely on management capabilities that cannot generate a lasting increase in functionality. Therefore, reducing the resilience discussion to bouncing back from adverse events could deceive organisations into cultivating a suboptimal mix of organisational capabilities lacking transformative capabilities, which pave the way for a structural change that aims at a sustainably higher functionality

Introduction to the special issue : management science in the fight against Covid-19

At the time of writing of this Editorial in April 2021, Covid-19 continues to ravage our planet, with an official global death toll now exceeding three million, and a horrendous legacy of economic and human damage. The roll-out of vaccination has given hope that we will soon reach the end of this chapter of history. However, it will take years for the world to overcome this calamity and many individuals whose health or livelihoods have been destroyed will never fully recover. This failure of the world to effectively respond to the challenge of Covid-19 is all the more bitter because the outbreak of a novel pathogen was entirely predictable; the spread, preventable; and the suffering, avoidable. The experience of different countries around the world shows that the ability to plan, and to execute plans in a disciplined fashion, can make all the difference between relative security and catastrophe. The challenge for Management Scientists is to show that our discipline can have a role – a critical role – as a part of this planning. Epidemiological models of disease dynamics have been prominent through this crisis but do not fully capture the constraints in the health system and cannot directly support many of the management decisions which have to be made as part of the response. As Management Scientists, our perspective and our modelling tools have the potential to address those shortcomings; but if our profession cannot demonstrate our ability to add value, others will do so in our place

Hospital management games: a taxonomy and extensive review

Hospital management games have gained importance in better planning for scarce resources in times of growing health care demand and increasing technology costs. We classify and investigate the main characteristics of these games from an Operations Research (OR) perspective. Hospital management games model the complex decision making process of internal resource, process, and financial management all influenced by the external hospital environment (e.g., purchasing markets, job markets, legal/political conditions, competition) and simulate situations of the real world. We also highlight the potential of these games for teaching OR in the classroom. Experiencing the advantages of OR may reduce the reservations policy makers have and could make them increasingly open to promoting OR applications in practice. We also disclose potential for new applications

Competition under different reimbursement systems: The concept of an internet-based hospital management game

We have developed an internet-based management game to illustrate the economic and organisational decision-making process in a hospital by using discrete event simulation. Up to six hospitals compete against each other for inpatients with different disease categories and budget depending on hospital mission, regional health policy, inpatient reimbursement system (day-, case- and global-budget based) as well as labour and radiology technology market for 12 decision periods. Players can evaluate alternative actions for capacity planning as well as patient scheduling and control problems depending on different game situations. The uniqueness of COREmain hospital game consists of the internet-based framework, the combination of resource, process and financial result management, the competition of hospitals within a region and the consideration of different inpatient reimbursement systems. The deployment of this game in teaching, policy and research might improve policy making both at a hospital, regional and national level and also induce further research in these fields