The health management of the covid-19 pandemic, an issue of institutional resilience

Abstract

The article is a reflection on emergency management in Italy and on the institutions role on decisions since the beginning of the pandemic. It also suggests consinderations on the clinical risk management role. The impression is that in the emergency management we did not move systemically, tackling multiple problems together, but in a sequential and top-down manner, with a strong centralization of decisions and without a holistic vision. This method has lengthened the response times to the emergency, in all its phases. Intensive care units and emergency departments established new organizational models to respond to the outbreak thanks to the will, professionalism and resilience of healthcare workers. In high reliability organizations (HRO), time represents the key variable and healthcare professionals seem to be the only ones who know it very well, because in coping Covid-19 we have not been able to anticipate the events, and not only in Italy. Now it’s time to answer to essential questions regarding how to manage the return to “previous” life and someone has to be in charge of it.