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כיצד הפעילות להבטחת בטיחות החולים יכולה לעזור בהתמודדות בתי החולים עם נגיף הקורונה��התמודדות ארגונים עם משבר והקשר למערכות איכות

פרופ' איתן נוה

הפקולטה להנדסת תעשיה וניהול

הטכניון - מכון טכנולוגי לישראל

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האם ארגונים עם מערכת איכות טובה יותר התמודדו טוב יותר עם השפעות קורונה על הארגון?

– כן / לא / מה קשור

מה למדנו מהניסיון עם נגיף קורנה על מערכות איכות?

איכות ונגיף קורונה
חדשנות ונגיף קורונה
חמלה בניהול ארגונים
התנהגות פרדוקסלית של מנהלים – גם וגם
עבודה מרחוק

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Patient Safety 🡪 COVID-19

Adhere to safety rules with appreciation for improvisation
Combine slow and fast learning
Innovate in real time

COVID-19 🡪 Patient Safety

Adoption of key attributes of safety culture: transparency, communication and collaboration
Rapid implementation of safety practices
Use of state-of-the-art health information technology (IT)

1. איכות ונגיף קורונה

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טכנולוגיה (תעשיה 4.0), איכות וקורונה�Using big data for understanding errors at DFCI (Naveh, Singer, et al.) Real Time Location System (RTLS)

radio frequency / infrared ID badges
worn by over 350 staff members and assigned to more than 1,000 patients per day.
A network of 1,000 sensors, covering seven floors, 28 infusion chairs per floor, detect the location of each badge every three seconds. Over 1 million points of data.

Patient Badge

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הטיפול בטעויות בארגונים וקורנה�Errors in Organizations via the Temporal Dynamism Lens

Before error occurrence

During error occurrence

(e.g., error detection, system responsiveness)

After error occurrence

Time

Error prevention

Learning

from errors

Lei, Z., Naveh, E. Commentary: "Stuck between two lives: The paradox of eliminating and welcoming errors". American Journal of Medical Quality. (2019)

Error - unintended and potentially avoidable deviations from organizationally specified goals and standards that

can yield either adverse or positive organizational consequences (Frese & Keith, 2015; Hofmann & Frese, 2011).

לדבר על פיוריטי שונים איך מאזן – מאמר רפואי עם ג'יקה

‘both and’ approach – does it work?

Organizations should simultaneously prevent errors from occurring while welcoming errors to achieve reliable performance and effective learning.

Ambidexterity

Structural separation
Temporal separation

Contextual ambidexterity

What organizations do – and these are the best organization that try to deal with errors

Temporal dynamism refers to the degree to which organizational emphasis is placed before, during, and after an error occurs; latent errors and feedback loops; and the timing of error responses.

The development of effective error strategies is partitioned into three phases: before, during, and after the occurrence of an error. In the “before” phase, prevention strategies are used to defend against errors. In the “during” phase, error management strategies are enacted, while in the “after” phase, error management shifts attention to learning, sustainable performance, and innovation.

The concept of latent errors refers to errors and their (often) damaging consequences that may be hidden for an unknown period of time until enabling conditions trigger them. Error feedback loops can be either error-amplifying (or positive feedback loops) or error-corrective (or negative feedback loops). Positive and negative feedback loops can jointly influence the occurrence and outcomes of (latent) errors.

Pace and timing refers to error responses and highlights the dual nature of either to fast or too slow response to errors.

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2. חדשנות ונגיף קורונה�Innovation is not an intuitive direction �in times of crisis:

Innovation requires (Miron, Erez, & Naveh, 2011)

Resources
Ecosystem
Innovation climate
Implementation

Taking risks
Not much to lose

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Crises may support innovation - Examples

In March 2020 (during a period of dramatic decrease in travel), this company launched and produced a technology that allows suitcases to fold to a thickness of two inches. It has since continued to innovate and develop its product.

Tamam Aircraft Food Industries Ltd.

Supply chain reversal:

Tnuva (supplier) 🡪 Tamam 🡪 Airlines

Tamam 🡪 Tnuva (distribution) 🡪

🡪 Supermarkets

Rollinik

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3. Compassion Perspectives During Crisis�Financially-oriented pressure vs./ and prosocial motivation

Doing well and doing good

Employee well-being and generosity programs

During the 9/11 attack on the World Trade Center, airlines laid off workers, negatively impacting both former employee well-being and inhibited industry recovery for years after the crisis (Gittell, Cameron, Lim, & Rivas, 2006).

While some organizations take steps to care for their staff during crises, e.g., home office allowances and extra days off, these people-centric practices are considered innovative, not the norm.

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4. Paradoxical leadership behaviors

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עבודה מרחוק ומערכת האיכות בארגון

וגם הדוגמה של למידה מרחוק באוניברסיטאות.

בקורונה ומה שמתרחש כעת.