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From reliability to pragmatism: Hospital management in the context of radical uncertainty

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  • Hervé Dumez

    (CRG I3 - Centre de Recherche en Gestion I3 - X - École polytechnique - IP Paris - Institut Polytechnique de Paris - I3 - Institut interdisciplinaire de l’innovation - CNRS - Centre National de la Recherche Scientifique)

  • Etienne Minvielle

    (CRG I3 - Centre de Recherche en Gestion I3 - X - École polytechnique - IP Paris - Institut Polytechnique de Paris - I3 - Institut interdisciplinaire de l’innovation - CNRS - Centre National de la Recherche Scientifique)

Abstract

The COVID‐19 pandemic presented a scenario of radical uncertainty that hospitals had to manage. Two strands of research can illuminate this management. The first puts forward the high‐reliability organization (HRO) principles that the hospital sector has applied for two decades. The second is based on pragmatism and underscores experimental, trial‐and‐error strategies appropriate for radical uncertainty. This strategy, utilized primarily in the political governance of crises, can be applied in hospital management as well. The results of our qualitative research into French hospitals (109 online interviews over 2020–2021) highlight the importance of pragmatic rationality in crisis management based on organizing collective inquiries. This concept of pragmatic rationality questions the notion of reliability, sticking to pre‐existing performance standards not applicable in such contexts. It invites to propose the concept of high pragmatic organization based on five principles that partially integrate those of an HRO.

Suggested Citation

  • Hervé Dumez & Etienne Minvielle, 2024. "From reliability to pragmatism: Hospital management in the context of radical uncertainty," Post-Print hal-04859365, HAL.
    • Handle: RePEc:hal:journl:hal-04859365
    DOI: 10.1111/emre.12665
    Note: View the original document on HAL open archive server: https://hal.science/hal-04859365v1
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    References listed on IDEAS

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