Crisis Mode Research Articles

Pivoting During a Pandemic.

When the coronavirus hit the United States earlier this year, hospitals across the country were forced to quickly convert to crisis mode. Overnight, health systems transformed clinical and administrative operations to care for rising numbers of COVID-19 patients. Now, as the country slowly reopens and we move back to "normal," hospitals again face a major reboot to regroup and recover. Those that meet this challenge successfully will survive. Many others will not. This month's Magnet Perspectives column examines how Magnet hospitals are uniquely positioned to ride the waves and manage the chaos. What are the components that helped them adapt and adjust when COVID-19 struck, and how are those elements facilitating response and recovery? The column also looks at how the Magnet Recognition Program itself responded to challenges posed by the coronavirus and altered some of its long-standing processes to meet customer needs.

Zwischen Traum und Trauma - Aufbau und Betrieb einer Kohortenstation für Patient_innen mit COVID-19 in einem Akutspital - Eine Fallstudie.

Description of the setting up of a cohort ward for patients with COVID-19 on a surgical ward including the development of the nursing team. The intrinsic retrospective case study describes the situation, identifies special phenomena in a reflective manner and links them to existing knowledge. Data were anecdotal, routine data were collected in the context of nursing practice development. Setting up the cohort ward in a Swiss hospital consisted of structural and technical planning, infection control measures, the establishment of interprofessional structures, and internal communication. During the four-week operation, 71 patients were treated. The use of practice development methodology initiated a cultural change. The reflection describes a field of tension between "dream and distress": As a dream, the lived experience of optimal care, with well-functioning processes, sufficient material, sufficient personnel and a very good interprofessional cooperation was evaluated. Distress in the form of high infection rates as well as psychological and physical stress did not occur. After the cohort ward was closed, there was a risk working back in normal operations based on existing economical and organizational conditions, with the knowledge that a different cooperation and organization is possible. Positive experiences from the "crisis mode" should be used to further develop essential operations during normal times.

Shared Governance During a Pandemic

When the COVID-19 pandemic struck US hospitals in early 2020, many nurse leaders went into crisis mode management. As the pandemic ensued, shared governance endured at hospitals with well-established models, even without council meetings. At other hospitals, clinical nurses began to wonder what happened to shared governance. This article offers advice and lessons learned from the interplay between the COVID-19 pandemic and shared governance at American hospitals.

Resuming elective surgeries in Corona pandemic from the perspective of a developing country

Since the COVID-19 pandemic, healthcare facilities have entered into a “crisis mode”. One of the measures used to allow hospitals to surge their capacity and serve the patient population with COVID-19 infection was the suspension of elective activity, most importantly elective surgery and other procedures. Now as the infection is fading, efforts are being made to resume elective surgical services keeping in mind the safety of the patient and health care workers. Resuming surgical services in developing countries is an uphill task.

Privilege and burden of im-/mobility governance: On the reinforcement of inequalities during a pandemic lockdown.

In order to contain the COVID‐19 pandemic, nation states have focused on the governance of im‐/mobilities: certain mobility restrictions have been enforced, while simultaneously some forms of mobility have been maintained or even enhanced in order to keep the system running in crisis mode. With a special focus on Austria, we analyse the specific politics of im‐/mobilities concerning the organization of paid work and show how the socio‐spatial conditions of who is permitted, denied or urged to work are inextricably linked to inequalities. It becomes apparent that while in principle all bodies are equally dependent on collective social relations and enduring infrastructure, not everybody contributes equally to their maintenance. In fact, the governance of im‐/mobilities follows and reinforces already prevalent inequality regimes based on class, gender and migration relations, thereby differentiating between bodies perceived as highly valuable and worth protecting and those categorized as less valued and potentially disposable.

Uncertainty Amongst a Geopolitical Crisis: An Event Study of the Ukraine Conflict

As the world falls into crisis mode, it becomes the time to make policy decisions that steer the course of a nation and push it across to the other side. During the Ukraine Conflict, many countries swooped in as the saving grace to Ukraine against the militaristic actions taken by the Russian Federation. This event study demonstrates the changes in the Global Economic Policy Uncertainty do occur during this window of time. However, these returns are not far enough from their mean to conclusively deem them as abnormal changes caused by this geopolitical crisis.

Embedded finance: the shadow banking system, sovereign power, and a new state–market hybridity

ABSTRACT With the rise of the shadow banking system, a new form of state–market hybridity has emerged, challenging existing monetary approaches to financial stability. A stable financial system today has essentially come to depend on a stable shadow banking system. Central banks are in the process of adapting to this new development. To secure the logic of laissez-faire market liberalism, the sovereign must resort to unprecedented measures and radically intervene in the financial markets. This new form of state–market hybridity forces central banks to provide ample reserves, to act as a dealer of last resort, and to give shadow banking actors access to their balance sheets. Such policies, however, produce new contradictions and fragilities. Based on Foucault's concepts of sovereignty and security, this paper argues that in today's world, the rationality of the laissez-faire security dispositif has become flanked by the rationality of sovereignty to a much greater extent than previously. Without losing its dominant status, the security dispositif is currently adapting so as to operate in crisis mode based on a post-laissez-faire rationality. The repo crisis of 2019 has demonstrated that central banks are still in the process of searching for ways to handle this new constellation.

Make or break

The sector is in crisis mode, with widespread underfunding, a workforce problem and rising costs. Just how bad will it become before it gets better? By Hannah Crown

Obstacles and Opportunities for Financing the Fight against Covid-19 in the Debt Trapped Zimbabwe

The coronavirus aka Covid-19 pandemic arrived in Zimbabwe at a time when the country was in the throes of its worst economic turmoil in recent years. Within months of its arrival, the pandemic has already upended the public healthcare system, eroded the livelihoods of millions of people, and further deepened the economic headwinds in the country. Apparently, Zimbabwe has been in a crisis mode since the beginning of the 21st Century. As such, the pandemic has added an extra burden to the country that is already creaking under mounting weight of external debt peonage, fiscal deficit, liquidity crisis, and international isolation among many other social and economic ills. In this context, the country faces an uphill task in mobilising financial and non-financial resources in order to contain the coronavirus crisis. This article therefore sets out to examine the obstacles and opportunities for financing the fight against Covid-19 pandemic within a discursive context of a debt trapped Southern African country.

In crisis mode

The Ukrainian government insisted at an early stage that the country was well equipped to deal with the corona virus. In reality, the health system is almost entirely incapable of dealing with a pandemic. The medical infrastructure is inadequate, doctors and nursing staff are underpaid and there is not enough personal protective equipment in the hospitals. At the end of March 2020, the cabinet declared a state of emergency. President Zelensky is exploiting the crisis in order to concentrate political power in his hands. This is a risky step, since in doing so, he is assuming sole responsibility for the handling of the pandemic. Due to his dwindling political support and the precarious economic situation, he has only limited room for manoeuvre.

Feminist Activism Confronts COVID-19

Activist Responses Feminist Studies 46, no. 3. © 2020 by Feminist Studies, Inc. 629 Constanza Tabbush and Elisabeth Jay Friedman Feminist Activism Confronts COVID-19 Even the most committed of feminists may see the current global health crisis as insurmountable.1 The COVID-19 pandemic has laid bare— and exacerbated—deep-seated and interlocking inequalities. Women and gender non-conforming people, particularly those without class and ethno-racial privilege, are affected in gender-specific ways.2 Women are on the frontline of the care response as healthcare workers as well as unpaid community and family caregivers.3 Stay-at-home measures heighten the risks of gender-based violence as they lock women and gender non-conforming people behind closed doors with their potential 1. Helen Lewis, “The Coronavirus Is a Disaster for Feminism,” The Atlantic, March 19, 2020, https://www.theatlantic.com/international/archive/2020 /03/feminism-womens-rights-coronavirus-covid19/608302. 2. Laura Turquet and Sandrine Koissy-Kpein, “COVID-19 and Gender: What Do We Know; What Do We Need to Know?” UN Women, April 13, 2020, https://data.unwomen.org/features/covid-19-and-gender-what-do-we-knowwhat -do-we-need-know; Amie Bishop, “Vulnerability Amplified: The Impact of the COVID-19 Pandemic on LGBTIQ People,” OutRight Action International , 2020, https://outrightinternational.org/sites/default/files/COVIDs ReportDesign_FINAL_LR_0.pdf. 3. Silke Staab, “COVID-19 Sends the Care Economy Deeper into Crisis Mode,” UN Women, April 22, 2020, https://data.unwomen.org/features/covid-19sends -care-economy-deeper-crisis-mode. 630 Constanza Tabbush and Elisabeth Jay Friedman aggressors.4 The economic downturn from halting production and consumption has also hit women harder than men.5 Reproductive and sexual health services have been deemed “inessential” in various countries .6 As troubling as the care and economic crises are, the pandemic response simultaneously threatens exactly what is needed to address them: intersectional feminist activism. For example, in Latin America, social isolation policies have thwarted the mass feminist mobilizations of the last five years. From the Southern Cone to Mexico, hundreds of thousands took to the streets in marches and dramatic street performances demanding government and societal accountability for ending violence against women, protecting reproductive rights, and addressing the gendered harms of neoliberal development.7 The dictates of physical distancing have also derailed gatherings meant to celebrate and stimulate action on the women’s international human rights agenda. The twenty-fifth anniversary of the 1995 UN Fourth World Conference on Women, for instance, promised to be a political opportunity for transnational movement building. Yet, instead of bringing women from different generations together, it became a symbolic day of commemoration.8 Has feminist activism been brought to a halt by COVID-19? Our answer, based on evidence from the Latin American region and transnational arenas, is a definitive “no.” Although pandemic policies 4. Amber Peterman, Alina Potts, Megan O’Donnell, Kelly Thompson, Niyati Shah, Sabine Oertelt-Prigione, and Nicole van Gelder, “Pandemics and Violence Against Women and Children” (Working Paper 528, Center for Global Development, April 2020), https://www.cgdev.org/publication/pandemicsand -violence-against-women-and-children. 5. “Policy Brief: The Impact of COVID-19 on Women,” United Nations, April 9, 2020, https://unsdg.un.org/resources/policy-brief-impact-covid-19-women. 6. Claudia Rivera Amarillo, “Feminism on Lockdown,” NACLA Report on the Americas 52, no. 3 (2020): 274–81. 7. Travis Waldron, “The Coronavirus Outbreak Has Stalled Argentina’s Historic Effort To Legalize Abortion,” Huffington Post, March 26, 2020, https:// www.huffpost.com/entry/argentina-abortion-legalization-coronavirus_n_ 5e7cae9bc5b6cb08a928f364; Laura Carlsen, “Mexico: From Women’s Uprising to COVID-19 Crisis,” The Indypendent, April 13, 2020, https://indypendent.org /2020/04/mexico-from-womens-uprising-to-covid-19-crisis. 8. See the letter of the Chairperson of the 64th Commission on the Status of Women: “Political Declaration on the Occasion of the Twenty-Fifth Anniversary of the Fourth World Conference on Women,” United Nations, March 2020, https://www.unwomen.org/en/csw/csw64-2020. Constanza Tabbush and Elisabeth Jay Friedman 631 have halted the most visible crest of the fourth feminist “wave” and facilitated crackdowns on women and LGBTQI activists, deeply rooted, digitally enhanced networks are driving an unprecedented response to...

The Government of National Unity as a Long Lasting Political and Economic Solution in Zimbabwe

This paper addresses the effectiveness of negotiated settlements in solving national disputes, with particular focus on the Government of National Unity (GNU) that operated in Zimbabwe from 2009 to 2013. Some of the experts interviewed for this study noted that the elite agreed to have a unity government in order to serve their self-interest. The Zimbabwe African National Unity Patriotic Front (ZANU-PF) party needed help in solving the crisis at hand while the Movement for Democratic Change (MDC) party wanted to experience running a government, at the same time reaping the benefits that came with it. We can conclude that the GNU in Zimbabwe was an elite settlement, without involvement of the general populace. The elite only meant to serve their own interests and ignored national interest. When its tenure expired in 2013, the situation in the country reverted into crisis mode, particularly the economy. It is therefore this paper’s position that any national settlement should involve the affected masses and all transitional settlements should have politically neutral players at the forefront, not political actors or individuals with political ambitions.

The paradoxes of necessity: Fail forwards neoliberalism, social reproduction, recombinant populism and Poland’s 500Plus policy

This article asks why Poland’s populist Prawo i Sprawiedliwości [Law and Justice] government promotes progressive forms of social reproduction in the context of the supposed crisis of neoliberalism. It illustrates how populism is a response to the ongoing social ambiguity of post-communist transition that redefines and recombines existing and novel political and social resources that are built both on and with existing social arrangements in Poland. It achieves this by analysing the current government’s flagship child benefit programme: 500Plus. The article claims that certain gender norms construct hegemonic neoliberal and populist discourses that legitimise particular policies, illustrating this by bringing into dialogue Janine Brodie’s neoliberal ‘paradox of necessity’, with the notion of ‘fail forwards’ neoliberalisation. The 500Plus policy remains ridden with contradiction, on one hand a potentially progressive intervention in social reproduction that deals with the crisis mode of society but that simultaneously helps ensure the continuation of neoliberalisation.

Prevention advocates toil to maintain influence in a field in crisis mode

Greater public and policymaker attention to substance use–related issues hasn't exactly made the case for increased investment in prevention an easier sell. If anything, a strong argument can be made that today's predominantly narrow focus on the opioid overdose crisis has so tilted the balance in favor of crisis intervention that less attention than before is being paid to the mission of preventing problematic substance use before it begins.

In Case You Haven't Heard…

Good news for substance use prevention and treatment overall in House appropriations: Partnerships for Success (from the Center for Substance Abuse Prevention [CSAP]) grants were restored, and funding for primary prevention was restored. It's likely that the Senate will look at appropriations over the summer. But for many, especially those who are new to Congress, the frame of reference is STR and SOR. They didn't grow up in the system, and they don't understand the complexities, which mean that once money is delivered to the states, it needs to be spent at a local level. “The rollout stunk,” one Washington insider told ADAW recently, referring to the STR process. As we have written many times before, STR was passed by Congress in December 2016, and states had less than two months to get in their applications. The money went out and “stuff appeared,” as our source said. The pressure to get resources out the door, given the opioid crisis mode, was clear. But moving forward — and this is where appropriations come in — it's important to look at the entire substance use problem. STR and SOR are only for opioids. Adding billions of dollars to the budget for opioids when methamphetamine is around the corner and more people are still dying from alcoholism than opioids means that a broader view is needed. The Substance Abuse Prevention and Treatment block grant, in which states decide where they need to spend the money, should come in for more funding. Under House appropriations, it doesn't. Still, the overall topline number increased for the Substance Abuse and Mental Health Services Administration in the House, proposed cuts to the Center for Substance Abuse Prevention were rejected and there was a small increase in funding to combat underage drinking.

Patient safety culture in Hungarian hospitals

PurposeThe Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses.Design/methodology/approachThe original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests.FindingsPositive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area “acceptable” regarding patient safety. Healthcare staff worked in “crisis mode,” trying to accomplish too much and too quickly. The authors note that a “blame culture” does not facilitate patient safety improvements in Hungary.Practical implicationsThe results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety.Originality/valueIntroducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.

The Chair as First Responder in Times of Crisis

The Chair as First Responder in Times of Crisis

Washington governor proposes fix to mental health system

Mental Health WeeklyVolume 28, Issue 47 p. 8-8 State News Washington governor proposes fix to mental health system First published: 17 December 2018 https://doi.org/10.1002/mhw.31707Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Washington Gov. Jay Inslee unveiled on Dec. 11 his budget and policy plans for fixing the state's struggling mental health system in the coming years, The Associated Press reported. Inslee said at a news conference that he wants to change the system from being “crisis-based” to one that focuses on prevention by providing mental health care to more people. The governor proposes opening housing in communities so people can be treated in centers that are closer to their families. Inslee said he wanted to invest in the troubled Western State Hospital to address safety concerns there, but he didn't mention the rise in assaults at the state's largest psychiatric hospital. A recent Associated Press investigation found that attacks by patients on staff and other patients have been increasing in recent years. The 850-plus-bed facility in Lakewood also lost its certification by the Centers for Medicare and Medicaid Services and federal funding after it repeatedly failed health and safety inspections. Workers at the hospital have said they are in crisis mode and fear for their safety as they go into work each day. Inslee said there was a critical shortage in mental health workers across the state, and his remedy would be to provide scholarships for people interested in pursuing a career in that area. His written plan calls for $56 million for infrastructure at Western and Eastern State Hospitals. It does not mention an increase in staffing, which is what workers want. Volume28, Issue4717 December 2018Pages 8-8 RelatedInformation

How many doctors do we actually need?

In many parts of Canada, there is a shortage of doctors. The New Brunswick Medical Society, for example, says the province has 39 vacancies for family physicians and 50 new positions are needed to meet demand. In British Columbia, family medicine is in “crisis mode” with shortages across the

The Power of Process Improvement

The Power of Process Improvement