in Health Organizations for Post Covid-19 Restart
FEATURED PAPER
By Marianna Spezie and Damiano Bragantini
Verona, Italy
ABSTRACT
Global emergencies require coordinated and global responses: the COVID-19 world pandemic has made explicit the strong link of the current situation with the culture of risk. In particular, the spread of this disruptive virus and the possibility that the epidemic may will reach such a great extent in terms of increating demands and pressed capacity of patients in hospitals that it will no longer be manageable with current health facilities: therefore, this paper aims at investigating the potential of the synergic use of Risk Prevention and Monitoring System (RPMS) practices in the health sector, with the aim of improving the ability to predict and manage the risk of a pandemic, with a comprehensive Risk Management approach, in order to contain the adverse effects on the territory and therefore on the whole society.
A literature review in the field of pandemic risk management was performed, with particular attention to the impact of the strategies and preventive models adopted in the health sector. In more details, organizational and managerial aspects, resources made available, advantages, enabling and hindering factors, and context of application were analysed, in order to grasp indications to promote the development of an integrated RPMS approach.
The application of RPMS practices stands as the barrier of considerable social importance for the improvement of the quality and effectiveness of preventive health measures and involves the establishment of collaborative relationships among all the organizations involved, as well as the spread of a risk culture, with the final intent to become more resilient towards pandemic risk as COVID-19.
Keywords: Risk Management, Pandemic risk, Risk Prevention and Monitoring System, Healthcare, Covid-19
INTRODUCTION
We have been living with the COronaVIrus Disease (COVID-19) for over a year: in December 2019, the phenomenon of collective pneumonia appeared in the South China seafood market in Wuhan, China [1], [2]. On 7 January 2020 a new virus was detected [3]: from that date on, the number of patients with pneumonia virus has skyrocketed and has spread throughout the nation, and unintentionally exported internationally. Globally, there are 115.094.614 cases of Coronavirus confirmed in the world since the beginning of the pandemic, while 2.560.995 are the dead (875.805 in Europe alone) [4].
In the face of the negative events and the difficulties of the last year related to the spread of the novel coronavirus, the Covid-19 pandemic is now still pushing healthcare systems around the world to the limit and, despite the heroic effort of healthcare professionals, hard work has often been not enough: Emergency Departments filled to the brim, hospitals struggling to treat everyone due to the very high number of people that the virus sends to the intensive care units (ICU), and exhausted staff who are often forced to work without adequate protective gear [5].
Additionally, in December 2020, the UK faced a rapid increase in COVID-19 cases, associated with the emergence of a new SARS-CoV-2 variant; at the same time, South Africa reported another SARS-CoV-2 variant, also potentially worrying, while in January 2021 Brazil reported the presence of an additional local variant. In recent weeks, despite an initial decline in the overall incidence of SARS-CoV-2, the epidemiological situation is still a cause for serious concern across the European Union (EU): since 21 January 2021, member countries have observed a substantial increase in the number and rate of SARS-CoV-2 cases of the variant first reported in the UK. Due to the greater transmissibility of the virus, the risk is currently assessable as high/very high for the overall population and very high for vulnerable individuals [4]. It is the UK variant which appears to be more transmissible than previously circulating strains and which causes more severe infections: several countries where it has become dominant have seen rapid increases in hospitalizations, overloaded health systems and excess mortality. Consequently, in the European Union, based on the current epidemiological situation with the greater circulation of more transmissible variants, immediate, strong and decisive public health interventions are essential to control transmission and safeguard health capacity, thus also minimizing opportunities that new variants emerge [6].
Despite the ability to respond to the crisis itself was a merit to be underlined, the lack of prevention of the event was crucial: this virus has such subverted the priorities of action for the systems-country to total level, particularly in Italy, where the absence of a management plan of the pandemic, or at least a deficiency of prevention of the same, has made control and modus operandi less effective and secure, both in terms of behaviour (progressive saturation of intensive terapie) and information management [7]. The main Project Management standards define a “risk” as “an event that, if it occurs, can have impacts on the objectives of the project, impacts that can be both negative and positive” [8], [9]. The risk represents the measurable part of the uncertainty itself, and it is expressed in the combination of two fundamental variables [10], [11]: the frequency of occurrence (understood as the probability of the risky event occurring), and the severity of the possible consequences (the magnitude of the damage that the risk can bring). The type of health risk referred to pandemics is identified as “pandemic risk” or “catastrophe”, and it’s officially defined as “the potential loss of human life, injury or destroyed or damaged property that could occur in a system, society or community in a given period of time, probabilistically determined according to danger, exposure, vulnerability and capacity “[12]. A salient characteristic of this risk is that it combines a low probability of occurring with high, potentially catastrophic, global impact, so it represents an extreme event, potentially in able to impact on an entire territory (in terms of health companies, citizens, local authorities) and on its resources (especially human and natural, but also economic). Difficult to predict due to the lack of sufficient historical data to support a quantitative analysis, pandemic risks in the health sector can however be mitigated if preceded, during the ordinary period, by a phase of preparation and careful planning of the response of health care in emergency: in fact, evaluation errors very often derive from an incorrect application of the basic techniques of Risk Management and risk prevention in a proactive way [13].
Risk Management (RM) is defined as the process intended to safeguard the activities of an organization from losses that could affect it in the exercise of its activities, by identifying risks, measuring their probability and the possible impact on events, eliminating or reducing their effect with the minimum investment of resources [14], [15]. To be effective, a Risk Management process should be integrated with the other activities of the organization, customized on the organization and its objectives, dynamic to respond easily to changes in the context and be inclusive, that is, involving stakeholders, in order to have a broader awareness and vision of human behavior and cultural factors that influence every level of the organization. In particular, Risk Management has as an important component Risk Prevention, which materializes in a RPMS (Risk Prevention and Monitoring System), a managerial approach of identification and analysis of new risks and reanalysis of existing ones, monitoring of residual risks and reviewing the execution of risk responses during the evaluation of their effectiveness [16], [17]. This Risk Management approach should be integrated with the stakeholder analysis as suggested in the “Stakeholder Shape” (StSh) by PMP Bragantini [18], in order to build a systemic and holistic framework that, through three new fundamental attributes (agreement, relationship and risk leverage of each stakeholder) will lead to a new bidirectional communication, in reference to the impact that each stakeholder could have for each specific and single risk [19].
The two basic joint analysis of the StSh methodology are outlined in Figure 1. [18]
Figure 1. Interaction of risks and stakeholders in the Stakeholder Shape methodology
However, only a little attention has been paid so far to the potentialities that the combination of RPMS practices and preventive models adopted specifically in the health sector can provide [20]: therefore, through a systematic literature review, this paper aims to supply a comprehensive view of the state of the art about the integrated approach of RPMS in healthcare, with the imperative to optimise both the prediction and management of a pandemic, in order to become more resilient towards pandemic risk as COVID-19 and to contain the adverse effects on the territory and therefore on the whole society.
The paper is organised as follows: Section1 with an introduction, Section 2 illustrates the objectives and the adopted methodology, Section 3 reports the results of the analysis and, finally, Sections 5 and 6 set out the discussion of results and conclusion, respectively.
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How to cite this paper: Spezie, M. and Bragantini, D. (2021). Promoting the Development of a Pandemic Risk Prevention and Monitoring System in Health Organizations for Post Covid-19 Restart; PM World Journal, Vol. X, Issue IV, April. Available online at https://pmworldlibrary.net/wp-content/uploads/2021/04/pmwj104-Apr2021-Spezie-Bragantini-pandemic-risk-prevention-and-monitoring-system.pdf
About the Authors
Marianna Spezie
Verona, Italy
Marianna Spezie is a licensed Engineer with a Master’s degree in Engineering Management from University of Padua (2020) with the thesis: “Project Management and the importance of Stakeholder analysis in Risk Management: the case of the Meter Commissioning Plan of electric smart meters 2G (PMS2) in Megareti “. She has done an internship in Project Management in Agsm Group, an important Italian utility in generation, distribution and supply of electricity and gas, and has worked also in the production plant of Coca Cola HBC based in Nogara (VR), in the role of Analyst – Budget Controller. Currently she is teaching ICT (Information and Communication Technology) in high school in the city of Verona. She is very interested in the Project Management field, in particular Risk Management and Stakeholder Engagement and the interdisciplinary nature of this topic, as well as the application of Risk Management practices in different fields, such as in health organizations. Marianna Spezie can be contacted at mariannaspezie95@gmail.com.
Damiano Bragantini
Verona, Italy
Damiano Bragantini is a Civil Engineer with more than 20 years of experience in Civil Infrastructure and Information Technology. Currently he is working with AgsmAim Group, an important Italian utility in generation, distribution and supply of electricity and gas. Mr. Bragantini was also a recognized teacher at the University of Liverpool (UK) where he taught in project management MSc. Mr. Bragantini is a certified Project Management Professional (PMP) from the Project Management Institute (PMI). He has been also actively involved with Project Management Institute (PMI) as a final Exposure Draft Reviewer for Project Cost Estimating Standard and Practice Standard for Earned Value and as internal reviewer of PMBOK Fifth Edition. Mr.Bragantini has also been actively involved and is still involved with the local PMI Northern Italy Chapter, where he has been a contributor to some projects. Damiano Bragantini can be contacted at damiano.bragantini@megareti.it.
