Antifragility amid the COVID-19 crisis : making healthcare systems thrive through generic organisational skills

• Published in: Sultan Qaboos University medical journal 2020-08, Vol.20 (3), p.241-244
• Main Author: al-Azri, Nasir Hammad
• Format: Article
• Language: English
• Subjects: Anatomy & physiology; Attitude of Health Personnel; Betacoronavirus; Clinical Competence; Communication; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; Efficiency, Organizational; Health Care Sector - trends; Humans; Leadership; Management of crises; Organizational Innovation; Pandemics; Physiology; Pneumonia, Viral - epidemiology; Practice Management, Medical - trends; Professional-Patient Relations; Resilience, Psychological; Safety Management - trends; SARS-CoV-2; Skills; Systems design; Teamwork
• ISSN: 2075-051X; 2075-0528
• DOI: 10.18295/squmj.2020.20.03.001

Disasters and crises are disruptive to the structures and functions of communities. However, the challenges they present also bring opportunities for learning and changing at both individual and organisational levels. Healthcare systems owe much of their developments and advancements to crisis situations. Hence, healthcare organisations need to pay attention to these opportunities for thriving— and not just surviving—amid the chaos of adversities. Thriving through and within crises requires systems to be antifragile. Taleb coined the term “antifragility” to describe systems that “benefit from shocks” and “thrive and grow when exposed to volatility, randomness, disorder, and stressors and love adventure, risk, and uncertainty”.1 Taleb advances the notion that “by grasping the mechanisms of antifragility we can build a systematic and broad guide to non-predictive decision making under uncertainty in business, politics, medicine, and life in general”.1 In other words, antifragile systems need to be built and designed so they not only survive during a crisis but thrive through it. The current global outbreak of COVID-19 presents exceptional challenges that can serve as an opportunity for healthcare systems to thrive and boost their antifragility as the pandemic continues to spread and evolve over time. This makes the current time a valuable chance for healthcare systems to develop their organisational skills proactively in tandem with the development of the crisis itself. This opportunity to thrive, however, should not be taken for granted. Instead, healthcare systems and organisations need to be prepared, guided and directed towards this thriving learning mode during the crisis. Unfortunately, many healthcare systems are ill-prepared for pandemic crisis management and are not prepared at all for the opportunity to thrive under such circumstances. In 2019, both the Global Preparedness Monitoring Board and the Global Health Security Index reported a global lack of preparedness for health emergencies worldwide.2,3 During a pandemic, health systems are typically absorbed in managing the chaos that ensues and these systems find themselves exhausted afterwards. Hence, they may lose a great opportunity to thrive amid the chaos of a crisis. It is the responsibility of healthcare leaders to guide their systems through the transition of surviving the crisis to thriving in it.