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Autistic youth face higher risks for experiencing mental health crises. To develop and test a county-level social network measure of care coordination between police departments and other systems that support autistic youth experiencing suicidal crisis.

To measure the structure of care coordination for autistic youth experiencing suicidal crisis, the authors created a roster of all police departments and youth servicing organizations in two East Coast counties in the United States. They met or exceeded the whole network recruitment threshold of 70% completion in both counties. From the data, the authors created a directed matrix for each county of all reported connections, which they used to create sociograms and calculate standard network measures, including indegree, outdegree and total degree for each organization in the network. Data management and processing were done using R-programming and ORA.

Social network findings indicated that about half of all police departments surveyed coordinate care for autistic youth in suicidal crisis. Coordination varied by county, with nonpolice organizations acting as connectors between police and other nonpolice organizations. Two structural configurations were found, including a nonpolice organizational hub structure and a lead police structure. More research is needed to determine how different police integration structures shape care coordination for autistic youth.

Limitations include the small number of counties included in the study. A larger sample of counties is required for generalizable results.

This article introduces new tools and approaches to assist police in building their capacity to measure and improve their coordination of care with other community systems during crisis situations for youth on the autism spectrum. Network science (e.g. matrix and graph theoretic algebra methods) can be used to measure the configuration of relationships police departments have with complex multi-level healthcare systems.

Implications for findings include the consideration of police integration across systems in ways that produce new collaboration possibilities to support autistic youth experiencing suicidal crisis.

While police departments play a critical role in coordinating care for youth in suicidal crisis, little is known if or how police departments collaborate with other systems to provide assistance for autistic youth during a suicidal crisis. Improving care continuity within and between systems could potentially address clinical and structural challenges and reduce risk for autistic youth experiencing a suicidal crisis.

This paper aims to synthesize health-care leaders’ experiences of the competencies required for crisis management.

The systematic review followed the joanna briggs institute (JBI) guidance for systematic reviews of qualitative evidence. The search strategy included free text words and medical subject headings and peer-reviewed qualitative studies published in English, Finnish and Swedish and was not limited by year or country of publication. The databases searched in March 2022 were Scopus, PubMed, CINAHL, ABI/INFORM and the Finnish database Medic. Gray literature was searched using MedNar and EBSCO Open Dissertations. Studies were screened by title and abstract (n = 9,014) and full text (n = 43), and their quality was assessed by two independent reviewers. Eight studies were included. The data was analyzed using meta-aggregation.

Fifty-one findings (themes and subthemes) were extracted, and 11 categories were created based on their similarities. Five synthesized findings were developed: the competence to comprehend the operational environment; the competence to stay resilient amidst change; the competence to adapt to and manage change; the competence to manage and take care of staff; and the competence to co-operate and communicate with diverse stakeholders.

This systematic review produced novel information about health-care leaders’ experiences of the competencies required for crisis management during COVID-19. This study complements the field of research into crisis management in health care by introducing five original and unique competency clusters required for crisis management during the acute phase of COVID-19.

The purpose of this paper is to propose to expand the political economic understanding of a “fix”, that is, capital’s ability to overcome crises of profitability through a displacement of its crisis tendencies, to include an analytical attention to the gendered, sexualised and racialised unwaged and underpaid (caring) labour that reproduces labour power within a capitalist economy.

A “care fix”, the author argues, involves attempts to manage a crisis of care in ways that do not resolve but merely displace the crisis, perpetuating the systemic imperative of capital to off-load the cost of social reproduction and care, thereby constituting a crucial dynamic of capitalist development and restructuring and resulting in the reorganisation of gendered and racialised class relations and historically contingent regimes of reproduction.

The maceration of the Fordist regime of reproduction under neoliberalism has given way to a new post-Fordist arrangement that, having exhausted its care fix, is now once again in crisis. A new care fix is currently under way, while at the same time it is being contested and redirected by the contemporary struggles over social reproduction, care and democracy.

Consequently, the author discusses the emergence of the notion of “caring capitalism” and contrasts this with proposals for democratising care, in turn investigating these developments in the context of an ongoing crisis of political representation in Europe and offering a notion of “care municipalism” as a possible way forward.

The practical implications concern the possibility of democratising the care sector.

The social implications pertain to the questions of how social, political and economic institutions shift when care is placed on their agenda.

The value of this paper is to make a theoretical contribution to the analysis of changing configurations of care, social reproduction and society in relation to questions of democracy.

This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized.

The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making.

The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers’ learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic.

The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics.

This study has explored learning during the COVID-19 pandemic and found a circular process, “the management learning wheel,” which supports management learning in prolonged crises.

This paper aims to analyze the ethical responses of the fashion industry to the first wave of the COVID-19 pandemic when the entire world was shocked by the rapid spread of the virus. The authors describe lessons from emergency ethics of care in the fashion industry during the initial months of COVID-19, which can assist fashion managers in improving ethical decisions in future operations.

Rapid qualitative research methods were employed by conducting real-time, in-depth interviews with key informants from multinational fashion companies operating in Spain, a severely affected region. A content analysis of news articles published during the first months of 2020 was conducted.

Five critical disruptions in the fashion industry were identified: (1) changes in public needs, (2) transportation and distribution backlogs, (3) defective and counterfeit supplies, (4) stakeholder relationships at stake and (5) managers' coping challenges. Additionally, five business survival responses with a strong ethics of care component were identified, implemented by some fashion companies to mitigate the damage: (1) adapting production for public well-being, (2) enhancing the flexibility of logistic networks, (3) emphasizing quality and innovation, (4) reinventing stakeholder collaborations and (5) practicing responsible leadership.

Despite the well-documented controversies surrounding unethical practices within the fashion industry, even during COVID-19, our findings inform managers of the potential and capability of fashion companies to operate more responsibly. The lessons learned can guide fashion companies' operations in a post-pandemic society. Furthermore, they can address other grand challenges, such as natural disasters, geopolitical conflicts and climate change.

There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.

Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.

HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.

Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.

The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.

The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

The purpose of this qualitative research study is to explore health-care providers’ perspectives and experiences with a specific focus on supports reported to be effective during the COVID-19 pandemic. The overarching goal of this study is to inform leaders and leadership regarding provision of supports that could be implemented during times of crisis and in the future beyond the pandemic.

Data were collected by semi-structured, conversational interviews with a sample of 33 health-care professionals, including Registered Nurses, Nurse Practitioners, Registered Psychologists, Registered Dieticians and an Occupational Therapist.

Three major themes emerged from the interview data: (1) professional and personal challenges for health-care providers, (2) physical and mental health impacts on health-care providers and (3) providing supports for health-care providers. The third theme was further delineated into three sub-theses: formal resources and supports, informal resources and supports and leadership strategies.

Health-care leaders are advised to pay attention to the voices of the people they are leading. It is important to know what supports health-care providers need in times of crisis. Situating the needs of health-care providers in the Carter and Bogue Model of Leadership Influence for Health Professional Wellbeing (2022) can assist leaders to deliberately focus on aspects of providers’ wellbeing and remain cognizant of the supports needed both during a crisis and when circumstances are unremarkable.

This study aims to explore the coping styles that can be inferred from the discourse of dyads with dementia, and how these appear to impact on care management.

This was a case study approach. Participants were recruited from two teams managing crisis in dementia in the UK. The authors conducted multiple qualitative interviews with people with dementia and their family carers over the course of one month. The analysis was first performed through thematic analysis. Data were further analysed through narrative inquiry to create a story line, or play in our case, for our findings.

Five dyads were interviewed and a total of 16 interviews were conducted. Three dyads were husband–wife and two were daughter–mother relationships. The mean age was 67.4 years for carers and 79.8 years for people with dementia. In these cases, the carer assumed responsibility for managing the episode and was more likely to seek formal help if a pre-existing plan was in place. Otherwise, when a crisis arose, dyads preferred to avoid involving professionals.

Psychosocial interventions should aim to identify and replace unhelpful strategies used by dyads to manage crisis episodes.

To the best of the authors’ knowledge, this is the first study using qualitative interviews of dyads to inquire into their experience of mental health crisis.