Organizational resilience in elderly care

How do you create resilient public sector organizations in a contradictory and fast-changing environment?

This question is particularly relevant given the outbreak of Covid-19, and the apparent failures of elderly care organizations to deliver safe and secure high-quality care to elderly persons.

Swedish elderly care operates within a welfare market where subsequent reforms have introduced demands for e.g., competition and collaboration, flexible individualized care and standardized productivity measures, needs-based resource allocations, and customer choice based on individual preferences.

These multiple and contradictory demands have to be interpreted, prioritized, and operationalized on the organizational level, which makes it a complex task for actors – from managers and accountants to social workers and nurses – when they work to create a well-functioning organization that can deliver services in normal times and times of crisis.

As the focus of a critical debate, several questions arise about how they know what to prioritize in such a complex environment.

How do they make use of e.g., professional expertise developed over long time, the knowledge provided by performance measures and economic calculations, and the situational understandings that allow for flexible work procedures?

And how do they configure these different sets of knowledge and understandings in practice, in order to create a resilient organization? This study makes an effort to answer these questions.