Bibliographic record
Abstract
Healthcare organizations face significant challenges in coordinating cohesive responses to large-scale unexpected disruptions. Previous studies have emphasized the need for protocols and planning in response to crises. However, for crises that are extended, novel, and ambiguous, the coordination of responses to the unfolding crisis becomes more important. In order to understand how coordination unfolded over time, we conducted a two-year qualitative field study in a frontline hospital during the 2020–2022 COVID-19 pandemic. Our findings reveal that such wide-spread crises unfold as multiple concurrent episodes, disrupting work across units and requiring flexible and evolving coordination practices. These practices enable the hospital to manage novel interdependencies, establish shared frameworks to navigate disruptions, and strategically foreground and background relevant expertise across the organization. Our study highlights how hospitals can leverage localized knowledge and resources to produce cohesive, organization-wide responses. This approach enhances efficiency, fosters innovation, and ensures coherence in addressing both routine and extraordinary challenges.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.014 | 0.007 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.002 | 0.012 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".