Holder of numerous training courses and specializations in the field of human resources, Gérald Brandt has been working in both public and private law organizations since 2001. He currently works in a hospital structure of regional importance as Chief human resources officer. He is also an expert for higher education in human resources, as well as a judge at the labor court.
He will defend his Executive Doctorate in Business Administration (EDBA) in September 2022, on the theme “Governing in the storm: structures, roles and interactions within the hospital governance in a health crisis situation“ under the supervision of Professor Michelle Bergadaà, Professor Emeritus at the University of Geneva.
The thesis focuses on the hospital governance during the SARS-CoV-2 pandemic, and especially on its structures, roles and interactions. The research was conducted within three different hospitals environments and demonstrates that a pandemic doesn’t affect the hospital’s governance structures and roles. This is mainly explained by a strong legal conformism of governance in hospital environments, not taking in account its specificities. In contrast, interactions are influenced and reinforced during a pandemic.
Thesis Direction
Pr Michelle Bergadaà
Thesis Title
Governing in the storm: Structures, roles and interactions of hospital governance in health crisis situations. Exploratory research in the French-speaking Swiss hospital sector.
Abstract
Hospital governance, based on the Anglo-Saxon model of the Cadbury report (1992) recommending making a distinction between the so-called strategic level and the so-called operational level, has imposed itself in a few years as being the ultima ratio, with a few notable exceptions, in terms of management of hospital environments, and this in a broad context of liberalization of the health market in Switzerland. This liberalization, desired by the various healthcare players, should contribute to strengthening inter-hospital competition and contribute to the reduction of healthcare costs. Thus, all Swiss hospitals have been given corporate governance, like listed companies, in the form of a board of directors called upon to deal with hospital strategy. We will mainly focus on the functioning of these hospital boards of directors, and more particularly on their structures, the roles exercised, as well as the human interactions induced by these two components.
This research focuses on a subject that lies at the intersection of three major themes that have already been the subject of numerous research and publications – and still do -, namely governance, human interactions and (health-) crises given that this research was carried out during the SARS-CoV-2 pandemic. Although these three subjects have already been the subject of much research, to our knowledge and to date, there is no research combining these three aspects. While the health system is a fundamental element of functioning in the societies we know, and its management is considered one of the most complex, mastering its governance means making it more effective and efficient, in the interest of its main customers: patients and policyholders. Thus, we will ask ourselves how a health crisis influences the structures, roles, and interactions of hospital governance.
To carry out this research, we are conducting it in using case methodology, and this on a defined research field made up of three non-university hospital organizations active in French-speaking Switzerland. We use a structured questionnaire carried out using the Sphinx Declic 2 software and addressed to the administrators of these organizations, and question, by means of an interview guide, the representatives of the owners of these organizations, as well as experts grouped together in two distinct groups, namely experts in governance and experts in crisis management. All the data collected is analyzed by means of a rise in abstraction and an analysis of the lexical field carried out using the NVivo software.
The results obtained by analyzing the contributions of the three main groups of contributors already mentioned, then by discussing them and confronting them with the theories mobilized, suggest that a health crisis has little impact on the structures and roles hospital governance, the latter being mainly influenced by legal constraints and thus operates according to the principles described through the positive agency theory (Jensen & Meckling, 1976). Thus, it appears that the hospital governances observed do not take into consideration other conceptions of governance, nor do they operate in a network. With few exceptions, few directors hold office in multiple hospital organizations. Regarding human interactions, these seem to tend to tighten between members of hospital boards of directors.
Based on the results obtained, we propose eight managerial recommendations, as main contributions from the research, which we complete with theoretical, methodological, and socio-economic recommendations. Finally, we propose various avenues for complementary research, to deepen the first contributions and avenues resulting from this research in terms of hospital governance in a situation of pandemic health crisis.