Social scientist (@RebeccaGruby) asks Ostrom’s Polycentric Governance should say a lot about how to handle outbreak.
The response to COVID-19 is a form of polycentric governance: multiple, overlapping decision-making centers operating with some autonomy, acting in ways that take account of others. Polycentricity scholars, what are some useful insights from our work? A few thoughts to start:
— Rebecca Gruby (@RebeccaGruby) March 11, 2020
She is correct and Resilience Engineering provides some results (from Resilience Engineering lectures on polycentric architectures):
Polycentric governance intersects with nonlinear layered networks in resilience engineering (eg Doyle):
1. how to be poised to adapt in advance of a future challenge?
2. how to facilitate adaptive responses as a challenge unfolds?
Ostrom’s Polycentric governance is a general finding: neither strictly hierarchical command architecture nor a completely decentralized flat network has sufficient adaptive capacity to overcome the basic risk of brittleness. Hard constraint for all systems & scales is “viability requires extensibility”. The discovery of graceful extensibility as a basic form of adaptive capacity required to overcome brittleness but it trades-off with pursuit of optimality. Thus, Ostrom really is posing a question: of the many architectures in between flat and command, what works well when & where? Those that build and sustain graceful extensibility. Another constraint comes from work on fundamental trade-offs: Need an architecture that builds in the ability to continue to adapt over longer cycles — to find new ways to balance constraints as change continues, especially since others adapt.
Initial challenges of this outbreak operate at continental & inter-continental scale #1: Societies with experience at previous outbreaks (SARS) have anticipated, mobilized & generated responses better than those without — a difference in proactive learning.
Once into a new challenge, what matters (#2)? Strategy in 4 parts
A. Empower decentralized initiative at Sharp End Layers, up close roles. …
B. Support reciprocity across roles as overload threatens by anticipating bottlenecks ahead.
C. Broad End Layers, distant ‘supervisory’ roles coordinate/synchronize over emerging trends to meet changing priorities. …
D. Horizontal learning & exchange will emerge spontaneously and informally across units/roles facing the challenges will emerge. Broad End Layers monitor for, facilitate, cross-check, & at least do not block this.
See Essentials of resilience, revisited & our studies on adaptation in a large mass casualty event at Researchgate.
Ohio’s response demonstrates these moving forward.
Preparing for another interview:
List of possible points to discuss in interview:
- Steering through threats and obstacles: verb, not category
- Risk of saturation as patients and severity increases and threatens to overload response capabilities
- Deploy, mobilize, generate additional response capabilities – build readiness to respond in advance of patients needing hospitalization
- Steering through threats and obstacles at this scale means:
- Multi-party and multi-level steering that is synchronized to expand ability to keep pace with increasing demands
- At some point lets’ break up questions and responses: eg. Scale, anticipation – staying ahead of growth of need, overload issues, rationalizing away threat, not an episode but a novel event triggering a process that will go on over a longer time scale, natural experiment in US
- At continental scale and intercontinental scale: polycentric governance, vertical and horizontal coordination as learn ways to treat and expand and preserve response capabilities. How upper echelons generate and move resources to build effectiveness, entrain/help synchronize responses across scales, remove blockages, …
- Anticipation paradox: generate a readiness to respond in advance of the patient needs
- How this threat adds load and constraints on generating response capability
- Isolation units – reconfiguration
- Protective gear in “hot” zone
- How to handle arriving patients who might have COVID-19, given non-COVID-19 medical problems will arrive too
- The nature of the threat affects clinicians providing care, thus reducing the ability to provide the needed care:
- time in hot zone limited,
- how to extend effective time in hot zone,
- clinicians become potential vector for transmission,
- workers who need to be quarantined reduce clinical response capability,
- sustained performance issues
- 8% of cases in Italy are healthcare workers
- Not just an episode
