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Resource Scarcity and Humanitarian Social Innovation: Observations from Hunger Relief in the Context of the COVID-19 Pandemic.

ABSTRACT: Humanitarian social enterprises (HSEs) are facing mounting pressure to incorporate social innovation into their practice. This study thus identifies how HSEs leverage organizational capabilities toward developing social innovation. Specifically, it considers how resource scarcity and operating circumstances affect the capabilities used by HSEs for developing social innovation, using a longitudinal case study approach with qualitative data from 12 hunger-relief HSEs operating in the United States. Based on 59 interviews with 31 managers and directors and related documents, several propositions are posited. The findings suggest that resource availability (i.e., scarcity vs. abundance) leads some HSEs to focus on developing social innovation using their collaborative capabilities, while others leverage their absorptive capacity. Further, HSEs adjust their approach to developing social innovation based on whether they are operating in ordinary circumstances (i.e., before the COVID pandemic) or extraordinary ones (i.e., during the COVID pandemic). Interestingly, the findings suggest that the organizational capabilities used by HSEs are adjusted as these enterprises become more familiar with extraordinary operating circumstances. For example, at the onset of the COVID-19 pandemic, resource-scarce HSEs focused on parallel bricolage to develop social innovation. Subsequently, they focused on selective bricolage. The findings offer novel insights by relating the social innovation of social enterprises to crisis management.

Supplementary information

The online version contains supplementary material available at 10.1007/s10551-021-05014-9.

SUBMITTER: Shaheen I

PROVIDER: S-EPMC8747850 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceDuring the COVID-19 pandemic, many US states issued or revised pandemic preparedness plans guiding allocation of critical care resources during crises. State plans vary in the factors used to triage patients and have faced criticism from advocacy groups due to the potential for discrimination.ObjectiveTo analyze the role of comorbidities and long-term prognosis in state triage procedures.Design, setting, and participantsThis cross-sectional study used data gathered from parallel internet searches for state-endorsed pandemic preparedness plans for the 50 US states, District of Columbia, and Puerto Rico (hereafter referred to as states), which were conducted between November 25, 2021, and June 16, 2023. Plans available on June 16, 2023, that provided step-by-step instructions for triaging critically ill patients were categorized for use of comorbidities and prognostication.Main outcomes and measuresPrevalence and contents of lists of comorbidities and their stated function in triage and instructions to predict duration of postdischarge survival.ResultsOverall, 32 state-promulgated pandemic preparedness plans included triage procedures specific enough to guide triage in clinical practice. Twenty of these (63%) included lists of comorbidities that excluded (11 of 20 [55%]) or deprioritized (8 of 20 [40%]) patients during triage; one state's list was formulated to resolve ties between patients with equal triage scores. Most states with triage procedures (21 of 32 [66%]) considered predicted survival beyond hospital discharge. These states proposed different prognostic time horizons; 15 of 21 (71%) were numeric (ranging from 6 months to 5 years after hospital discharge), with the remaining 6 (29%) using descriptive terms, such as long-term.Conclusions and relevanceIn this cross-sectional study of state-promulgated critical care triage policies, most plans restricted access to scarce critical care resources for patients with listed comorbidities and/or for patients with less-than-average expected postdischarge survival. This analysis raises concerns about access to care during a public health crisis for populations with high burdens of chronic illness, such as individuals with disabilities and minoritized racial and ethnic groups.

Dataset Information

Resource Scarcity and Humanitarian Social Innovation: Observations from Hunger Relief in the Context of the COVID-19 Pandemic.

Supplementary information

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