BCG Henderson Institute

The Institutionalization of Excellence

What governments should learn from their own success stories in responding to Covid-19.

On December 12, 2019, a cluster of patients in the city of Wuhan, China, began to experience the symptoms of an atypical pneumonia-like illness that did not respond well to standard treatments.[1]https://www.cdc.gov/museum/timeline/covid19.html#:~:text=December%2031%2C%202019,fever%20occurring%20in%20Wuhan%2C%20China. Within weeks, the Covid-19 outbreak would dominate the headlines and be top of mind for leaders of governments across the world. It posed extremely complex and urgent questions for governments that lacked reliable information and proven playbooks on which they could base their answers. Everyone was scrambling for a strategy to guide their response.

In the subsequent period, much of what governments did to curtail Covid-19 was met with severe criticism. Governments were accused of being unprepared, responding hesitantly, providing unreliable information, investing in failing initiatives, and deploying hasty and inconsistent policies. Despite these criticisms, it would be a mistake to conclude that the responses were in all cases without merit.

The Covid-19 crisis is a classic example of a “wicked problem”: a problem with uncertain, incomplete, contradictory, and shifting conditions under which it can be solved. In fact, it was initially far from obvious what solving the problem entailed—eradicating the disease, managing it effectively on an endemic basis, or minimizing social and economic damage? In the case of wicked problems, one cannot meaningfully assess performance by virtue of the results alone, as there are no clear benchmarks for expected outcomes. Instead, one needs to look under the hood of the decisions that were made and the solutions that were organized.

When looking under the hood of Covid-19 response, one finds not just failures but also a wealth of extraordinary achievements. No country was comprehensively successful, but many countries excelled at one or more aspects. For example, South Korea excelled at testing, Senegal at communication, New Zealand at whole-of-government orchestration, Switzerland and Singapore at app development, Hong Kong at swift deployment of social distancing policies, and the US at the vaccine development and approval process.

While governments are often characterized as slow, untransparent, and introverted, the Covid-19 crisis produced a plethora of examples of project delivery at relentless speed, seamless cooperation within and across governmental organizations, open communication with the public, and fruitful collaboration with the private sector. These success stories cannot easily be explained away by factors such as money or individuals rising to the occasion. Rich countries did not necessarily outperform poor countries in their response to Covid-19.[2]https://foreignpolicy.com/2022/06/26/coronavirus-pandemic-global-response-devi-sridhar-review/ And there are countless examples of government projects where money is in abundance which nonetheless fail, such as large infrastructure or IT projects. There is no doubt that many individual civil servants went above and beyond to face the challenges of Covid-19—whether on the frontlines in the medical sector or behind-the-scenes in drafting emergency policies. But individuals are only able to excel insofar as their organizational environments allow them to.

Now that the dust is settling, it is imperative for leaders of government to codify and institutionalize the lessons from these extraordinary achievements so that they can be repeated. There are three distinct levels of good performance during a crisis:

  1. you responded effectively;
  2. you understand why you responded effectively;
  3. the key elements of your response have been codified and institutionalized.

Few governments have reached the second level, and virtually none are on the third. That means that the success stories may not be repeatable for the next crisis, while many are already on our doorstep—such as the energy shortage, surging inflation, economic downturn, climate change, geopolitical tensions, the erosion of social trust, and more.

It would be a mistake to frame the learnings of Covid-19 response as just a “wartime playbook”; they also provide a potent roadmap for improving the effectiveness and efficiency of governments in their business-as-usual. As we are entering an era of persistent multidimensional uncertainty, governments will have to prepare for a permanent state of crisis. While the challenges for government are mounting, they will have to make do with fewer and fewer resources. The years of capital and labor abundance have come to a crashing halt, due to rising interest rates, demographic aging, and increasingly fierce competition for talent.[3]https://bcghendersoninstitute.com/new-abundance-resource-constraints-as-strategic-opportunities/ Inefficient use of resources is a luxury governments can no longer afford. To preserve the quality of life for their citizens in the next decade and deal with a succession of new and complex problems, governments need to institutionalize the excellence behind Covid-19 success stories.

Seven key lessons from crisis response

This article aims to help leaders in governments learn from Covid-19 responses by providing seven important lessons based on our experience in supporting them. The list is not exhaustive, and we encourage readers to contribute their own insights.

Rebalance compliance with performance

Civil service rules are valuable instruments that prevent government organizations from falling into a variety of traps. Typically legitimized by historical antecedents, civil service rules lay the foundation for good governance and embody principles such as accountability, privacy, consistency, and integrity in the civil service. But a rigid adherence to the rules can also come at the expense of performance, especially in the face of urgent or novel challenges.

The philosophy that performance should trump compliance was at the heart of many of the success stories in Covid-19. For example, South Korea’s highly effective test/trace/isolate system challenged privacy constraints. South Korea achieved the highest per capita test rate in the world by March 2020 by leveraging a large network of private and public facilities for its testing operations and delivering results back in as fast as six hours, while other countries, such as the UK, were still only able to perform tests within hospitals.[4]https://www.vox.com/22380161/south-korea-covid-19-coronavirus-pandemic-contact-tracing-testing & https://www.csis.org/analysis/timeline-south-koreas-response-covid-19 Setting up such an operation at speed did require them to work around the existing rules.[5]https://decorrespondent.nl/13020/amateurisme-paniekvoetbal-onkunde-deze-oud-baas-van-vws-laat-je-heel-anders-kijken-naar-de-aanpak-van-de-coronacrisis/1149772308300-7c2ab54c

Similarly, the Netherlands successfully averted a PPE shortage by allowing the government to work around its own procurement regulations. While not formally responsible for the procurement of medical equipment, the Department of Health showed great resilience by heeding the call of healthcare institutions to help acquire PPE in the face of an impending shortage. The department rapidly pulled together a taskforce of public and private procurement experts, which was supported by a panel of medical professionals. They managed to procure reliable masks from a market that was overrun with low quality products and kept hospitals from running out, which would not have been possible without a flexible interpretation of the rules.

We do not argue for civil service rules to be discarded wholesale. But when choosing a policy or strategy, a rule should not push you into an ineffective decision. A number of actions are needed to rebalance compliance and performance. First, engender new mechanisms for trustworthiness. Civil service rules create trust in the moral behavior of civil servants by providing clear boundaries for them to operate in. It essentially centralizes the moral conscience of civil service into the leadership that codifies the rulebook. Relaxing civil service rules pushes some of the moral responsibilities onto lower levels. That requires other mechanisms of trust, such as consensus-based decision-making, organizational vigilance, a culture of integrity, and careful after-the-fact evaluations.

Second, adjust your measures for success. One-sided scrutinization of compliance by watchdogs and regulatory agencies can hinder the flexibility of civil servants to pursue performance over compliance. The Health department of the Netherlands, for example, was heavily criticized by an internal government auditor for spending over €5 billion illegitimately in its procurement of PPE, and was subsequently ridiculed and demonized by politicians and the media. The nature of illegitimacy, however, was not that anything had fundamentally gone wrong, but that the ministry chose to favor speed over procedural matters such as requesting bank guarantees from suppliers or collecting receipts of delivery.[6]https://decorrespondent.nl/13020/amateurisme-paniekvoetbal-onkunde-deze-oud-baas-van-vws-laat-je-heel-anders-kijken-naar-de-aanpak-van-de-coronacrisis/1149772308300-7c2ab54c Similarly, the evaluation criteria used for HR decisions, such as promotions and raises, need to incentivize high performance rather than just “keeping your head down.”

Overcommunicate

Winning the support of the public is more than just a political goal; it can also be essential to the effectiveness of your policy. Covid-19 showed that governments that lacked trust lost important tools in their battle against the pandemic, such as social distancing and masks, as large swathes of the population simply refused to follow the measures. The reverse was also true: governments that earned high trust from the population were much more effective, which meant that ultimately fewer and milder measures were needed.

Key to gaining trust are transparency and communication. Many governments initially communicated poorly about the disease.[7]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461274/ Governments struggled with a dilemma: should they be transparent about their lack of knowledge or would that undermine their authority to enforce measures? Successful governments navigated this dilemma with regular, large-scale communications and clear, simple messaging.

A case in point is Senegal. The country understood early that, despite the uncertainty, it needed to inform the public with whatever information was available.[8]Devi Sridhar, Preventable: How a Pandemic Changed the World & How to Stop the Next One, July 2022 & … Continue reading They focused on simple messages and leveraged a large network of trusted authorities in the country, such as religious leaders and musicians, to spread these messages—especially in regions with lower access to television, internet, and radio. Instead of feigning total control, they admitted to the uncertainty of the situation but nonetheless asked the population to support the measures—which were harsh. Despite the country’s lack of medical resources, Foreign Policy ranks Senegal second after New Zealand on its success in battling Covid-19, crediting Senegal’s communication strategy as major contributor.[9]https://globalresponseindex.foreignpolicy.com/?_gl=1%2A1fprmyq%2A_ga%2ANzMzMjQ0NTQ1LjE2Njk4MzA5MzU.%2A_ga_T5CKP06L0Y%2AMTY2OTgzMDkzNS4xLjAuMTY2OTgzMDkzOS4wLjAuMA..

Embrace failure

The Covid-19 crisis was characterized by high uncertainty and volatility. At any point in time, much was unknown: how exactly was the virus transmitted, at what stages of the disease life cycle was a person contagious, how effective were different solutions? The situation was not only uncertain but also rapidly evolving, due to mutations in the virus and a shifting social and economic environment which continuously reshaped the context for public health policies. In the face of such dynamic uncertainty, chances are that you will fail—often. But only by embracing the failure of individual measures can you hope to learn and avert failure overall.

The first element of embracing failure is to gamble on many wrong horses. Investing in different solutions, including those with poor prospects, is necessary to create sufficient options. Even when one solution has proven to be effective, successful governments combine the exploitation of that solution with the exploration of others. This “ambidexterity” provides governments with a greater arsenal of tools to respond with if the crisis takes an unexpected turn.[10]https://www.bcg.com/bcg-henderson-institute/ambidexterity For example, despite New Zealand’s early success with strict border controls, it continued to build up its testing and tracing capacity, which greatly helped to beat back subsequent outbreaks.[11]https://www.brookings.edu/research/policy-and-institutional-responses-to-covid-19-new-zealand/

The second necessary form of failure is to overinvest on important bets. Given the uncertain nature of the Covid-19 crisis, attempting to analyze and calibrate the necessary number of masks, tests, or vaccines is impossible. It is dangerous to strive for efficiency as it could be the enemy of effectiveness. Covid-19 has shown that redundancy is essential in dealing with unpredictability. For example, Germany’s large intensive care capacity, which has often been referred to as excessive when compared with other European countries, provided the country with much more leeway to absorb spikes in infection rates.[12]https://apps.who.int/iris/bitstream/handle/10665/351083/Eurohealth-28-1-41-45-eng.pdf?sequence=1&isAllowed=y

Empowering civil servants to make mistakes requires a shift in mindset for many actors. Journalists, watchdogs, and politicians are prone to singling out individual projects or initiatives and criticize their failure. But if civil servants get slammed for mistakes in a previous crisis, they may be unwilling to take risks in the next. Tolerance for failure is essential.

Focus on the speed of learning

From the outset, Covid-19 policies were prone to disrupting many aspects of society as they triggered a plethora of effects across our health, economic, and social systems. Due to the many feedback loops among these systems, it would have required an extremely meticulous process to engineer specific outcomes, if such a thing were even possible. At the same time, the Covid-19 crisis above all required a fast response. As Albert Bourla, CEO of Pfizer, remarked to us: “time is life.” Governments could not afford to avoid all mistakes. What mattered most was how quickly they were able to learn from them.

The early experience of Northern Italy provides a poignant illustration of the importance of learning.[13]https://hbr.org/2020/03/lessons-from-italys-response-to-coronavirus Two nearby regions, Veneto and Lombardy, were hit severely by Covid-19 around the same time. Initially, both struggled to formulate a response, with “plenty of operational screw-ups and shifts in tactics as policy makers and health experts searched for the best solutions.”[14]https://medium.com/@michelezanini/managing-the-pandemic-lessons-from-italys-veneto-region-4d1259091879 Lombardy by and large committed to its initial strategies and was conservative about changing them. Veneto, on the other hand, continuously adjusted its approach as new information became available on what was working and what wasn’t. For example, they started testing people with only mild symptoms, made specific efforts to monitor employees of healthcare facilities and high traffic locations such as supermarkets, and reorganized select hospitals into dedicated Covid-19 facilities to streamline intensive care. As a result, by the end of March 2020, Lombardy held the grim record of 5,000 deaths among a population of 10 million, while Veneto fared significantly better, with 287 deaths among a population of 5 million—despite the similarity of their initial situations.

There are different tactics and tools available to speed up organizational learning. The first important element is to be experimental: try different approaches to see what works. Avoid analysis paralysis and seeking perfect alignment among all stakeholders, but decide fast and see what works in practice.

A second element is to ensure availability of the right information. That means identifying the right metrics for the evaluation of initiatives and collecting the required data. A war room can be an effective tool. It serves as a mechanism to pool information from across the organization, and in turn accelerates the diffusion of emerging insights.

A third element is the mutualization of learning with other organizations. To learn fast is to learn together. Successful policies were typically the result of a collaborative effort by experts across different healthcare institutions, policy departments, medtech suppliers, civil society organizations, and more. An example of successful collaboration is provided by the seven Northeast states in the US, which set up a collaborative structure to share learnings on a systematic basis across a wide range of topics, including containment of the disease, monitoring and treatment of infections, and distribution of vaccines. This allowed each state to learn from the actions of others, and provided a platform to discuss and coordinate potential changes in policies and approaches.

Ensure fluidity of collaborative structures

An often-heard quote is that civil servants should “break free from their silos” and collaborate seamlessly across agencies or departments as if the government was a single organization. There is some truth to this, but the view is simplistic. Partitions in public organizations serve an important purpose. They provide a managerial tool to assign responsibilities, a legal tool to determine mandates, a political tool to secure a diversity of viewpoints, and a psychological tool to shape social interactions.[15]https://www.nsob.nl/sites/www.nsob.nl/files/2020-11/NSOB%20-%202020%20-%20Grenzeloos%20Samenwerken.pdf Large organizations need partitions, and they need structures to collaborate across those partitions. However, it is dangerous when these partitions and collaborative structures become overly complex and rigid. In a changing environment, government should continuously re-evaluate the fit of their collaborative structures with the challenges at hand.

New Zealand, for example, realized that many of the challenges emerged at the intersection of the Ministry of Health and other departments, such as border control issues with the foreign affairs department, lockdowns of schools with the education department, and economic stimuli packages with the economic department. Led by an all-of-government controller and the nation’s Ministry of Health, the government launched a coordinated effort with involvement of all ministries and agencies to integrally shape its Covid-19 response.[16]https://www.brookings.edu/research/policy-and-institutional-responses-to-covid-19-new-zealand/ As a result, lockdowns and other measures were much better received and coordinated in New Zealand than in many other countries.

Fossilized partitions appear not only within government, but also between government and the private sector. A number of countries successfully breached those in the development of Covid-19 tracing apps. Switzerland, for example, cooperated with various universities and experts in developing SwissCovid. It was the first app worldwide that made use of Apple’s and Google’s exposure notification systems.[17]https://www.swissinfo.ch/eng/business/switzerland-launches-swisscovid-contact-tracing-app-for-residents/45859778 Similarly, the Netherlands organized hackathons to develop the CoronaMelder app. The transparency of the design process helped create social support for the app, despite its arguably invasive privacy practices, and has been credited with leading to higher adoption rates.[18]https://magazines.algemenebestuursdienst.nl/abdblad/2020/01/coronamelder

Adopt a multi-timescale strategy

As described earlier, speed mattered greatly in the battle against Covid-19. The situation shifted daily, and a slightly slow response would often lead to a surge in infection numbers and a consequent need for harsher and more harmful measures to bring them back down. The threat of overcrowded intensive care units was never more than a few days or weeks away. As a result, strategies needed to be crafted and reiterated on a daily timescale and were often attuned to hourly variations in infection statistics.

Yet at the same time, the Covid-19 crisis triggered many slow-burning effects. As Covid-19 patients consumed the capacity of hospitals, they crowded out other important surgeries and treatments, and backlogs exploded. Lockdowns led to financial hardship, and often bankruptcy, for many small and medium-sized businesses. Children suffered disadvantages from growing gaps in their education. Friendships drifted apart as people struggled mentally in isolation. Many of these long-term consequences did not receive much attention initially, as the effects were often diffuse, lagged, and hard to quantify. But eventually it became clear that beneath the daily infection and mortality statistics, a much broader and enduring crisis was unfolding.

Effective governments recognized this early on. In response, they adopted a multi-timescale strategy to balance the costs and benefits on multiple timescales and evaluate their response from all of the associated perspectives.[19]https://bcghendersoninstitute.com/strategy-on-multiple-timescales-6bafe19aae90 There are a number of tactics one can deploy to make a multi-timescale strategy work.

The first is a smart choice architecture, which reduces the dimensionality and complexity of decisions. As described before, the myriad feedback loops among health, economic, and social systems prohibit an in-depth understanding of the effects that a policy measure produces across all timescales. The easiest way to simplify trade-offs is to use heuristics: for example, several countries decided they would prioritize saving lives first, and worry about the economy later. Another common heuristic was to minimize the impact on children before considering effects on adults. Scorecards are a slightly more advanced choice architecture. Gradually, they can be refined to incorporate more insights and information to improve the trade-offs as experience accumulates.

A second tactic is the principle of regressive reversibility and compensability. To achieve goals on short timeframes, first use measures that can easily be reversed in case harmful effects on longer timescales become apparent. Similarly, prioritize measures where the harmful effects can easily be compensated. Only after the reversible and compensable measures are exhausted, deploy others.

A third tactic is to designate “champions” for the different timescales. A single team which is responsible for the overall policy will have a diffuse accountability for many objectives, with the risk that timescales with less direct feedback loops will be ignored. Instead, embrace conflict and contradiction by assigning different teams the responsibility to gather information and present arguments for objectives across different timescales. This ensures diversity of perspectives when designing the response.

Harness imagination

Government agencies, like other large organizations, are notoriously prone to the institutionalization of beliefs, or in other words, groupthink. Individuals are rewarded for following a dominant narrative—as it gives a higher likelihood of getting projects approved, receiving praise from colleagues, and making a promotion—and by following the narrative, they in turn reinforce it. This vicious cycle is detrimental to the ability of government agencies to envision different futures and different ways of preparing for them.

Agencies should instead harness the heterogeneity of beliefs among their employees, as well as their imagination, to craft creative, forward-looking policy. Covid-19 provided a welcome shake-up in this regard: suddenly, it was crystal clear that the world was changing in radical and unexpected ways. Everyone’s guess was fair game. The narrative of the “new normal” was an open invitation for people to reimagine the future of their field or agency.

Successful governments capitalized on the reborn imagination of their civil servants. The UK, for example, recognized early on that the shift towards digital public service delivery was likely to stay after the end of lockdown, and encouraged civil servants to imagine what that should look like. It invested heavily in its Gov.uk website and the data capabilities of agencies.[20]https://www.computerworld.com/article/3640524/pandemic-gives-the-uk-governments-digital-services-a-boost.html The Government Digital Services project is estimated to save £1.7 billion per year.[21]https://www.forbes.com/sites/forbesbusinesscouncil/2022/04/12/the-digital-transformation-of-government-during-covid-19/?sh=243e0b1e2dbe

Two elements are important in harnessing imagination. The first is to foster diversity of thought. Don’t think of preparing for the future as a one-off forecasting exercise resulting in a stable outlook, but urge employees to continuously challenge the dominant view. Second, operationalize the imagined futures in scenarios and act on them. Imagination is often associated with vagueness or dreaming, but it doesn’t have to be. Follow up on potential futures with real action, for example with seed investments in new tools or teams. Organizational vigilance to a broad spectrum of potentially disruptive futures is essential in an era of persistent multidimensional uncertainty.

The codification and institutionalization of lessons

In the face of the Covid-19 crisis, many new heroes stepped up within public sector agencies: action-oriented individuals with fresh ideas, who solved issues in real time. These individuals were driven by a deeply felt sense of urgency and empowered by an organization that cleared the red tape from their path.[22]https://hbr.org/2021/07/your-employees-stepped-up-in-a-crisis-what-happens-when-its-over But from the perspective of a manager, relying on the surge performance of your most creative employees empowered by extraordinary circumstances is not a reliable strategy. To carry forward the successes of Covid-19 response to the next crisis, or more importantly, to your business-as-usual, governments need to understand what they did right and then entrench that in their organizations. In other words, they need to codify their success and institutionalize it.

Codification starts with a forensic after-action review. Formal after-action reviews were first developed by the US military and later adopted by many types of organizations, including, for example, hospitals.[23]https://www.pslhub.org/learn/culture/good-practice/how-can-after-action-review-aar-improve-patient-safety-r411/ Essential to an after-action review is that it is forward-looking: the goal is to analyze what happened so you can distill lessons that will help the organization perform better in the future. For that reason, assigning blame or issuing reprimands are antithetical to an effective after-action review. Many countries have launched formal evaluations by investigative committees with legal or political purposes, but these are rarely conducive to organizational learning.

A second characteristic of a productive action-after review is that it is performed by the protagonists of the operation. Assessments from journalists, think tanks, and academia are useful, but cannot replace the self-reflective exercise from government. All the relevant stakeholders—both senior and junior—need to participate in the after-action review to ensure that all perspectives are included in the analysis, and that everyone can benefit from the lessons.

The after-action review itself is not yet sufficient to codify the lessons. As the leadership of government is always changing, and different agencies may need to spearhead the next crisis response, it is important that insights are repackaged into bite-sized pieces that can easily be operationalized. A detail-ridden and context-specific report will provide little guidance for future praxis. The after-action review needs to translate into a playbook: a set of pragmatic guidelines on how to approach the next crisis or project.

It is a good move to write down what went well during Covid-19 response and how it can be repeated for the next crisis, but smart governments go much further. Instead of just codifying the success stories, one should aim to institutionalize them. That means making structural changes to the organization, acquiring new capabilities, and adjusting processes and regulations. This article has provided some general directions for institutionalizing the seven lessons, but other lessons could emerge from the after-action reviews of your agency; what is crucial is that you take action to entrench them in the organization, and to avoid a slow reversion to pre-crisis norms.

As John F. Kennedy noted, the Chinese use two characters to write the word ‘crisis’: one for danger, and another for opportunity. It is best to strike the iron while it’s still hot. Governments across the world are currently transitioning out of their crisis mode—relinquishing expanded mandates, dissolving taskforces, discontinuing temporary collaborative structures, and scaling down emergency capacity. Many agencies experience a strong pull to slowly revert to old ways of working.[24]https://hbr.org/2021/07/your-employees-stepped-up-in-a-crisis-what-happens-when-its-over Now is the time not to do that.

Author(s)
Sources & Notes

References

References
1 https://www.cdc.gov/museum/timeline/covid19.html#:~:text=December%2031%2C%202019,fever%20occurring%20in%20Wuhan%2C%20China.
2 https://foreignpolicy.com/2022/06/26/coronavirus-pandemic-global-response-devi-sridhar-review/
3 https://bcghendersoninstitute.com/new-abundance-resource-constraints-as-strategic-opportunities/
4 https://www.vox.com/22380161/south-korea-covid-19-coronavirus-pandemic-contact-tracing-testing & https://www.csis.org/analysis/timeline-south-koreas-response-covid-19
5, 6 https://decorrespondent.nl/13020/amateurisme-paniekvoetbal-onkunde-deze-oud-baas-van-vws-laat-je-heel-anders-kijken-naar-de-aanpak-van-de-coronacrisis/1149772308300-7c2ab54c
7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461274/
8 Devi Sridhar, Preventable: How a Pandemic Changed the World & How to Stop the Next One, July 2022 & https://www.brookings.edu/blog/africa-in-focus/2020/11/10/localized-communication-plans-help-senegal-control-covid-19/
9 https://globalresponseindex.foreignpolicy.com/?_gl=1%2A1fprmyq%2A_ga%2ANzMzMjQ0NTQ1LjE2Njk4MzA5MzU.%2A_ga_T5CKP06L0Y%2AMTY2OTgzMDkzNS4xLjAuMTY2OTgzMDkzOS4wLjAuMA..
10 https://www.bcg.com/bcg-henderson-institute/ambidexterity
11, 16 https://www.brookings.edu/research/policy-and-institutional-responses-to-covid-19-new-zealand/
12 https://apps.who.int/iris/bitstream/handle/10665/351083/Eurohealth-28-1-41-45-eng.pdf?sequence=1&isAllowed=y
13 https://hbr.org/2020/03/lessons-from-italys-response-to-coronavirus
14 https://medium.com/@michelezanini/managing-the-pandemic-lessons-from-italys-veneto-region-4d1259091879
15 https://www.nsob.nl/sites/www.nsob.nl/files/2020-11/NSOB%20-%202020%20-%20Grenzeloos%20Samenwerken.pdf
17 https://www.swissinfo.ch/eng/business/switzerland-launches-swisscovid-contact-tracing-app-for-residents/45859778
18 https://magazines.algemenebestuursdienst.nl/abdblad/2020/01/coronamelder
19 https://bcghendersoninstitute.com/strategy-on-multiple-timescales-6bafe19aae90
20 https://www.computerworld.com/article/3640524/pandemic-gives-the-uk-governments-digital-services-a-boost.html
21 https://www.forbes.com/sites/forbesbusinesscouncil/2022/04/12/the-digital-transformation-of-government-during-covid-19/?sh=243e0b1e2dbe
22, 24 https://hbr.org/2021/07/your-employees-stepped-up-in-a-crisis-what-happens-when-its-over
23 https://www.pslhub.org/learn/culture/good-practice/how-can-after-action-review-aar-improve-patient-safety-r411/
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