Communal Experiences from the First Time of the Coronavirus Crisis

The corona crisis has transformed everyday life for all Danes. A large part of the public sector takes a huge responsibility on behalf of the community, to ensure the protection of the elderly and vulnerable and all Danes from coronavirus. The cooperation between authorities and various health actors stands its test at this time, and it is impressive to see how decisions and difficult priorities are made, made and realized within a short period of time.
‍

In Resonans, we have conducted interviews and received input from 10 municipal crisis managers (municipal directors, directors, bosses and managers) from 4 different municipalities about their experiences of the first days and weeks of the Coronavirus crisis. We have this because we want to contribute to the recognition of this extraordinary effort, but also because we want to examine what factors, both organisationally, managerially and humanly, are helping to ensure joint action in the face of a health crisis of which no one expected the scale of.

“I like to work in crises. It gives a huge pride that we can achieve it. We can work miracles in a matter of hours. I've only experienced one organisation that has thrown itself into the fray. I am enormously proud of the employees and the public sector. The corona can help to build trust in the public sector — even those professional groups that have been scolded and not very recognized, for example, educators, teachers, etc.” - Interviewed director in municipality

“Personally, I have felt how fast time passes — for example, in two days — as much has happened as has happened in 10 years.” - Interviewed director in municipality

“We are not finished with the crisis in the elderly. How long is there gasoline in the tank and excitement to draw on?” - Interviewed director in municipality

“We have seen nothing yet. The big task consists of slow and controlled opening in the areas of elderly and health care. We need to be able to walk on two legs. Make sure to give citizens what they usually get -- and in a split second could establish a contingency. And could be in a state that is 'alert'.” - Interviewed director in municipality

Although the health sector in the municipalities was prepared for a possible virus outbreak, the scale of the ongoing coronavirus crisis came as a surprise to the broad section of the municipal organization, as one director states: “The whole organization was not prepared. We sat for dinner while we heard Mette Frederiksen's announcement that Denmark is shutting down. It was a surprise. So we were hit with the adrenaline.”

As one city manager said: “When the announcement came about the shutdown, the focus was on playing each other super strong and 'you say a prayer'. Now it has to stand the test — do you have the basic capacity for cooperation and the basic professional competencies in place? Do we have the right relationship skills? And do we believe we can?”

In this article, on the basis of interviews with municipal directors, directors, bosses and managers from four backgrounds (see who at the bottom of the article), we examine how the task of management during the first Corona crisis has been approached. We are committed to deriving the municipalities' very first experiences of transitioning in a time of crisis, and we have a special focus on picking up the learning points and new forms of cooperation that may become important to maintain in the future.

Part 1: The role of management

Top management and crisis management — a management laboratory

Usually, everyday municipal leadership and democratic organization are characterized by open dialogue processes, lengthy development processes and co-creation with politicians, citizens, companies and associations. The usual way of working changed immediately during the first coronavirus era, when crisis management became the primary form of management.

A form of leadership that, for the majority of the municipalities surveyed, was characterized by top management — and that of standing “alone on the bridge” as a top leader and mayor. However, the top leaders are very aware that this kind of governance and management is not sustainable in the long term, but has been necessary in the initial crisis management. The municipalities involved have all experienced effective crisis management and well-functioning preparedness, as one director states:

‍“Things have gone strong — and we have been skilled and effective in getting our crisis management up and running.”

There was a lack of time and space at the start of the crisis to have long-term dialogues and discussions on the ways forward to take. Classic management practices such as orders and command management have been used in many ways, rather than the usual consensus management. As one director states: “I think of it as a big management lab. We usually make decisions close to citizens with a vision that reads: People meet people. We've become very top-down in this day and age. It's scary how easy it is to enter the role of power. And this is probably only going well precisely because we have a different culture for everyday life with trust and focus on setting employees free. Now the trust situation is benefiting — our orders are received positively and translated.”

It is pointed out that state governance by the prime minister, government and health authorities has created an acceptance of topdown governance. A topdown management in which there is also room for uncertainty and the possibility of making mistakes. For example, a director says:‍

“Thank you to Mette Frederiksen for making mistakes. The fact that Mette Frederiksen said it directly, that you can make mistakes, it has created an openness about mistakes. The national part of governing -- it's worked. We play along. We're all in the same boat. There is support for that.”

Several of the directors are concerned with the importance of clear leadership, but at the same time using the crisis to collaborate in new ways, as one municipal director puts it: “It's about being clear. It's more about management than governance. And to establish a cooperative relationship with people.”

Another municipal director has weighted the trust-based approach to his strategic management task as articulated: “I thought at first that I hope I have hired the right one. I have tried to create community leadership, but now it had to stand the test. What can I do? Don't get in the way -- and make sure the messages are strong when they come from my position. As a leader, you have to be able to trust your organization.”

Crisis management has also influenced the dialogue processes in municipal politics — and in the majority of municipalities, politicians have left the management to the administration during the first coronavirus era. As a municipal director puts it: “We have had a political leadership that has said: 'Yes — you are skilled — and we communicate that out'. Politicians have avoided making a fuss. There's going to be a reaction from the political at some point. '

Part 2: Political Leadership

Politicians' Dilemmas and the Role of Communication Ambassadors

In the municipalities interviewed, it is different what role the broad group of municipal politicians has played in the first month of crisis. Of course, the mayor everywhere has been at the center of crisis management qua the mayor's role as the municipality's top political and administrative leader.

In one of the municipalities, a positive experience during the crisis has been that the Executive Board has worked in new ways with communication to the city council. As one director states:

‍“In relation to the political level, as the Executive Board, we have made visible the dilemmas facing politicians in a different way than we usually do. The fact that we dare to open up. We get credit for and support for that.”

The experience of sharing dilemmas and the consideration of the balances at play in a decision and prioritising an action is generally something politicians have taken well to. While the dilemmas associated with the Corona crisis are certainly not simple, they may have been more evident. For example, in one of the municipalities, it is emphasized that the gradual reopening of Denmark must not take the focus away from the central infection minimization efforts in the elderly area, as well as cooperation with hospitals and the region.

In another municipality, the administrative management has felt that the city council has wanted to be a strong player. For example, the city council has been widely engaged as communication ambassadors. From the fact that it was initially about cancelled football matches, the role of disseminating positive everyday stories from emergency care in day care and digital homeschooling in primary schools became clearer along the way. At the same time, the city council has brought input back into the administration by sensing the general mood of the city, among others, among the local business community.

Several of the municipalities have focused on collecting everyday reports from the many working decentralized functions as a different “progress report” for the city council. This has inspired, among other things, a unified city council to offer all residents of the municipality's nursing homes and housing services, as well as the Church Cross Army Heating Room, a delicious lunch during Easter week from a local restaurant. So that municipal politicians could both help create a little more joy in life during the lonely coronavirus era and at the same time provide an economic salt water injection to the city's cafes and eateries.

A general feature of the municipalities interviewed is that the national top management has also influenced municipal self-government in the first corona era. As one municipal director states: “We take the 'tjep-tjep' decisions in short decision-making sessions. We lack time to discuss and have dialogue. It can be scary to be a top manager in this day and age. Decisions are made by crisis management. The mayor has had to make mayoral decisions.” And another municipal director puts it this way:“We have had a political leadership that has said: 'Yes — you are skilled — and we communicate that out'. Politicians have avoided making a fuss. There's going to be a reaction from the political at some point. '

A boss complements:

“The politicians have shown us the confidence that many decisions could be made in a short period of time. There has been no time for anything else. When it was going to be fast — we felt a lot of confidence. Now politicians want to know more and ask more questions.”

Part 3: Everyday Innovation Through New Collaborations

Common core task across disciplines and citizen's needs in focus

Despite the dire situation in Denmark's economy and health care, all the directors are very impressed by the new thinking brought about by the corona crisis. Cross-disciplinary cooperation across professional groups such as nursing home staff and educators, digital learning styles in primary schools, flexible use of homework, digital preventive home visits, joint psychological counseling are just some of the examples cited as positive side effects of the crisis.

In addition to the fact that a crisis itself provides a common purpose around a burning platform, the situation has also created an increased common understanding of the purpose from a citizen's perspective. As one municipal director states:

‍“The purpose is so clear and meaningful to everyone. So we haven't spent time writing down the core assignment.”

There is no doubt that the municipalities' focus on key formulations of the core task over the past years, now with the Corona crisis, is in a large-scale live scenario, which has provided the best experience base for future cooperation in a holistic manner around the needs of citizens.

The opening of the school for grades 0-5 is a further example of how cooperation between teachers and educators is given a completely new framework when many schools work with principles from the all-day school and many other forms of learning other than the classic 45 min classroom teaching. In connection with the opening of the school and day offer, new ideas have also been given in relation to new types of tasks and different organisation of the day. For example, several municipalities have hired extra hands to handle hand washing in day care institutions and have deployed 'festival guards' to help the children get started with the new school day.

Another example of a successful cross-cutting citizens' initiative by one of the municipalities is that a need for coordinated action was quickly met for especially vulnerable families during the coronavirus crisis, as stated by a municipal director,

“An overnight decision was made so that there is one phone number you can call. And everyone backs up because the purpose is indisputable.”‍

In addition, the municipality has experienced that the municipality's own psychologists from the children's area have made themselves available for cross-cutting crisis counseling for all professional groups, which the management had expected that they would have to buy externally. So another powerful example that many have stood up extraordinarily for each other.

Another concrete example of new multidisciplinary synergies was at a care center where a dementia consultant was on night duty to help with on-call coverage due to many repatriated employees with covid symptoms. There was a resident who couldn't sleep and the dementia consultant, who usually didn't have his walk at night at the care centre, found out it was about the resident being scared of his bed and with his professionalism put the resident to sleep.

One of the reasons why cross-cutting solutions have been successful, for example, is a well-functioning cooperation with the MED organisation and the professional organisations in some of the municipalities. As one municipal director states: “One of the things I'm really proud of is our collaboration with the professional organizations where we It creates flexibility and agility. We creates new solutions such as moving employees around and working at different times than they are used to. We have focused on integrity, volunteerism and work environment. Rights have come second. Here we have a task to succeed. We can only solve it if we have each other with us.”

In general, the municipalities agree that the many changes have been supported by a special community that the crisis has brought about, says one director:

‍“We have a strong team spirit, you are part of something. You are driven by that motivation and enthusiasm for the new.”

In particular, a municipality highlights the enthusiasm for the many everyday changes that the decentralized institutions have seized. For example, educators in daycare have recorded goodnight songs for the children and 130 teachers quickly signed up for an online course in digital homeschooling, in order to strengthen their skills in a time of crisis.

‍

Part 4: Collaborative relationships in health care

The crisis and collaborative relationships in health care

The development of cooperation between municipalities, general practice, hospitals and regions has over time proved to be a difficult terrain, with challenges, but also with great potential synergies and potentials. There is no doubt that the Corona crisis, according to the municipal leaders, has accelerated cooperation. This is again justified by the clear common task expressed by the health crisis. In the same way that municipalities have focused internally on solving the task rather than classical discussions about resources and professionalism, the experience has been that the cooperation between the actors in the close health care system has mostly done the same.

As one municipal director states:

“The health care reform we've talked about so much, it's sort of happening on its own in terms of accelerating cross-sectoral cooperation.”

In particular, it is pointed out that the great openness and communication about how municipalities and regions have felt challenged in the first weeks of the crisis has meant a lot for cooperation in the first time. The usual positioning and “struggle for resources” have been put aside rather than solving the task, which has been a liberating experience. As a municipal director puts it:

“The state also provides an important premise when money is not an issue.”

A director states: “The open and honest approach has made you want to help the party that has problems as best you can. We help each other across municipalities and regions — and a common spirit of community has emerged across the board. This may apply, for example, to beds and lack of protective equipment. The nature of the task means that we do not discuss who should pay for your or dat. It must come afterwards. We'll fix that later.”

At the same time, one of the municipalities has experienced that cooperation with the general practitioners and the local general practice has been characterised by the fact that the doctors have been more approachable and very flexible in changing their task solution. This has been demonstrated, among other things, by new forms of cooperation with the municipality regarding civic health, such as video consultations, home rehabilitation and dose dispensing. However, in general, there is still a great cultural difference between how the cooperation with local GPs and the specific hospitals is carried out.

As one boss puts it: “We shall not go back to the fact that the PLO has to have everything possible to be able to talk to us on a Skype connection. We could do digital meetings with our general practitioners. This could not have been done a few months ago. There is also much more of a gap in cross-sectoral cooperation. We reach out our hand. I can call in the director if I have a problem. There is actually being trade and people bending towards each other. And there is listening and action being taken to solve the problems. Roles, responsibilities and finances are in the background right now — as everyone is focused on the ball.”

It is also highlighted that meetings with the region's top management every week have strengthened the municipality's self-understanding. The perception that the work of the municipalities has been taken seriously is cited by the municipalities as an important factor in the efficiency shown so far. As one of the directors states:

‍“It feels like we are considered equal partners. It has been lifted up by the Corona crisis. Suddenly we can get data daily that we've been waiting for for 2 years.”

The municipalities are experiencing that solidarity and trust have been put to the test in a time of Corona — a test that in many ways has shown a positive outcome. In particular, the four municipalities feel that there is room for action and confidence in the restructuring of the task solution — and not least in the professionalism and professionalism of the municipal employees. It highlights the fact that previously excluded professional groups, such as educators, teachers, care and health workers, are now increasingly recognized as important professional groups.

Internally within the municipality, the corona crisis has strengthened cross-municipal cooperation, for example, around temporary places. As one boss states: “Cooperation around temporary places has been a new way of working, including home care and temporary visitors. We are experiencing a new flow in relation to our seats that we have not experienced before — and that we can use in the future.”

However, in the first weeks of the crisis, there has also been a battle for resources and protective equipment in the field of health, as one municipal director describes:

‍“Where it challenges us — it's when people are pressured. It's such a low-level battle for resources and protective equipment. The same effect is going on in terms of hoarding toilet paper”

Another major challenge has been ambiguity about testing strategy by the state and a lack of coordination of test scores by regions. As one boss puts it: “The test part has also been unclear. What exactly was the strategy? Couldn't they have a common contact person so you wouldn't have to call around every single doctor. When we have tested many citizens in a ward — we have called each doctor, rather than receiving word from the region.”

The role of the state in the national health crisis, in addition to being positively governing and leading, has also been characterized by a more negative bureaucratic 'automatic pilot' and a lack of coordination across boards, ministries and departments. The participating municipalities experience that during the first crisis period there was a very high level of governmental ambition in relation to reporting and classic bureaucratic procedures. As one director states: “We have boxed a lot with the notices centrally from. We needed to quickly shut down and set up contingencies. Only after that, KL and the ministries had the entire legal framework in place for the decisions that had been taken. It created noise at our crisis management meetings. And created a heavy bureaucratic process in which, on the back end of the many actions that had been taken, we had to ensure that we followed all regulations. All of a sudden, we came back to bureaucracy again. If we had entered the red scenario already there, we would not have had time to go back to the classic bureaucratic work.”

And a boss adds: “It has been hectic that there have been so many new messages coming in all the time from the state and KL. Once we've been through the announcements, then we should change direction. There has been pressure on. But I feel that everyone has taken part in the task. And we have broken down some of the barriers that set in such an organization as a municipality.”

At the same time, the municipalities have experienced that the Ministry of Health and the Elderly and the Department, as well as the four boards: the Danish Health Agency, the Danish Medicines Agency, the Agency for Patient Safety and the Serum Institute, have not coordinated well enough, which has been expressed in the form of conflicting statements. Finally, municipalities have experienced that state actors have not sufficiently involved municipalities in ensuring that communications to citizens and employees are at 'eye level', which has meant that some of the important communications have not been understandable to the end user.

KL is positively highlighted by many of the municipalities for having played an important role in coordinating the national health crisis, as KL has constructively helped to unravel the threads when confusing reports have emerged from the state authorities involved. As one municipal director puts it:”KL has currently been able to send out 66 elaborate emails in which they communicate the many policy areas and have been very agile. We see the depth of the crisis in these emails.”

The practical experience is, among other things:

• Strong experience base for the use of digital meetings and services, homework, as well as new forms of telephone setup and virtual consultations and preventive home visits.
• Cross-cutting cooperation among professional groups such as educators and nursing staff in nursing homes around the dining function and the easier care tasks, including teachers and educators in connection with emergency education in the reopened school from grades 0-5, as well as new forms of cooperation, including the social and elderly area, for example, regarding the handling of protective equipment in the cross-sectional Protective Services Team, effective training of new employees and new ways of working together to settle freedom and vacation.
• Cross-cutting health projects with steering groups that have looked at each other from completely different angles, which can strengthen the future cooperation relationships in the close health care sector, “if the battle for resources does not take over again.”
• Difficult in practice to activate free choice actors and private suppliers in the possible crisis tasks.
• Private companies have supported with recognition, for example, cake for everyone — and in some places the local business community has also wanted to contribute to the production of protective equipment.
• In many places, civil society has taken strong initiatives to coordinate assistance to the vulnerable in relation to shopping, walking the dog, etc. Here, the municipalities involved have recognized and motivated, but deliberately not taken over, the coordination of positive civil society engagement.

Managerial experience:

• Positive elements of direct management in the form of shorter chains of command, in addition to the widespread participatory consensus culture: “We can shift gears and be more efficient.” And at the same time: “We have also been good at leadership, where we have gone in front, set direction and at the same time retreated into the background.”. “We work with the balance of trusting the leaders and at the same time controlling the spread of infection that can explode in our heads”
• Ditch the automated pilot by starting by discussing the economic and professional barriers -- and instead put the holistic needs of the citizen at the center and use the resources that already exist.
• Work targeted and focused across municipalities, sectors and hierarchies around a common cause, pausing the usual roles and positions. For example, cooperation and relations between municipalities and directors in the field of health and welfare have also been strengthened. “Health care has become more important.”
• Continue to work on testing and experimenting, for example, in relation to using digital communication and technology in civic processes where citizens remain critical. As one leader puts it: “We have become much more efficient. We do small trader tests and fixes along the way. We haven't had time for anything else. We have implemented huge changes in the organization.”

Contributors

Many thanks to the 10 contributors that the article has been created in collaboration with:
‍

• Lisbeth Binderup, Municipal Director, Skanderborg Municipality
• Lone Vesterman Rasmussen, Director Skanderborg Municipality
• Martin Roed, Director of Glostrup Municipality
• Britt Bergstedt, Head of Centre Elderly and Health, Glostrup Municipality
• Søren S. Kjær, Municipal Director, Sorø Municipality
• Annette Homilius, Social and Health Manager in Sorø Municipality
• Pia M. Nyborg Hansen, Head of Health and Care, Sorø Municipality
• Mia Linda Møller, Head of the Health Centre, Sorø Municipality
• And municipal director and boss from an anonymous municipality