Abstract：
BACKGROUND: Previous research has identified some tensions that public organizations may encounter during crises. However, there remains a scarcity of research examining how public health care organizations effectively navigate these tensions to reconcile the diverse interests, needs, and demands from various stakeholders.
OBJECTIVE: The study seeks to shed light on the dynamics underlying the tensions experienced by public hospitals during the COVID-19 pandemic. It illustrates how different hospitals\' actors have navigated these tensions, identifying solutions and approaches that fostered collaborative endeavors among internal and external stakeholders.
METHODS: The study draws on qualitative analyses of 49 semistructured interviews and the notes from two focus groups involving key informants at one of the largest university hospitals in Italy. We also rely on the verbatim transcripts from meetings involving the members of the temporary emergency team constituting the taskforce.
RESULTS: The results highlight the tensions that emerged throughout the different waves of the COVID-19 pandemic and how various actors have managed them in a way to reconcile opposing forces while unleashing adaptability and creativity.
CONCLUSIONS: Hospital managers would benefit from developing a paradoxical mindset for crisis preparedness, allowing them to embrace existing tensions and devise creative solutions to favor resilience and change.
OBJECTIVE: The study seeks to shed light on the dynamics underlying the tensions experienced by public hospitals during the COVID-19 pandemic. It illustrates how different hospitals\' actors have navigated these tensions, identifying solutions and approaches that fostered collaborative endeavors among internal and external stakeholders.
METHODS: The study draws on qualitative analyses of 49 semistructured interviews and the notes from two focus groups involving key informants at one of the largest university hospitals in Italy. We also rely on the verbatim transcripts from meetings involving the members of the temporary emergency team constituting the taskforce.
RESULTS: The results highlight the tensions that emerged throughout the different waves of the COVID-19 pandemic and how various actors have managed them in a way to reconcile opposing forces while unleashing adaptability and creativity.
CONCLUSIONS: Hospital managers would benefit from developing a paradoxical mindset for crisis preparedness, allowing them to embrace existing tensions and devise creative solutions to favor resilience and change.
摘要：
背景：先前的研究已经确定了公共组织在危机期间可能遇到的一些紧张关系。然而,仍然缺乏研究公共医疗保健组织如何有效地应对这些紧张关系以调和不同利益的研究，需要,以及各种利益相关者的要求。
目的：这项研究旨在揭示公立医院在COVID-19大流行期间经历的紧张关系背后的动态。它说明了不同的医院行为者如何驾驭这些紧张局势，确定促进内部和外部利益相关者之间协作努力的解决方案和方法。
方法：该研究利用了49个半结构化访谈的定性分析以及来自两个焦点小组的笔记，这些焦点小组涉及意大利最大的大学医院之一的关键线人。我们还依赖组成工作队的临时紧急小组成员参加的会议的逐字记录。
结果：结果突出了在COVID-19大流行的不同浪潮中出现的紧张关系，以及各种行为者如何以调和对立力量的方式管理它们，同时释放适应性和创造力。
结论：医院管理者将受益于建立一种矛盾的危机准备心态，允许他们接受现有的紧张局势，并设计创造性的解决方案来支持韧性和变革。
目的：这项研究旨在揭示公立医院在COVID-19大流行期间经历的紧张关系背后的动态。它说明了不同的医院行为者如何驾驭这些紧张局势，确定促进内部和外部利益相关者之间协作努力的解决方案和方法。
方法：该研究利用了49个半结构化访谈的定性分析以及来自两个焦点小组的笔记，这些焦点小组涉及意大利最大的大学医院之一的关键线人。我们还依赖组成工作队的临时紧急小组成员参加的会议的逐字记录。
结果：结果突出了在COVID-19大流行的不同浪潮中出现的紧张关系，以及各种行为者如何以调和对立力量的方式管理它们，同时释放适应性和创造力。
结论：医院管理者将受益于建立一种矛盾的危机准备心态，允许他们接受现有的紧张局势，并设计创造性的解决方案来支持韧性和变革。
