Quantum Management of Hospital in the Post-COVID-19

The aim of this study is to present a management approach to transforming the deficiencies in crisis management during the pandemic period into a strong facet of businesses. In this research, phenomenology and grounded theory were adopted. The results of the study revealed five basic principles in the form of quantum management of hospital management: Infinity of possibilities, resilience to waves of uncertainty and making sense, the complementarity of diversity and complexity, significance of chaos and crisis, interactive outputs. These basic principles are under the influence of three basic factors based on medical, administrative, sharing-interaction.


Introduction
COVID-19 has had significant impacts on the healthcare industry [1][2][3][4]. The rate of transmission of the virus and the emergence of new variants have adversely affected doctors, nurses, caregivers, doctor's secretaries, and assistant staff in the context of psychology and health [5][6]. In addition to these negative effects, different side effects of vaccines on patients, fluctuations in the decrease and increase in the number of cases necessitated the development of a management method that will provide rapid adaptation to these variable situations in the administrative context of hospitals [7][8]. Hospitals continue to make serious and meaningful efforts to improve doctor-patient, staff-patient relations in their corporate management. Difficulties in implementing the vaccine to individuals in developing countries cause serious difficulties in the management of hospitals [9][10]. Problems in policies related to social security make this situation even more difficult. Trying to turn the negative effects of the pandemic into an opportunity, hackers access confidential information about patients and hospitals through cyberattacks and commit cyber fraud [11][12].
Hospitals, hospital staff, and patients are at risk for their personal data being stolen due to cyber attacks [13]. Hospital managers should identify and implement the necessary strategies in order to eliminate these risks. Cyber attacks can damage the gerontechnological infrastructure of hospitals. These harmful effects may hinder the treatment of the elderly and palliative patients [14][15]. On the other hand, technological devices used in the operating room and patient treatment units can be damaged due to these cyber attacks [16]. Such attacks have been added to the lack of infrastructure that emerged during the COVID-19 era [11][12][13][14][15][16]. Therefore, crisis management in hospitals has become necessary. The aim of this study is to present a management approach to transforming the deficiencies in crisis management during the pandemic period into a strong facet of businesses.
This management approach will bring new principles to the postpandemic management of businesses. The infinity of possibilities, waves of uncertainty, the complementarity of diversity and complexity, the significance of chaos and crisis and interactional outputs of the quantum approach were taken into account in the development of new management principles.
In accordance with the purpose of the research, the research question was determined as follows: What is the new management approach that emerged in Post-COVID-19 Hospital Management?
Which management principles benefit patients, doctors, staff, and stakeholders in Post-COVID-19 Hospital Management?
After these research questions, interviews were conducted with supervisors, human resources managers, and general managers of 11 hospitals from three provinces (Adana, Mersin, Osmaniye) in order to investigate hospital management. Three participants from each hospital determined by the pre-sampling method were included in the interviews. Interview questions are presented in Table 1. Some of the findings obtained from the conducted interviews required obtaining information from further samples.
For this reason, interviews were conducted with 12 managerial personnel of 4 hospitals operating in Antalya and Niğde through theoretical sampling. This was because the emerging heading/ dimension "Complementaryness of difference and complexity" about the quantum approach needed more evidence. In particular, the systemic and individual-based elements of the differences in hospital management were clarified with the theoretical sampling method. 2 What uncertainties has COVID-19 created in the context of hospital management? What strategies have you adopted to eliminate these uncertainties? 3 What steps has COVID-19 prompted you to take regarding differences and complex situations in the context of hospital management? 4 How did the chaos and crisis that emerged during the COVID-19 period affect hospital management? What did you do about it?
5 What kind of outputs did your interactions with patients, doctors, staff and stakeholders provide to hospital management during the CO-VID-19 period?

Ethical Rules and Implication
In the study, the participants were informed that the participation was carried out on a voluntary basis and that they could end answering the questions of the researcher at every stage of the interview. In addition, the participants were informed about the title, subject, purpose, outputs, limitations, and confidentiality of the study by means of a consent form. The personal data and business titles/brands of the participants were kept confidential.
During the coding, all information about the participants and hospitals was anonymized.

Coding Results
Coding in qualitative research consists of three stages: Open, axial, and selective [25][26][27]. At these stages, raw data is processed and data is separated with open coding, categories are associated with axial coding, and central and subcategories are revealed with selective coding [25][26][27]. During the coding in the research, it was determined that the categories were similar to the basic features of quantum philosophy. This determination was supported by theoretical memo-writing ( Table 2). The coding results revealed five basic dimensions: Infinity of possibilities, resilience to waves of uncertainty and making sense, the complementarity of diversity and complexity, significance of chaos and crisis, interactive outputs.
These dimensions were found to be related to the infinite system, centrifugal force, and fluctuations, twisting properties created by the gravitational force of the Quantum philosophy. For this reason, the findings were associated with the Quantum philosophy.

Dimensions Sample Expression Supporting expression
Infinity of possibilities "COVID-19 has shown us that all possibilities are possible.
Despite the current vaccines and advanced technology, we learned that we need to take precautions against possible risks in the treatment of infectious diseases." "We need to focus on the differences emerging in doctor-patient, hospital-stakeholder relations in the management of hospitals.
Differences are the endless factors that make us who we are, create our mission, and shape our vision. Cardiology, psychiatry, gynecology, and all other departments play a complementary role in the treatment of diseases." The significance of chaos and crisis "The pandemic has taught me to cope with difficulties in a time of crisis. The pandemic has created meaningful awareness on many issues such as the vaccination of patients, the methods followed in the diagnosis and treatment of chronic diseases, cooperation with health institutions and the state." "COVID 19 has caused a change and revolution in the management approach of our hospital. Patients' respect for healthcare workers and doctors increased. I can say that the pandemic provided an important meaning to the individuals who provide services to the health sector." Interactive outputs "The collaboration that emerged with the pandemic created an interaction-based synergy. We interacted for public health with some companies that we had relations with due to unfair competition before. This allowed us to expand our stakeholder network." "The basic rule in hospital management is to manage institutional and individual psychology well. This is possible by gaining positive momentum in interaction with actors such as patients, personnel, pharmaceutical representatives, companies selling medical drugs, tax offices, professional organizations, non-governmental organizations with whom we are in contact."

Theoretical Memo-Writing
Theoretical memo writing has an important function in revealing the theoretical structure [28][29]. This method is applied to determine whether the data obtained is sufficient for the development or construction of a theory and whether more evidence is needed [30]. In order to obtain more information about the strategy applied against the waves of the uncertainty of the pandemic in the questions asked to the hospital operators, interviews were conducted with 12 managers of 4 hospitals operating in Antalya and Niğde by means of theoretical sampling.