13

The objective of this article is twofold: to better understand the organizational decision-making processes of hospitals during the first year of the COVID-19 pandemic in order to deal with the crisis; and to verify how similar these processes are to those deployed by high reliability organizations (HROs). The results of this exploratory research carried out in four university hospitals show that the decision-making process manifests itself differently during three successive periods: when COVID-19 first appeared in France, the process was that of a Weberian bureaucracy; during the first wave until its end it became flexible and agile; and finally, with the second wave, it resumed its initial bureaucratic character. The last part highlights the contribution of HRO theory to management science and the management of French hospitals.