Continuity of operations over repeated crises. Case study of the biggest Ukrainian CRO

Abstract

Pharmaxi (hereinafter CRO) is a Ukrainian group of companies providing full service in clinical trials. At the beginning of the massive military Russian invasion of Ukraine on the 24^th of February 2022, it was the biggest CRO in Ukraine with 17 full-time employees and 8 contractors.

Founded in 2013, it has grown up increasingly while building resilience to repeated crises in Ukraine, sustaining continuity of operations. The company evolved through political instability during the Revolution of Dignity, the subsequent beginning of the Russian occupation of Crimea, the beginning of hybrid armed conflict in the Eastern part of Ukraine in 2014, and the COVID-2019 crisis. In the sixth month of the active Russian-Ukrainian war, the company continues business operations and is ready for further development.

This case study investigates the strategy and best practices for ensuring business stability through contingency, resilience, and recovery actions analysis, expert interviews with management, and the SWOT analysis of the study findings. In particular, the organisational continuity framework features financial policy, human resources management, organisational behaviour practices, internal communication, and diversification.

While investigating the case of company's continuity of operations, it appeared that the company had a crosscutting orientation on stability. The core domains ensuring resilient company's activity over repeated crises were the diversification, utilization tools for financial stability, distinct human capital management and design of operations.

Study's results might be relevant to small and middle-sized service companies.

1. Introduction

In general, the Ukrainian business development context is hindered by the Ukrainian fragile economy and persistent instability. Other particular issues are the small size of the internal market and limited access to financial resources. Nevertheless, promoting factors to launch a new company in Ukraine are a good taxation system for small companies, multiple high schools, and relatively easy access to educated, motivated and proactive personnel.

At the same time, modern Ukrainian business often faces repeated crises of diverse origins.

Pharmaxi LLC (hereinafter CRO) was founded in 2013 as a Ukrainian contract research organisation. It is a B2B (business to business) health-related company, providing clinical research services primarily to pharmaceutical and biotech companies. Initially, the company was focused on the domestic market and on non-interventional projects.

Thus, its operations were massively affected by the turmoil of the Revolution of Dignity (Euromaidan revolution), the annexation of the Crimea peninsula by Russia and the beginning of the hybrid armed conflict in the Eastern part of Ukraine. These events led to the danger of significant territory losses, provoked economic instability and reluctance of the principal pharmaceutical market players to launch any long-term investments, e.g., clinical trials. Therefore, the complex crisis in 2013–2014 disrupted CRO sales strategy and led to the need for a change of target market and refinancing by the co-owners.

From 2013 to 2014 to 2020, CRO grew to the biggest Ukrainian CRO with established liaisons and successfully executed projects with all major Ukrainian pharmaceutical companies, which put efforts into international market expansion.

Amidst the COVID-2019 crisis, CRO's operations could have been jeopardised by the global negative correlation between the number of COVID-19 cases and clinical trial activity. The decline of non-COVID-2019 trials with the maximum of −57.3% was observed between April 2019 and April 2020. However, the organisational capacity built from 2013 to early 2020 and released from non-COVID-2019 trials made it possible to undertake demanding COVID-2019 projects. Carrying out these projects allowed the company to keep full solvency, avoid personnel reduction, and gain repeated experience of operational continuity.

Since then, the company retains a wide portfolio of services encompassing medical writing, biostatistics, electronic data collection, data management, site management, medical monitoring, trial master file management, regulatory and IRB/EC submissions management etc. Wide portfolio of services and flexible pricing policy, consequently, potentially engendered the increasing diversity of the company's clients. From 2013 until 2022 CRO provides services to the big pharmaceutical companies, major medical device manufacturers, and small biotech startups.

The company is self-sustained financially, with no external or credit funding. No further financial information can be disclosed in this case study.

The most recent protracted country crisis commenced with the beginning of the massive Russian military invasion of Ukraine on 24^th of February 2022 and is ongoing. However, CRO has managed to bypass the closure of the business operations, insolvency, and disintegration of the team. On the contrary, during 5 months within the biggest war in Europe since World War II, CRO scaled up to a Ukrainian-Polish group of companies providing full service in clinical trials, extended the range of services, and didn't stop recruitment.

From February to July 2022, CRO consists of executive departments, support departments, and top management. Activities of execution departments, namely Biometrics, Clinical Operations, Data Management/IT, are supported by the Quality Assurance Manager, Business Development, and Financial Departments under the overall supervision of the C-level management. C-level managers - CEO and COO - are concurrently co-founders and co-owners of CRO.

Organisational culture, according to the Competing Values Framework (CVF), is prominent adhocracy [1], harnessed by espoused values, namely truthfulness, frankness, mutual respect, trust, right to err, common sense, and flexibility.

Despite the fact that 17 full-time employees and 8 contractors are distributed between departments, the organisational structure is agile and personnel may be redistributed to the project groups within a department or deployed to an interdepartmental functional group/task force. Since the first COVID-19-related lockdown in Ukraine, the operations of the company have been decentralised with staff predominantly working from home, with scheduled visits to office in Kyiv and company gatherings.

The company encourages discovering lessons learned and best practices. Moreover, potential relevance of CRO's experience to small and middle-sized service companies, comprehensive internal research was conducted.

The global aim of the research is deriving the organisational strategies set successfully employed for organisational continuity over repeated crises in Ukraine. This paper focuses on the description of strategies adopted, studying changes in organisational strategy domains employed during the Russian invasion of Ukraine, and definition of the organisational strategy domains ensuring resilient activity of the company over repeated crises.

The paper presents the phenomenon of CRO's organisational sustainability in the aggravated circumstances of the Ukrainian economy through:

• ●an action list annotated and complemented the list with organisational continuity strategies,
• ●insights from the internal expert interviews,
• ●complete matrix of organisational strategy domains,
• ●results of the SWOT-analysis of the matrix of organisational strategy domains.

2. Material and methods

Object: the biggest local Ukrainian small CRO.

Subject: organisational practices over repeated crises, namely Revolution of Dignity (provoked by attempts of the pro-Russian authorities to retreat from the declared integration to the European Community), COVID-19 pandemic, Russian invasion of Ukraine.

Purpose: to derive the set of organisational strategies successfully employed for organisational continuity by the small contract research organisation over repeated crises in Ukraine.

2.1. Objectives

• 1.To describe which strategies were adopted by the company to ensure continuity of operations of the company in crisis conditions, considering previous experience (Revolution of Dignity, COVID-19 pandemic, Russian invasion of Ukraine).
• 2.To investigate the changes in organisational strategy domains occurred during the 5 months of Russian invasion of Ukraine, namely in operations, executive decisions, communication policy, and human capital policy.
• 3.To determine the organisational strategy domains ensuring resilient activity of the company over repeated crises.

Data generation: on 1st step the generation of a list of organisational strategies pertinent to organisational continuity. The Head of Business Development Department prepared the list of emergency actions performed starting from 24^th of February 2022 till the end of June. The CEO annotated and complemented the list with organisational continuity strategies, which were implemented over repeated crises and led to the successful implementation of the emergency actions list.

Data analysis: 1st step the obtained list was analysed by the CEO and structured to the information matrix of Business Continuity Planning into three domains, namely resilience, recovery, and contingency by 31st of July.

Based on this data the guide for expert interviews with key managerial staff (except the first author - Head of Biometrics) was created.

Data generation: on the 2nd step four interlocutors: CEO, COO, Head of Business Development Department, Head of Data Management/IT Department were interviewed in the first decade of August. Expert interviews [2] were conducted by experienced moderator in line with the interview guide (Appendix A) that wasn't employed by the company during the 5 months of Russian invasion of Ukraine. Interviews were conducted and transcribed verbatim in Ukrainian.

Data analysis: 2nd step data retrieved from expert interviews were structured to the information matrix of Business Continuity Planning into three domains, namely resilience, recovery, and contingency. Received information was processed by substantive analysis and the main points are presented in the article. New information obtained was merged with the list of organisational strategies and transformed into the matrix of organisational strategy domains.

Data analysis: 3rd step – SWOT analysis [3] of the matrix of organisational strategy domains by CEO facilitated by the first author (Head of Biometrics), generation of recommendations.

2.2. Limitations

Methodologically, the study presented cannot be generalised.

Data collection limitations: No financial information can be disclosed in the study. As the expert interviews were used, the Hawthorne effect, errors of memory and judgement might influence the study results. Being the first author, the Head of Biometrics was not interviewed during the series of expert interviews and may be biased as a participant observer.

Data analysis limitations: the researcher bias might be a limitation to the study results interpretation.

Disclosure: The first author and moderator had been employed by CRO during the case study period.

3. Action list annotated with organisation strategies

Please see Table 1.

Table 1.

Action list annotated with organisation strategies.

Action	Resilience	Contingency	Recovery	Comments
Preventive actions	X			Preventive actions were intended to increase long-term sustainability of the company. They were performed to build the company's resilience to the crises of the unpredictable nature.
Diversified portfolio	X			CRO implemented diverse services in the clinical trial market. It gives more chances to identify proper services which are requested in a volatile market, but delivering diverse services is time- and cost-consuming.
Export-oriented promotion and business development	X			Local Ukrainian market was always small and fragile. The market research was performed and analysed to identify the most promising regions and countries, where CRO services could be requested.
Continuous learning and personal involvement of the top management into development and implementation of the export-oriented strategy	X			The most valuable information was obtained while learning a course by the Ukrainian Export Promotion Office, funded by the Ukrainian government with the Canadian embassy.
Diversified geography of the potential clients	X			CRO implemented tools to reach Northern American companies, Europe, Israel, and South Korea.
Networking	X			CRO established and maintained CRO Partnership Network. It was an initiative to merge the capacity of the multiple small and medium CROs globally.
				This Network is free for all participants. The idea is to leverage the potential of the geographically distributed community creating a basis for collaboration into multiple temporary alliances assembled to perform a project.
				In the beginning of 2022 CRO Network encompassed 81 companies.
Collaborations	X			CRO was involved in long-term collaborations with several European companies.
				Cooperation with German MedTech consulting companies led to common projects for the medical devices and in vitro devices sector. The best synergy was achieved when services provided by partnering companies were complementary.
Long-lasting financial stability and savings	X			The top-management realised that crises were always unexpected and unpredictable. The combination of the reduced revenue and additional investments to transform business and adapt it to a new reality was fatal for many companies.
				The rule implemented in CRO was that available financial resources should cover at least 6 months' salary to sustain the team and to endure the required transformations.
Employment of motivated people only	X			Exceptional attention is given to the hiring process. Soft skills are prioritised over hard skills in recruitment. Motivation, ability to learn, and other soft skills are more valuable than expertise for the sustainability of the company.
The culture of the continuous improvement	X			In CRO a process that motivates staff to constantly learn above the current area of responsibility.
Wide skill set of every employee	X			The efficient company structure was built on the involvement of the same person in different projects.
				Motivated and continuously learning people were financially incentivized to expand their area of expertise and to build expertise in another.
				Therefore, a relatively small team was built to manage different projects, maintaining a diversified portfolio. The team, consequently, was ready for a crisis and was equipped to adjust to a new reality.
Cross-functional teams	X			Some projects cannot be efficiently managed within one department, so the cross-functional teams created in CRO were assembled from the people of the different departments. The team was managed by one leader in flat organisational structure.
Once war begin
3 key messages to all employees		X		Many fears were at the beginning of the war and the company tried to eliminate some of them.
1. CRO will fight for survival		X		Top management invited all staff to the videoconference. The CEO spoke openly. The first message was about our future. The CEO clearly said that war was not the end, and “we will do everything to continue business operations”. It was a promise of a stable future in crisis.
2. Everyone will get full salary within at least three months		X		The second message was about personal financial stability. The company took responsibility to pay salaries no matter what. Everyone had to know that one would not lose their livelihood for several months.
3. No one will be fired		X		The third message was aimed at ensuring psychological stability. The guarantee of a workplace was important for everyone.
The priority now is everyone's safety		X		The priority of personal safety over performance was clearly communicated. At least during the first week, management disregarded projects, compared to the well-being of the personnel.
Regular and direct communication with employees		X		From the first day of the war, the top-management organised daily online meetings at 9 a.m.
				The first goal was to understand if everyone was alive and safe, who could participate and from where, not to have updates on working tasks.
				The second goal was to demonstrate that CRO existed, and the company was united as much could be changed or destroyed within the following 24 h.
				The regularity of meetings gave confidence to the staff that the company was still operational.
Tracking table to understand available resources and mental ability to work		X		After one week of war a spreadsheet to collect information about availability of the Internet connection, computers, and readiness to make working tasks was created.
				Based on the information collected the management could plan, which tasks and projects could be prioritised and dealt with.
				As the top-management and staff admitted then, working tasks shifted attention from the overwhelming news and maintained mental health.
Future communicated to employees		X		The Business Development Department and top management worked late after working hours during the first month of war. For instance, the CEO personally performed up to 90 video conferences with potential clients and partners a month.
				Some potential projects and contracts were discussed both with external partners and employees. It was extremely important to delineate the perspective amidst the devastating crisis.
Linkedin, Partnership Network, and collaborations become a factor of our survival		X		Previous connections and considerable support from European and American colleagues were vital to keep financing of ongoing projects, launching new projects and maintaining the stability of the company.
New services launched			X	Due to the flexibility and ability to learn fast, CRO was able to run new services.
				For example, statistical programming and clinical evaluation of medical devices fitted the portfolio, but they required additional efforts and self-motivation to learn while the war continued.
CRO Poland registered			X	The services like data management, statistics, and medical writing could be performed remotely and CRO could sell them continuously.
				Conversely, the site-related clinical operations stopped as Sponsors didn't take a risk to finance several clinical trials in Ukraine. Consequently, the clinical trial management promotion continued under newly registered CRO in Poland with a local team, whose creation was facilitated by trusted local partners.
				The new legal entity in the EU might be a new CRO development milestone as many negotiations were devoted to potential clinical trials in Poland during the period of war.
Ukraine still on track			X	Ukrainian Armed Forces defended the sovereignty of Ukraine, which remained an independent country. 5 months of the war passed, and the line of contact moved to 500 Km away from Kyiv, so central and western parts of Ukraine got back to normal economic activity.
				The negotiations about two new potential projects in Ukraine started.
				The successful preservation of the company and its successful transformation allowed employees to help the Ukrainian army and volunteer projects in support of the country's defence both individually and in a corporate format.
				CRO top management believed the clinical trials industry in Ukraine would prosper after the day of victory of independent Ukraine.

4. Insights from expert interviews

In this section several outstanding insights from expert interviews are demonstrated apart from quotes provided in the Information matrix of Business Continuity Planning. The insights selected for this chapter were either shared by all interviewees (CEO, COO, Head of Business Development Department, Head of Data Management/IT Department) or provided solid and relevant information for the context.

Firstly, founding the company amid the major crisis, political and social turmoil constituted an overall managerial mindset. In CRO the way of thinking is strongly oriented towards the company's stability and the necessity for cross-cutting organisational flexibility. Consequently, enduring the repeated crises and undergoing the subsequent crisis (post-traumatic) transformation originate in capacity building in preparation for business continuity challenges. This preparation is, in turn, based on the explicit and implicit strategies of the company's management.

Secondly, the managerial decisions executed during the preceding crisis and maintained further might serve as preparatory measure amidst the following crisis.

Two prominent examples pertaining this statement are modification of the work format and reorientation to the external markets.

Modification of work format, namely decentralisation of operations with home-based work visiting the office in Kyiv and company gatherings, happened with the COVID-2019 lockdown in March 2020. Almost 2 years of experience managing a decentralised team enabled straightforward redistribution of the key human capital assets. Previous experience allowed relatively smooth transition into the fully remote format. Additionally, fully remote work triggered sharing of the remotely done services between the teams to which these services were inherent, and teams, to which these services were alternative to their usual tasks.

Emphasis put on work that can be done remotely led to the expansion of the range of services. Moreover, the involvement of field staff to remote activities allowed to avoid the personnel reduction. Nevertheless, effective involvement of all team members strongly required the considerable retraining of the employees.

Mainstreaming the reorientation to the external markets (European Union, USA) had been carried out since the first crisis in 2013–2014. Every subsequent crisis reinforced the need for international representation and organisational networking for strengthening CRO's position in the global market. This domain was covered, on the one hand, with the creation and maintenance of CRO Partnership Network. CRO Partnership Network is a system of connections between small and middle-sized clinical research organisations for sharing capacities, projects, and expertise. On the other hand, communication and networking strategy was fulfilled through active participation in industry-specific conferences. However, these strategies could have been jeopardised by the full-scale war, especially activities, which require travelling.

Thirdly, the need to execute the communications and sales strategy required the creation of the Business Development Department to bolster the respective actions by top management. Correspondingly, the Business Development Department underwent the most change under the aggravated circumstances of Russian invasion of Ukraine. Concerning the communication policy, new strategies e.g., outreach campaigns and posting in social media were used to inform the business actors about the devastating impact of the war in Ukraine to the state, its citizens, and the clinical trials industry. The probable adverse implications of continuous support of clinical trials in the Russian Federation were outlined in the same messages. Moreover, the critical need for the Business Development performance optimisation instilled a definite outline of the company's future marketing strategy. Marketing strategy was narrowed down to the specialisation in the therapeutic sphere and in services provided remotely. However, these limitations did not imply the restriction on the incoming request, which are processed by the support departments and performed by the execution departments in a regular mode. Concurrently, to lower potential risks for the site-related and regulatory affairs services, the separate limited liability company CRO was established in Poland in April 2022 along with recruitment of local Polish staff. Thus, CRO became a Ukrainian and Polish group of companies providing services in Ukraine and the European Union.

Fourthly, becoming a group of companies, redistribution of personnel and sales efforts between markets and services triggered the need for a rigorous management accounting. The obligation to prevent any cash gap provoked implementation of instruments for quantifying efficiency of staff's and contactors' work, the Sponsors' and projects' accrual.

Finally, throughout the repeated crises the company's top management remained the principal decision-making centre. However, the top management willingly accepted the input of middle management (heads of departments) on the company's strategy, position, and capacity. The company's values (truthfulness, frankness, mutual respect, trust, right to err, common sense, flexibility) and the position of the top management supported the team and helped to determine the points of the company's stability, thus facilitating the continuity of CRO's operations.

5. Information matrix of Business Continuity Planning

Please see Table 2.

Table 2.

Information matrix of Business Continuity Planning.

Phenomenon/Action (eng)	Positive/Negative	Area of business	Timing	Domain	Quotation (eng)
The company's general readiness for war	Positive	Managerial decisions	Before war	Resilience	"In my opinion, the company was ready. And this is not an accident … We did a whole bunch of preparatory things in order to build such nonspecific resistance, in medical terms. That is, the immune system does not know what it will encounter, but there are mechanisms of nonspecific resistance. Therefore, by analogy, I, as a doctor, built resistance mechanisms at the company level. And many of these preparatory actions worked. And I will even say that if there was no such preparation, the company would not have survived … a large percentage of companies could not withstand this combination of factors, which led to a loss of income and the inability to pay salaries … " CEO
					" … we had plans for a certain period of adaptation to work in nonstandard conditions … shifting a focus, which would allow to adapt to the environment that is changing" COO
					"I believe that no one would be ready for such a crisis. But the company already has experience in how to act and how to adapt to crisis situations, as was the case with COVID. Therefore, there was already some experience and a vision of how to get through this, how to adapt and not to lose customers, not to lose work, maintain workload and keep the company afloat and support employees" HDМ
					" … the previous covid crisis played a big role in this, which taught us how to work remotely, which taught and gave understanding to the management, first of all, how to expand the range of services in order not to be tied to one and local thing … " НBD
Geographical diversification – entry into the international market, expansion of offers for different markets	Positive	Managerial decisions	Before war	Resilience	"I always understood that the Ukrainian market is not a market where a company from our field can develop and exist stably. That is, clinical research at some point became obvious that it is not about Ukraine. That this is Europe, this is America, that the markets are there, the customer is there, and so on. I probably spent five years trying to understand how to reach a Western client, how to build a network, what tools to use, money was also invested in this, and the relevant people were engaged and money was spent on conferences and exhibitions of foreign countries to certain networking events, so that, well, that is … We even studied at the Export Promotion Office, which is a program financed by the state, so … In order to understand, and how to do it, this export promotion. How to sell services abroad. And over time, this bunch of preparatory actions and so on, it led to the fact that we diversified geographically, we stopped being 100% dependent on the Ukrainian customer" CEO
Diversification of the portfolio - a wide range of services, willingness to learn new things (statistical programing), offering services at all stages of clinical trials	Positive	Managerial decisions	Before war	Resilience	"We constantly expanded the sphere of competences. And this portfolio is currently expanding. That is, the company has existed for almost 9 years, and for 9 years we have been expanding the portfolio of products we work with. We worked with medical devices, not only with the pharmacy. We did not say that medical devices "are not for us, we do not know how, do not even come to us … " A food supplement - we studied food supplements, stem cells - give us stem cells … Interventional study? - Let's go. Non-interventional study? - Sure. Postmarketing? - Okay … it allowed us to survive the COVID, because some services were in demand, others fell off. During the war, a completely different composition. Those that were in demand during COVID are not needed, as there are full-scale clinical trials, we stopped, that's it, zero. There is … And related services, they are allowed to earn money, sign contracts, refocus on new services and so on … " CEO
					"Diversification of services, i.e. we did not focus on any specific areas before, such as, for example, we sell only the EDC system and configure it and that's all, this is our main responsibility and our main specialisation. On the one hand, it may have been more difficult for us as performers, when we have to be responsible for a wide range of activities, adapt to different requirements and different requests. But on the other hand, it turned out to be a plus for the company. Because now, if in the current conditions the demand for, for example, services from the EDC system decreases, we can cover all this with data management services … " HDM
Approach to personnel selection – motivated personnel with extensive expertise and/or willingness to learn new competencies, adaptability to new requests	Positive	Managerial decisions/Communication policy	Before war	Resilience	" … when we recruit staff, we are focused not on ones who are already super experts, know everything, can come. and start performing. And we always focus on those people who are young, who have a medical or biological background, we spend tons of time and money to teach them, yes … But we select internally motivated people, and those who like to study. And this gives us flexibility at the moment when, in addition to these services, we need to learn a new examination, or a new guideline or standard, and so on. That is, this is a person who studied with us for 4 years, they will also study for the 5th year" CEO
					"As for some work tasks, there were no changes here. Because before that we worked with a wide range of tasks. That is, until now we have not focused on any separate direction and on a limited range of tasks. That is, there were a lot of diverse requests even before the start of the war, to which we quite easily adapted and performed the work. After the start of the war, we also had to adjust, adapt to new tasks for us, a new format of services and, in principle, we cope well with this." HDM
Financial cushion – a salary fund for 6 months, a cushion for paying for the services of contractors and partners	Positive	Financial stability	Before war	Resilience	"We realised at some point that we need to have a good surplus on the accounts so that if suddenly everything stops in some kind of crisis, we could live for a while without income at all. And by analogy with the reserves of the National Bank, that is, the reserves of the National Bank must cover 6 months of critical imports. Accordingly, I understood that it is necessary to have a surplus for at least 6 months of the entire salary fund for the CRO team. We worked on it, we didn't spend money on any super celebrations, we didn't spend money on super renovations in the office, we didn't rent an office on Khreschatyk (central street in Kyiv, the capital city of Ukraine, author's note), although there was money and so on … That is, we were careful about the expense part, each time we were thinking, whether to make this investment, this purchase, and so on and so forth. And that's why we entered the crisis not with debts, as sometimes happens, but we entered the crisis with a good state of financial accounts'' CEO
					"We have used certain mechanisms to optimise our costs. And due to this, we even managed to increase the volume of working capital, which we need to fulfil our obligations. That is, we can absolutely safely ensure our commitments to investigators, to providers, to our partners who are involved - this is on the one hand. On the other hand, we can absolutely safely ensure the fulfilment of our commitments to the employees. During this time, we were able to conduct one so-called quarterly evaluation of personal development and evaluation of the efficiency of employees, according to the results of which no one was definitely punished there with a decrease in wages, and some, I think, even a large part even received additional funds in the form of bonuses, allowances and additional payments" COO
Industry networking - CRO Partnership Network - an association of companies operating and providing versatile services in the field of clinical trials	Positive	Communication policy/Managerial decisions	Before war	Resilience	"CRO Partnership Network it is an initiative in which I personally spent hundreds and hundreds of hours, which is built on such a win-win ideology, when small companies from our field, as CROs, we united them under one umbrella - CRO Partnership Network, and we can carry out together projects of different levels and scopes … Without an additional search for contractors, we can cover more than 20 countries … an hour ago we discussed a project for 12 countries" CEO
Transition to a completely remote format - providing employees with tools for work, providing a digital document management system	Positive	Managerial decisions/Financial stability	Before war	Resilience	"The changes are, accordingly, geographical, that is, partly people left the borders of Ukraine. We had to establish new methods of work. Although it was not difficult in principle, because during COVID we adapted to remote cooperation within the company and this helped us to adapt to the fact that in the first 2 months of our work, no one even came to the office." CEO
					"We have been working in such a mixed format for two years, maybe more, before the war we sometimes came to the office as needed, but most of the time everyone worked remotely at home. That is, since the beginning of the war, we did not need to adapt to a new format, so we worked in the same format. For some employees, the locations in which they work have changed only a little." HDM
The representative office of the company in the sales market (EU) - a legal entity in Poland	Positive	Managerial decisions/Communication policy	Before war/During the war/In the future	Resilience	"CRO Poland is a legal representative of the EU. I once dreamed about it. I thought it was difficult. We have a legal entity in Poland, with a bank account, address, etc. That is, CRO has become a company that conducts its activities in the European Union. This is also a change, a certain sprout that can grow into a strategic direction," CEO
					"And again, reopening in Poland … Will it justify itself? Well, obviously, yes. Because the interaction at the level of signing contracts has already started. That is, there are clients who started, who initially signed contracts with us and issued invoices from Ukrainian legal entities. Now they completely calmly switched to paying for these services to the Polish grouping. So … and this also adds such an element of stability … It is difficult to think about any global changes, and among them, including the full-scope launch of our projects with the participation of our Polish component, where the Polish regulator will be involved, the Polish insurer, the Polish local depot Polish sites, payments, examinations, notaries, such full-scope machine and including our line employees will be involved, some of whom are studying the Polish language for this, and we have contacts with our providers or colleagues, contractors or subcontractors, to whom we can turn in case we need some expert support" COO
Reliable and trusting relations with sponsors and their support in the future	Positive	Communication policy	Before war/In the future	Resilience	"For me, it is very important that the maintenance of relations with our clients is not purely commercial in nature, long-term partnership relations are possible and they are formed when contracts and projects are the result of interaction and maintenance of relations. That is, we must demonstrate and try to find rational solutions for our clients in such places, where perhaps they are not even looking … Well, for me, it is very important, again, to maintain relations with our providers and partners, contractors. Because the effectiveness of the final product depends very much on which of the experts is next to you and how effectively they perform their role. This applies to laboratories, distributors, transport companies, local depots and others, everyone else. And here it is very important to build a relationship with them in such a way that they clearly understand what we expect from them, that they understand the criteria for evaluating their work and efficiency, that they understand that we can be relied on as a specific customer. Therefore, if such an element is the formation of reliable relations with those on whom you also depend." COO
					"We have partners with whom we work constantly and have built such contacts and interaction with clients who come constantly, on a regular basis, apply and we cooperate with them. Due to the fact that these are such defaulting clients, it helped to preserve financial assets." HBD
The quality management system is an important component of qualification for sponsors, although it does not bring money in itself, but is an item of expenses	Positive	Managerial decisions	Before war	Resilience	In my opinion, the quality management system is quite effective. Such a process, which integrates different departments, different processes, different approaches, formalises it in the form of certain documents. A person who is engaged in the integration of these moments has a very high level of competence, this is one, loyalty, this is two, proactivity - three, that is, they proactively offer some solutions and at the same time constantly learn. That is, they share their experience on the one hand, on the other hand, they learn and share some things they acquire. And accordingly, we have a good situation related to the potential risk of some audits or inspections … Well, if there is some temptation to save on a department or on a field of activity that does not directly bring money. That is, we do not sell quality management as a service, we do not conduct audits, we do not develop a quality management system or standard operating procedures or policies at someone's order. And you can't seem to get money for it. But this system, its support, constantly consumes some resources. And it turns out that you are spending money and resources, you cannot invoice it, but the absence of this component does not give you the opportunity to pass the qualification and move on to signing contracts and implementing projects. So this is also a confirmation that, apparently, these are the right things and there is absolutely no need to change anything … " COO
Cancelling projects that were scheduled to start soon or that were already in the process of implementation	Negative	Managerial decisions	During the war	Contingency	" … several projects that had started stopped and they could not be resumed. That is, they would go and bring money, employees would be busy and everything would be fine. But because of the war, the Sponsor said they recalled everything" CEO
Loss of projects that were at the stage of contracting	Negative	Managerial decisions	During the war	Contingency	"We didn't sign a bunch of contracts that were already about to be signed and they didn't start because the Sponsor couldn't spend money on a clinical trial in a country at war … huge risks and so on." CEO
Curtailment of the development and modification of the electronic data collection system due to the employee's entry into the ranks of the Ukrainian Armed Forces	Negative	Operational activity	During the war	Contingency	" … after the start of the war, we had to put on hold the development of the electronic collection system for many reasons, one of which is that our developer is now defending our homeland in the ranks of the Armed Forces." HDM
Review of feasibility and profitability of work with sponsors	Positive	Operational activity	During the war	Recovery	"It is easier for us to keep it simple now and to have underloaded employees, at some point to use them in those projects where there is higher efficiency, productivity and higher profitability of the business, a normal kind, than to load them endlessly … This (narrowing the portfolio of customers, author's note) must also happen from time to time." COO
The advantages of working with Ukraine in terms of conducting clinical research are the high interest of patients, the willingness of doctors to work for less money due to the decrease in the number of clinical trials on the territory of Ukraine	Positive	Communication policy	During the war	Contingency	"Let's say, there are some projects that have recovered, and even one project has recovered at a faster rate than before the war. That is, there were more patients, doctors became more involved in research, recruitment started better, and so on and so forth. That is, there is even such a dynamic. Conditionally, the one who dared to continue further, won. Because there are not so many studies left in Ukraine, and the patients accordingly came to one study … now two companies are considering doing a clinical trial in Ukraine, because there are huge advantages - there is an advantage of the speed of approval of clinical research materials, that is, for COVID, you can initiate research in 7 days and get approval from the regulatory body. And in Poland it is 100 days. That is, there is a difference between 7 and 100. Further, the fee is now lower for the investigators. Because now they want to earn at least something. There are no other studies. That is, it is economically more profitable, it is much faster in terms of regulatory procedures, and therefore, those companies that consider these risks as acceptable, they are now communicating with us and saying: "Well, make a quote for (trial in, author's note) Ukraine" CEO
Daily team calls as a point of support, feeling of team unity, psychological support	Positive	Operational activity	During the war	Recovery	"The first thing we did, in the first days of the war, we made daily calls to all employees. That is, we were the first to say that you are allowed not to work, but to take care of your own security instead … Then we made daily calls at 9:00 a.m. because the whole company was in Zoom and again we didn't talk about work. "Where are you, how are you, alive, not alive, how are you doing?", this, that and the other … That is, the first week or two the conversation was about people, not about projects … and the logic was that war is instability, and my task was to give people stable support" CEO
					"The first day of the war and the first week there were morning meetings for all employees. It was more so that there would be no panic, in order to save the team and it was Yuri's (CEO's, author's note) initiative" HBD
Full salary guarantee and employment guarantee for 3 months	Positive	Financial stability	During the war	Recovery	" … on the first day of the war I summoned everyone and said that for the first three months everyone would receive 100% of salary regardless of anything, whether they were working or not working, where they were, if there were projects, if there were no projects, everyone would receive a salary for exactly 3 months. And I kept my word, everyone received 3 months' salary … I said on the first day: "No one will be fired for the first three months, everyone is getting paid no matter what, and now take care of your own safety." These are the first such stable things that I declared and that the company fulfilled … " CEO
Formation of working groups, retraining of employees, which helps to avoid staff reduction and allows to attract team members who cannot perform their main duties	Positive	Operational activity	During the war	Recovery	"Clinical Operations is also currently underloaded … we have temporarily transferred people from Clinical Operations to help the Biometrics department and they are also working there. There are still not as many clinical studies as there were. And that allows us to do more medical writing product, load people from Clinical Operations, get money to pay their salaries" CEO
					" … that's what I would call the formation of working groups, and a working group is nothing more than a project group, yes, but outside the boundaries of Clinical Operations (department, author's note). Previously, our project groups were built only to perform tasks of Clinical Operations (department, author's note). Now they have already been formed for certain Biometrics tasks. So, project groups, they are interdepartmental. There may be a full-time employee from Biometrics, a full-time employee from Clinical Operations, a full-time employee from Data Management, all of them performing different functions there, that is … Well, for the most part, it now falls entirely on Biometrics … responsible for the quality of the final product." COO
Increasing the share of services that can be performed remotely (medical writing, data management, statistical programming) and developing the team's competencies for the implementation of services	Positive	Managerial decisions	During the war/In the future	Recovery/Resilience	"In medical writing, we understood a new sector, we entered a new field of services, and it's cool. Then it is a growth point. Further, probably, it can grow from 4 people, and there can be 40 people who are only engaged in this. Therefore, this is not just a short-term, temporary move, which will then fall off and we will go back. This is a step forward and a sprout in a new direction … We do statistical programming now, which we have never done, which is in great demand, which we did not know how to do, but now we already know how. So, this is a new sector of services in the Data Management department, which is profitable, which is quite in demand, and which can also be developed" CEO
					"If we talk about a new format of tasks, new types of tasks, first, among the novelties are requests for R-programming of some custom reports according to customer requirements. We have not worked with this before, we had some minimal experience of working with the R language, but we have not used it fully in practice until now." HDM
					" … many services that are not tied locally. In fact, in Ukraine, we first lost medical monitoring, we lost local submission to authorities, logistic services, but we did not lose data management, we did not lose medical writing, we did not lose services related to the development of specific documents. And in principle, some services remained afloat … to lean on during a difficult period … We focused on the departments that do work remotely and we distributed people from the operations department who could not do their work remotely to those departments. And for the first ten days, the entire company worked in Business Development … In other words, all efforts were made to increase the network of clients … " HBD
Communication with sponsors to ensure communication regarding current and potential projects	Positive	Communication policy	During the war	Recovery	"In the first month, I had 92 calls only from abroad, not including internal ones. These were continuous communications during the first or second months, just non-stop. And I had to contact the Sponsors, who were scared and said: "That's it, we're stopping everything." And I had to say: "No, don't worry. We'll figure it out here now. We'll tell you how ready the doctors are, are they in place, how far they've travelled, are they ready to continue, whether the documents have been preserved, etc." That is, I had to communicate with all the available sponsors to keep what I had. I had to communicate externally through LinkedIn and say: "Friends, CRO is working, looking for work. We don't need humanitarian aid and charity, give us work." CEO
					"We managed to interact with the main customers and demonstrate our involvement and readiness to solve customer issues globally, even in crisis situations, when the question arose in general, whether Ukraine exists there or not, whether the company exists or not exists whether you work or not … And when we said: "Yes, Ukraine exists. Yes, Ukraine is resisting. Yes, Ukraine will not surrender. Yes, the company continues to exist, works and we have established processes for remote performance of tasks … " They didn't say: "Yes? Well, thank God if you are, let's quickly wrap everything up and goodbye." But they asked: "Well, how can we help you in this situation?" And we say: "Well, we don't really need personal help. The only thing we ask you now - not to cancel the projects, not to take them away from Ukraine. And we will adapt over a certain period of time, make up for certain delays … oh … well, as a backup, additional opportunities, we say: "Come on, there is an opportunity to attract Polish part of our business, yes, Polish territory, Polish sites, and there we will be able to compensate for the losses that occurred as a result of the loss of the territory, respectively, of certain sites … " COO
					" … we decided to call most of them or ask them for a meeting in order to say, first of all, that we continue to work, that we are preparing an action plan for how to save the project and how to continue the project in Ukraine in the event of the client's refusal, that we have the opportunity to move the project to Poland." HBD
Communication with new clients and new communication rules - communication trackers to increase the effectiveness of communication	Positive	Communication policy	During the war	Recovery	"And the first thing that was done from such innovations was that we started to keep communications trackers. That is, we started monitoring every line of communications. From the first letter to some actions. That is, we tracked, and we have a follow-up system in three days, in 7 days, and in 10 days, and when we postpone communication for a month. That is, we have such a system, it appeared natively, a system of conducting active communications. We did not have this before the war. And because now there are a lot of contacts … " HBD
Development of the business development department as a separate department with specific tasks to perform	Positive	Managerial decisions	Before war/During the war	Resilience	" … then two such important events took place in the framework of structuring the company - that is, the formation of a full-fledged, independent department for business development, for interaction with potential customers, for sales abroad - this is the Business Development Department, which before that was represented mostly by such personalities, yes, or functional staff units such as the CEO, once, and the Business Development manager, yes … And in the last month, the department, firstly, an additional staff unit appeared there, secondly, it fully functioned as a separate system structure with its own plan, with its own key performance indicators, with its own tools, with its own resources, even, yes, systematised … " COO
Informing about the situation in Ukraine	Positive	Communication policy	During the war	Contingency	"In the same way, we sent mass mailings, we sent a letter in the following format: the first paragraph we wrote about what is happening in Ukraine. … We briefly described the situation to spread information about what is happening in Ukraine. We wrote the following "The CRO company is a Ukrainian company, we work in such and such a field, currently our main task is to provide our employees with work, salaries, support the economy, so if we can cooperate … and we listed three or four services that we could provide remotely. What we could provide from any point of the planet and there was no need to be tied either to Kyiv or to Ukraine, because a lot of people relocated. We wrote that let's cooperate, let's schedule a meeting, we'll be happy to talk." And I had a lot of negotiations after those letters. And our first contracts at wartime came from this LinkedIn mailing." HBD
Collection of information about employees' ability to work and their local needs (availability of work gadgets, Internet, workplace, etc.)	Positive	Communication policy/Financial stability	During the war	Contingency	"He (CEO, author's note) also created a table that he asked everyone to fill in, in which they had to write data on the key parameters of the person's ability to work. There were, respectively, the name of the employee, where they are now, how many days they need to relocate if they plan, whether they will have the equipment to work there, how many hours a day they can work, whether they have the Internet and comments so that people can write - they are ready to work, not ready, will, will not." HBD
The signing of new contracts with foreign sponsors	Positive	Operational activity/Managerial decisions	In the future	Recovery	"Well, first of all, this is active work on entering external markets … from the point of view of receiving orders … and performing some practical or clinical part. Very interesting in this regard is the experience of these last months, when systematised work on interaction with clients began and we stopped focusing on finding clients in Ukraine …”
Implementation of the system of accounting for the performance of employees for individual projects and revision of the criteria for measuring the efficiency and payback of robots	Positive	Operational activity/Managerial decisions	During the war/In the future	Recovery/Resilience	" … the latest initiative, which is currently being implemented, is related to project-specific resources tracking … The function is the resources accounting that we spend on the performance of certain tasks … in terms of time, project, in terms of an employee, where many parameters are connected. There is the use of the resource, the use of money, compliance with the scope of the task or the contracted client's expectations, the level of inconsistencies … When we implement this thing, we will be able to adequately evaluate this ratio. And we will be able to get rid of those services that hold us back in development. And develop those services that, on the contrary, give good revenue …” COO " … one of the last and most significant changes in this regard is the introduction of hours accounting, which will allow us to find out in which tasks we are currently working less efficiently. Because, since we had to adapt to a new type of tasks, it is quite obvious that we cannot work on these tasks with efficiency that is close to 100%. Since they are new to us, we need to spend even more time on learning. And to understand in general what kind of dynamics we have in these tasks, that is, how well we have adapted to them, to the extent that our efficiency in working with these tasks increases, then the tool for accounting for the hours spent will come in handy. It will help to objectively assess what we spend time on, how efficiently we spend it and what we need, for example, what knowledge, what processes, and what organisational issues are possible to maximise our efforts and effectiveness. " HDM

6. SWOT analysis output

The SWOT analysis (Table 3) presented was carried out by the CEO facilitated by the first author (Head of Biometrics). Prior to the meeting, the matrix of organisational strategy domains was shared by the first author with the participants to set the framework of the discussion. The purpose of the SWOT analysis is to assess the organisational strategy for potential gaps and omitted opportunities.

Table 3.

SWOT analysis.

Strengths	Weaknesses
Export-oriented promotion, independence from the local market.	High competitiveness of the external market leading to considerable investments (time, efforts, funds) in promotion.
Availability of proprietary funds to cover acute crisis phase and post-crisis transformation.	The human capital is not developed to obtain narrow and deep expertise in a particular field.
Agility of internal processes, ability to build cross-functional teams to undertake new services.	Recruitment and selection demand high time and cost spending.
Intrinsically motivated human capital ready to perform under pressure redistributed to challenging positions and tasks vertically and horizontally.	Limitation of scaling because of inability to hire many staff members simultaneously.
Loyal participative leadership style.	Possible perception of loyal leadership style as an absence of administration, with pointwise loss of performance and productivity.
Opportunities	Threats
Willingness of external partners to share business networks.	Global crisis still has the potential to disrupt the continuity of operations.
Eagerness to support CRO as a Ukrainian company by outsourcing internal tasks.

The results of the SWOT analysis were used to generate recommendations.

7. Conclusions

The studied small contract research organisation operating in Ukraine (CRO) survived three major crises: Revolution of Dignity (Euromaidan revolution), annexation of Crimea peninsula and beginning of the armed conflict in the east of Ukraine; COVID-2019 crisis; ongoing war starting as hybrid war in 2014 and followed with the massive Russian invasion of Ukraine on 24^th of February 2022.

While investigating the case of its continuity of operations, it appeared that the company had a crosscutting orientation on stability. Consequently, the derived set of organisational strategies successfully employed for organisational continuity comprised most, if not all, strategies enforced and supported by the company's management.

The most prominent domains ensuring resilient activity of the company over repeated crises were the choice of a stable business environment, employment of financial stability tools, specific human capital management, distinct mechanisms for the design of operations.

CRO's business environment stability was established through clear orientation to the external market. Export-oriented promotion is conditioned by narrowness and instability of the internal Ukrainian market adversely impacted by repeated crises. The relatively stable business environment allowed the company to secure resources to guarantee certain financial stability.

Financial stability in CRO is ensured by using only proprietary funds and retaining the crisis fund. The crisis fund is maintained at volume, which is able to cover at least 6-months company's expenditures without any inbound payments and without personnel reduction.

Personnel reduction is considered a last resort within the company's management. Conversely, the team is treated as the main pillar of a company's operations continuity. In CRO much time and cost are dedicated to the hiring and staff development process, despite the fact that human capital stability limits the scaling.

The stable human capital comprised of intrinsically motivated people combined with a loyal leadership style and available financial "safety cushion" ensure the continuity of operations. The principal way leading to the continuity of operations in CRO is an ability to build a cross-functional team to undertake a particular task. The team combines professionals with diverse expertise tend to successfully cover any service required by the customer, notwithstanding the absence of equivalent experience.

During the 5 months of Russian invasion of Ukraine from 24^th of February 2022, the changes in organisational strategy domains occurred in the company's operations, executive decisions, communication policy, and human capital policy.

The human capital policy remained predominantly unaffected. In the meantime, internal communication policy and the role of the company's management were considerably adjusted to the new circumstances.

The role of CRO's management right after the invasion began was to securely attach the team in the sphere of influence, obtain the information about the team member condition and act accordingly. Following the most acute period of uncertainty the role of CRO's management evolved to agents of change. Being agents of change implied gradually introducing changes to the teams and consecutively conveying the messages set by the co-owners.

Regarding internal communication policy, clear messages were conveyed by the CRO's top management during the morning meetings established from the first day of the invasion. They concerned workplace and payroll security and the emphasis on personal safety above the working tasks. In the meantime, the spreadsheet shared with the whole team was used to track the location and the condition of the person and their capability to perform any working tasks. The succeeding messages were based on the readiness of the personnel to carry out either billable or non-billable tasks related to the business development.

The Business Development department, in turn, led the external communication policy implementation. The suspension of several projects related to site-management activities released the working time of the staff members, which was used in performing low-skill business development activities. Globally recognized emergency in Ukraine enabled the effective usage of social media, widespread mass-mailing, and reactivation of the backlog of business contacts. By these means, the massive communication efforts converted into more than 90 business meetings performed during the first months by the CEO. The external communication strategy not only allowed to inform the interlocutors about the operational condition of CRO, but generated new contracts for the remote services delivery.

In communication the interlocutors expressed straightforward concerns on the risks of doing business with the company operating in Ukraine during the war. Accordingly, CRO's top management carried out the risk reduction action by registering a new legal entity in the European Union. Registering CRO in Poland supported the CRO's positions in negotiations on potential projects related to clinical operations.

Several requests generated through a massive external communication campaign in the first month of war were not equivalent to the company's experience. So, agile creation and development of the respective cross-functional teams enabled undertaking new services outsourced by the sustained and new business-partners. The task force approach to the project performance had been employed in CRO before. However, the fast-track cross-functional team creation was a new strategy introduced by the company's management given the aggravated circumstances.

Widespread practice of cross-functional activities reduced the direct access of the company's management to the performance indicators. System of performance tracking used before the war was predominantly based on the supposition that one project was undertaken by one department. In the meantime, the cross-functional approach made this performance tracking system obsolete. As a result, the process of time and resource tracking underwent the transition. The introduction of a web-based tool for time and resource tracking allowed to obtain a clear trail of the coworker's time spending and reveal the inefficiencies at coworker, project, team and company level. It allows deriving the comprehensible indicators of the company's efficiency without limitations on the organisational flexibility.

Alongside the prominent benefit of organisational flexibility for the continuity of operations, there is a certain pitfall of keeping a portfolio diversified by services and therapeutic fields. A diversified portfolio creates a working environment not developing human capital to obtain narrow and deep expertise in a particular field. Consequently, during the war the idea of the company's specialisation for a particular market niche was seriously considered and was translated primarily to the sales strategy. In the meantime, no requests concerning other services or therapeutic fields were rejected to ensure the adequate workload and business continuity.

8. Results and discussion

For overcoming crisis situations, the company reorganized internal and external communication policy. The personal safety was emphases above the working tasks and working communication was established in the first month of war. Thanks to the timely reassignment of employees to critical fields and established external communication strategy, the company generated new contracts for the remote services delivery.

The conclusions drawn from this case might be relevant to small and middle-sized service companies. In particular, the strategies employed by CRO's management might be recommended for consideration to the management of small and middle-sized service companies. This potential relevance is based on the current global economic instability and increasing risks of turmoil of a different nature.

As the study has limitations by its methodological and internal nature of the research, the additional data collection will be undertaken. To expand the scope of the investigation the insights of internal research will be used to bolster the external research. During the external research the expert interviews with international sponsors are planned to be conducted. The purpose of the second-stage expert interviews is to determine the external point of view on anticrisis decisions of Ukrainian companies, CRO in particular, during the war.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The first author, Mariia Yashchenko, declare being the Head of Biometrics at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.), Postgraduate student and Senior lecturer at National University of Kyiv-Mohyla Academy, National Consultant at the World Health Organisation (Ukraine).

The author, Yurii Lebid, declare being the CEO at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.).

The author, Andrii Zaremba, declare being the СОО at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.).

The author, Svitlana Bolman, declare being the Junior Statistician at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.).

The author, Iryna Hoi, declare being the Head of Business Development Department at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.), Student of Master Program Public Policy and Administration at Kyiv School of Economics.

The author, Roman Bystrov, declare being the Head of Data Management Department at Pharmaxi group of companies (“Pharmaxi” LLC, “Pharmaxi-Ukraine” LLC, “Pharmaxi Clinical Research” LLC, “Pharmaxi Clinical Solutions” LLC, “OnlineCRF” LLC, Pharmaxi Poland sp. Z o. o.).

Appendix A. Expert interview guide. Version 1.0

Study objectives:

• 1.To describe which actions were implemented by the company prior to the beginning of the massive military Russian invasion of Ukraine to ensure continuity of operations of the company in crisis conditions, considering previous experience (Revolution of Dignity, COVID-19 pandemic).
• 2.To investigate the changes occurred during the 5 months of Russian invasion of Ukraine, namely in executive decisions, communication policy, human capital policy, and operations.
• 3.To determine the organisational strategy domains ensuring resilient activity of the company over repeated crises.

I. Introduction and explanation of the rules (up to 5 min)

• 3.Moderator's introduction.
• 4.Explanation of the rules: there are no correct or incorrect opinions, right or wrong answers.
• 5.Meeting will be recorded (the record will not be published).
• 6.Respondent introduction: name, position and main responsibilities in the company, experience in this area.

II. Discussion of changes (20–30 min)

• 7.Do you think the company was ready for such a crisis as war? Why is it? Why not?
• 8.Which criteria have you used to assess the company's resilience and readiness for new challenges?

First, spontaneous response, then elaboration on:

• ●Financial stability (financial cushion, possibility to pay salaries to employees, possibility to implement ongoing projects and cope with main parameters of the planned ones – deadlines, budget, efficiency indicators, achievement of project goals);
• ●Communication policy (informing partners and sponsors about the position of the company, call on termination of cooperation with Russian Federation);
• ●Managerial decisions (modification of the work format, modification of management format, decrease/increase of the team, redistribution of functions within the company);
• ●Operational activity (change of instructions and protocols of work, creation of new protocols, extension of the range of services).

Ask for each of the directions on question 5:

• 9.What has been changed/ready beforehand (during quarantine or earlier)? What has to be changed during the war?
• 10.Who was involved in the implementation of the changes? What department/coworker?
• 11.Who has been affected by the changes (department/work area)? Who is the most affected by the changes?

General questions about changes during the war:

• 12.What was the main thing that you have changed? What should not be changed?
• 13.Was the process of adapting to the new realities of the working process difficult?

14. Are you satisfied with the result of the implemented changes? Why is it? Why not? What criteria do you use to assess the success of the changes? Give examples.

III. Working strategies and plans for the future (up to 10 min)

• 15.What plans do you have for the near future? Are there any planned, but not implemented changes?
• 16.How can you describe the further development of the company's sustainability? How can you describe your contribution to this sustainability?
• 17.How would you name the strategy chosen by the company to increase sustainability during the crisis? What is the most important in it? Why?
• 18.What recommendations could you give to other similar Ukrainian businesses working in the field of clinical research?