Crisis leadership: A review and future research agenda

Crisis leadership behaviors in healthcare: survey validation and influence on staff outcomes in primary care clinics during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic triggered an unprecedented transition from in-person to virtual delivery of primary health care services. Leaders were at the helm of the rapid changes required to make this happen, yet outcomes of leaders' behaviours were largely unexplored. This study (1) develops and validates the Crisis Leadership and Staff Outcomes (CLSO) Survey and (2) investigates the leadership behaviours exhibited during the transition to virtual care and their influence on select staff outcomes in primary care.

METHODS

We tested the CLSO Survey amongst leaders and staff from four Community Health Centres in Ontario, Canada. The CLSO Survey measures a range of crisis leadership behaviors, such as showing empathy and promoting learning and psychological safety, as well as perceived staff outcomes in four areas: innovation, teamwork, feedback, and commitment to change. We conducted an exploratory factor analysis to investigate factor structure and construct validity. We report on the scale's internal consistency through Cronbach's alpha, and associations between leadership scales and staff outcomes through odds ratios.

RESULTS

There were 78 staff and 21 middle and senior leaders who completed the survey. A 4-factor model emerged, comprised of the leadership behaviors of (1) "task-oriented leadership" and (2) "person-oriented leadership", and select staff outcomes of (3) "commitment to sustaining change" and (4) "performance self-evaluation". Scales exhibited strong construct and internal validity. Task- and person-oriented leadership behaviours positively related to the two staff outcomes.

CONCLUSION

The CLSO Survey is a reliable measure of leadership behaviours and select staff outcomes. Our results suggest that crisis leadership is multifaceted and both person-oriented and task-oriented leadership behaviours are critical during a crisis to improve perceived staff performance and commitment to change.

Healthcare Decision-Making in a Crisis: A Qualitative Systemic Review Protocol

Background. Throughout history, communities have faced outbreaks of infectious diseases and other natural and man-made disasters that pose significant threats to lives, public health, and business continuity. Many of these disasters are crises that require critical decisions to be made in a short, crucial time with limited information and unforeseen circumstances amidst panic, fear, and shock. The COVID-19 pandemic is a recent example, with public leaders responding to and formulating strategies to attenuate the relentless waves of transmission and surges in resource demands. The pandemic underscored the importance of understanding how healthcare leaders make decisions in-crisis and what factors healthcare leaders prioritize in their decision-making process. Methods/Design. PubMed(NLM), Embase(Ovid), Scopus(Elsevier), Business Source(EBSCOhost), and ProQuest will be searched for primary qualitative studies published in English to explore the multi-faceted decision-making processes of healthcare leaders during a public health crisis. A meta-ethnographic approach will synthesize insights into healthcare leaders' experiences and perspectives and generate a conceptual theory of decision-making in crisis. Discussion. Understanding how healthcare leaders make critical decisions during public health crises takes advantage of the lessons learned to inform how future health crises are managed. (This systematic review is registered in PROSPERO: CRD42023475382).

In the eye of the storm: Hospital leaders' resilience during the COVID-19 pandemic

BACKGROUND

Although hospital leaders were already at a high risk for psychological and physical illnesses long before the pandemic, the COVID-19 pandemic exacerbated this situation.

PURPOSE

Recognizing the crucial role of leaders in organizational crises and building on the conservation of resources theory, our study examines how hospital leaders cope with difficulties that endure over an extended period of time. By using the COVID-19 pandemic as an example for prolonged adversity in hospitals, we provide insight into the different responses to a given adversity and further expand knowledge about the role of time in crisis and for resilience.

METHODOLOGY/APPROACH

Qualitative expert interviews were conducted with 44 hospital leaders in Austria between December 2020 and November 2021. For data analysis, we used a hybrid approach, consisting of both deductive and inductive coding.

RESULTS

By extending Bardoel and Drago's (2021) conceptual approach on acceptance and strategic resilience, our empirical study shows that during enduring adversity, hospital leaders use both types of resilience. The choice between them and their suitability depends on both the duration of exposure and severity of the adversity.

CONCLUSION

Our findings further show that when immediately confronted with adversity, leaders tend to rely on resource-preserving acceptance resilience, whereas when dealing with enduring adversity, leaders are more likely to use resilience-enhancing strategic resilience.

PRACTICAL IMPLICATIONS

Even though leaders rely on both types of resilience, our findings also imply that if opportunities to build strategic resilience are limited, higher burnout and turnover rates might be the consequence.

Why do democracies respond differently to COVID-19? A comparison of the United States and South Korea

Background

COVID-19 has posed severe challenges to crisis management in democracies. Different democracies respond to the crisis differently. This article proposes an analytical framework to explain why democracies respond differently to the public health crisis and how different contextual factors affect crisis response in democracies.

Methods

By comparing COVID-19 responses in the US and South Korea, this article conducts a comparative case study with a most similar system design. The two countries have been selected as cases because they are both developed democracies with a robust healthcare system. However, different contextual factors in the two countries have created different crisis responses by shaping different crisis leadership and political and social solidarity. This study collected data from different sources, including government documents, official websites, leaders' speeches, research reports, academic articles and news media. We tried to enhance the reliability of the data by comparing different data sources.

Results

We found that individual, institutional and cultural dimensions of contextual factors can influence different crisis responses of democratic countries by shaping crisis leadership and political and social solidarity. On the individual and institutional dimensions, leadership style and governance structure shape crisis leadership (sense making, decision making and coordinating, and meaning making), which in turn influences crisis management. On the cultural dimension, political and social solidarity measured by political polarization and social cooperation are shaped by cultural and social norms.

Conclusion

Our findings indicate that democracies require strong crisis leadership and a high degree of political and social solidarity to tackle public health crises. A centralized and coordinated system, as well as a political elite leadership style shaped by rich crisis response experience, expertise and high sensitivity to crises are conducive to crisis management. Fostering a cultural and social norm that facilitates state-society collaboration can promote crisis management. These findings provide valuable insights for decision-makers to effectively respond to future pandemics.

Building resilient hospital information technology services through organizational learning: Lessons in CIO leadership during an international systemic crisis in the United States and Abu Dhabi, United Arab Emirates

BACKGROUND

The COVID-19 pandemic was an international systemic crisis which required an unprecedented response to quickly drive the digital transformation of hospitals and health care systems to support high quality health care while adhering to contagion management protocols.

OBJECTIVE

To identify and assess the best practices during the COVID-19 pandemic by Chief Information Officers (CIOs) about how to build resilient healthcare IT (HIT) to improve pandemic preparedness and response across global settings and to develop recommendations for future pandemics.

METHODS

We conducted a qualitative, interview-based study to sample CIOs in hospitals. We interviewed 16 CIOs from hospitals and health systems in the United States and Abu Dhabi, United Arab Emirates. We used in-depth interviews to capture their perspectives of the preparedness of hospitals' information technology departments for the pandemic and how they lead their IT department out of the pandemic.

RESULTS

Results showed that healthcare CIOs were ambidextrous IT leaders who built resilient HIT by rapidly improving existing digital business practices and creating innovative IT solutions. Ambidextrous IT leadership involved exploiting existing IT resources as well as exploring and innovating for continuous growth. IT resiliency focused on four inter-related capabilities: ambidextrous leadership, governance, innovation and learning, and HIT infrastructure.

CONCLUSIONS

We propose conceptual frameworks to guide the development of healthcare IT resilience and highlight the importance of organizational learning as an integral component of HIT resiliency.

Developing adaptability and agility in leadership amidst the COVID-19 crisis: experiences of early-career school principals

Purpose

During the COVID-19 crisis in Victoria, Australia the complexity of school leadership increased greatly for school principals. This study focused on the lived experiences of early career principals in the independent school sector from March to November 2020 in Victoria, Australia. It investigates transformative work that was undertaken by these leaders in leading their schools over a protracted crisis.

Design/methodology/approach

The study builds on constructs of crisis leadership, adaptive leadership, agile leadership and emotional intelligence, exploring the leadership approaches undertaken by twenty-two early career principals in Victoria, Australia. Using a narrative inquiry approach, across three temporal points in 2020, storied productions drawn from the findings present four emergent types of emotionally intelligent leadership approaches undertaken by these principals. These leadership approaches are presented as the commander-leader, the conductor-leader, the gardener-leader and the engineer-leader with each approach demonstrating both organisational leadership approaches as well as individual leadership styles used by these principals as they led their schools.

Findings

The findings have direct implications for professional development programs focusing on aspiring principals and early career principals with emphasis on the importance of developing emotionally intelligent skillsets in principals for use during periods of rapid change or high crisis in schools. The findings present insight into the support useful for early career principals in the first five years of principalship.

Originality/value

This study uses a unique emotional intelligence approach to understand school leadership during and after a crisis.

Developing local crisis leadership - A research and training agenda

The crisis triggered by Covid-19 has exposed the interdependencies of modern society and sparked interest in local response to protracted and complex crisis situations. There has been a growing awareness and interest in the key roles of political and professional stakeholders, their emotional regulation and how they influence team performance and outcomes in dealing with uncertainty and complex crisis situations. While cognitive and behavioral aspects of crisis leadership are well researched, less is understood about how one can mitigate negative emotions, instill trust, or restore public faith and support of security forces and emergency response teams during crises. In addressing this gap, we propose a simplified conceptual roadmap for research and training of local crisis leadership. In this, we emphasize complex problem solving, team interaction, team context and technology and team training design. These four factors represent significant barriers if neglected. On the other side, they may be considerable force multipliers when better understood and managed. We suggest how seven research and training questions could be linked to the four conceptual factors and guide an evidence-based approach to develop local crisis leadership.

Why time matters when it comes to resilience: how the duration of crisis affects resilience of healthcare and public health leaders

The meaning of time, especially in crisis, where situations are likely to become even more complex, uncertain, and disruptive, is crucial. Incorporating previous research on organizational crises, organizational resilience, extreme context, and individual resilience, we know that leaders do play a crucial role when it comes to handle adversity in organizations but also that leaders might influence organizational resilience and employee resilience. Intensified by the COVID-19 pandemic, the leaders' ability to effectively deal with a critical situation becomes even more important in healthcare organizations. We argue that time is not only important when it comes to crisis management but also that it is highly significant when it comes to leaders' resilience. Considering the aspect of time implies that different temporal demands, especially regarding the persistence of adversity, require different resilience strategies applied by the leader. Therefore, we call for future research on examining how different leaders' resilience strategies (short term vs. long term) affect crisis management outcomes as well as the resilience in healthcare and public health organizations.

Leading in the Paradoxical World of Crises: How Leaders Navigate Through Crises

Living and operating in a global world, the risk for a global economic crisis has never been greater. As ongoing events, such as the COVID-19 pandemic, the recent war in Ukraine or the sharply increasing inflation have shown, organizations need to be highly resilient to persevere in a crisis-prone world. Even though we know that crises serve as a focal lens on leadership behavior and leaders play a crucial role in these scenarios, little is known as to how leaders handle an existence-threatening organizational crisis. Using an inductive analysis of 32 interviews on crisis leadership, we show that in the case of an acute crisis, leaders apply different paradoxical behaviors to cope effectively with the situation and navigate their organizations through these events. More specifically, our study contributes to existing literature by, first, showing that the distinctiveness of crises results from the fact that leaders are confronted with paradoxes that they can otherwise smoothly separate in terms of time or organization, second, revealing that the leader's paradoxical behaviors as a respond are derived from their mindset to consciously recognize the contradictory demands of the crisis, and third, from their action in terms of a compressed situational leadership. By identifying six pairs of paradoxical behaviors, we demonstrate how leaders effectively deal with the unsolvable contradictions that arise from the crisis, and thus contribute to the organizations' ability to cope with crises.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s41471-022-00147-7) contains supplementary material, which is available to authorized users.

Coach leadership in a crisis context: Investigating effective coach behaviors during the COVID-19 pandemic with a process view

Introduction

Drawing from the crisis leadership conceptualization, this study aims to investigate coaches' opinion patterns on effective leadership behaviors during the COVID-19 pandemic. The study used a process view to explore how coaches as leaders act in pre, during, and post-crisis phases.

Method

Thirty-two fulltime professional coaches (28 males and 4 females) from individual and team sports who experienced the entire COVID-19 pandemic from January 2020 to July 2021 in the United Kingdom were invited to express their perceptions of effective leadership behaviors. The study used Q methodology to analyze coaches' perceptions and experiences.

Result

The study revealed that the most effective coach leadership behaviors occurred during-crisis phase, which has the most positive ratings (n = 48) compared to the pre-and post-crisis phases (n = 18). The study's main findings highlighted different phases of the COVID-19 pandemic demand various effective countermeasures from coaches. These practical and successful experiences were summarized as: division of labor, athlete-centered, team-driven, consulting, safe environment, and online coaching.

Discussion

The findings of this study further highlight (1) the importance of coach leadership in creating a safe environment as it provides a much better platform to prepare for a pre-crisis stage, (2) that coaches should employ more positive than negative behaviors while interacting with team members more frequently especially during the crisis period, reducing athletes' negative feelings such as anxiety and worry, and (3) that the online training-related activities and interactions during the crisis time can be expanded to noncrisis times, as a crisis event can have positive implications for the future if handled properly.

Crisis leadership in COVID-19: A qualitative study of Norwegian business leaders

Background

On March 11, 2020, the World Health Organization declared the novel coronavirus outbreak a global pandemic. The crisis that follows presented significant adverse challenges for organizations and business leaders around the world. The present study aims to explore how the extreme context of the COVID-19 influenced crisis leadership, with emphasis on coping and adaptive approaches, in Norwegian leaders during the early stage of the pandemic.

Materials and methods

A group of 11 Norwegian business leaders from different private sector companies were subject to an in depth, semi structured interview after the first 9 months of COVID-19. A sensemaking perspective and the Cognitive Activation Theory of Stress (CATS) were used to interpret the results.

Results

The pandemic called for crisis leadership and a rapid adaptation to a radically changed situation. Restructuring of organizational processes and introduction of new routines were followed by support and caring for their employees during the first wave of the pandemic. All the leaders coped well with the situation, and some were excited over the opportunity to make a difference in this demanding and stressful situation. Many emphasized that the pandemic was an external threat, resulting in an acceptance of the situation, more transparency, collaboration, and generosity within the organization. Especially the willingness to change was challenged in a positive way. A more blurred line between office and home, and absence of social activities were mentioned as negative outcomes.

The Emergence of Collective Leadership During a Terrorist Attack: Dynamic Role Boundary Transgressions as Central in Aligning Efforts

The current article examines the emergence and dynamics of leadership during an extreme situation—a terrorist attack at the foreign subsidiary of a multinational energy corporation—and the crisis response undertaken at the corporate headquarters. The inductive analysis reveals that the in-situ crisis leadership involved impromptu interactions between multiple individuals leading collectively. Multiple sources of leadership emerged to carry out four critical leadership functions, namely strategic framing, ad hoc structuring, relational coping, and instant developing. These functions were carried out by several formal and informal leaders together, enhancing the overall leadership capacity in the crisis management organization (CMO). With increased capacity to lead efforts in different domains came specialization, which could have led to misalignment and fragmentation. But this was avoided by leaders acting as “role boundary transgressors,” expanding the boundaries of their responsibilities across roles, functions, and levels to foster the alignment of collective efforts across the CMO. Based on rich data from a leadership situation that researchers rarely have access to, this study contributes to the understanding of leadership during extreme situations by illustrating who leads (the emergence of multiple leadership sources), what leaders do (leadership functions), and how leadership plays out over time and across levels (through dynamic role boundary transgressions).

A five-nation study of the impact of political leaning and perception of crisis severity on the preference for female and minority leaders during the COVID-19 pandemic

Research on underrepresented groups in leadership has shown that women and ethnic minorities are preferred as leaders during a crisis. In the present study, we investigated factors that shape voter preferences for minority political leaders in the COVID-19 crisis. We examined participant perceptions of the severity of the COVID-19 crisis in health, social, and economic domains and self-reported political leaning, and their impact on preference for a female (vs male) or minority political leader. We collected survey data in autumn 2020 using online platforms in France, Japan, the United Kingdom, the United States, and a snowball sample in Germany (total N = 1,259). Results showed that female leaders were generally more preferred by politically left- than right-leaning participants independent of severity perceptions of the social or economic crisis. In addition, we found that preference for female leaders amongst right-leaning participants increased when their current regional leader's actions were judged insufficient to manage the health crisis, an effect primarily driven by participants in Germany and the United Kingdom. Left-leaning political orientation also predicted the preference for minority leaders across countries. Moreover, a more severe perception of the social aspects of the crisis increased minority preference, as expected, but mostly in Germany and the United States. We discuss cross-country variation of our results. Overall, our findings affirm and expand prior research showing the importance of political leaning and changing leadership demands in a crisis and their impact on the preference for minority leaders.

Responding to pandemic challenges: leadership lessons from multinational enterprises (MNEs) in India

Purpose

The business sector plays a major role in achieving comprehensive economic development goals in emerging economies. Consequently, the effects of business responses to the COVID-19 pandemic are receiving increasing research attention from an organizational management development perspective. This article aims to examine the role of leadership in charting the course in an extraordinary crisis context.

Design/methodology/approach

Using institutional leadership theory, leadership contingency theory and dynamic leadership capability theory, the authors present a research framework that defines macrochallenges and organizational level responses and outcomes. The article adopts a case study approach, which includes the identification of four target companies and conducting in-depth interviews with senior management professionals within those companies at different time periods.

Findings

Based on the interviews, the steps that Indian companies adopted to respond to the COVID-19 challenge are identified. Expanding the insight from the case study, the findings suggest that although feeling overwhelmed at first, organizational leaders combine prudent (i.e. timely and speedy actions for survival first) and bold (i.e. future envisioning for expansion and growth) actions enabling these firms to weather two waves of the COVID-19 pandemic in India.

Originality/value

These multiple case studies are unique in exploring MNEs from different industries. This study also highlights the dynamic relationships between leadership practices, risk management strategies and performance outcomes based on a sound theoretical model and rigorous study methods.

Facing disruption: Learning from the healthcare supply chain responses in British Columbia during the COVID-19 pandemic

The healthcare supply chain crisis surrounding Personal Protective Equipment (PPE) during the onset of the COVID-19 pandemic presented unique and complex challenges in achieving the primary aim of supply chain management, that is, delivering the right amount of the right supplies to the right people at the right time. This article describes the key findings from a case study on PPE supply chain responses to the COVID-19 pandemic in British Columbia (BC). It highlights a set of constructive response mechanisms to potential crises along healthcare supply chain. Effective and trusted leadership, a unity of purpose, integrated and robust digital infrastructure and capabilities, consistent learning, resilience building, and environmental sensing for reliable intelligence were found to be essential for preparing, for containing, and mitigating the crisis as it evolved across various phases of crisis management.

A CEO's Future Temporal Depth and Organizational Resilience

Scholars have long investigated the organizational antecedents of resilience, but less is known about CEO-level antecedents. This is surprising, since upper echelons research suggests that a CEO influences major firm decisions. Addressing this gap in our knowledge, we suggest that a CEO prepares for and adjusts to unexpected events in the environment on the basis of the individual future temporal depth (FTD). It reflects the temporal distance into the future that a CEO usually takes into consideration when contemplating future events. Our study of CEOs of 462 S&P500 firms during the Global Financial Crisis and the COVID-19 pandemic shows that a CEO's longer FTD is associated with less severe economic losses but with a longer recovery time from adversity. If such a CEO can draw on a functionally diverse TMT, the losses are less severe, while prior organizational crisis experience reduces the recovery time. Our paper contributes to organizational resilience research by uncovering its cognitive underpinnings and offering a contextual learning perspective on organizational resilience. We also contribute to upper echelons research by unveiling a CEO's role in preparing for and adjusting to adversity.

Public Health and Health Sector Crisis Leadership During Pandemics: A Review of the Medical and Business Literature

The global scale and unpredictable nature of the current COVID-19 pandemic have put a significant burden on health care and public health leaders, for whom preparedness plans and evidence-based guidelines have proven insufficient to guide actions. This article presents a review of empirical articles on the topics of "crisis leadership" and "pandemic" across medical and business databases between 2003 (since SARS) and-December 2020 and has identified 35 articles for detailed analyses. We use the articles' evidence on leadership behaviors and skills that have been key to pandemic responses to characterize the types of leadership competencies commonly exhibited in a pandemic context. Task-oriented competencies, including preparing and planning, establishing collaborations, and conducting crisis communication, received the most attention. However, people-oriented and adaptive-oriented competencies were as fundamental in overcoming the structural, political, and cultural contexts unique to pandemics.