Twelve Lessons on Hospital Leadership during COVID-19 Pandemic

Nurses' perceptions of the performance of nurse managers and senior hospital management during the COVID-19 pandemic

BACKGROUND

The first waves of the COVID-19 pandemic had a negative impact on health systems and health professionals, due to the high number of cases and a lack of preparation. The aim of this study was to understand how nurses working in hospital units and in intensive care perceived the performance of nurse managers and senior hospital management during the first two waves of the pandemic.

METHODS

The phenomenological approach proposed by Giorgi was used to investigate perceptions of the performance of nurse managers and senior hospital management during the first two waves of the COVID-19 pandemic in Spain. Fourteen clinical nurses who worked on the front line in inpatient units or intensive care units of the Health Services of Extremadura and Madrid in the first (March-April 2020) and second (October-November 2020) waves of the COVID-19 pandemic participated in this study. The data was collected through semi-structured interviews, following a script of themes, in a theoretical sample of nurses who were worked during the pandemic.

RESULTS

Two main themes emerged from the analysis of the data: (1) perceptions about the performance of nurse managers and senior hospital managers during the first and second waves of the pandemic (health system failure; belief that senior hospital management professionals could have managed the pandemic better; recognizing the efforts of middle management (nursing supervisors); insufficient institutional support) and (2) strategies employed by nurses to compensate for the weaknesses in pandemic management.

CONCLUSIONS

The clinical nurses perceived that the nurse managers demonstrated better management of the pandemic than the hospital's senior management, which they attribute to their proximity, empathy, accessibility, and ability to mediate between them and the senior management. The nurses also believe that the senior management of the hospitals was to blame for organisational failures and the poor management of the pandemic.

What Makes a Hospital Excellent? A Qualitative Study on the Organization and Management of Five Leading Public Hospitals in China

Purpose

To summarize the organizational and management experiences and explore the organizational theoretical model of five leading public hospitals in China.

Patients and Methods

Purposive sampling was used to select five leading hospitals in different regions of China under the National Health Commission and Provincial Health Commission as study hospitals for the study. From August 2021 to March 2022, 8 leaders and 39 managers from these hospitals were surveyed using semi-structured interviews. The data and information were analyzed in four dimensions using thematic analysis and grounded theory, focused on summarizing the experiences and practices of China's leading hospitals in organizational system, culture, operations and performance management, and employee development. This study complied with the COREQ guidelines for reporting qualitative research.

Results

An organizational system model of the characteristics of hospital excellence was developed using four core attributes: organizational system, organizational culture, operations and performance management, and employee development; the model was named the System-Culture-Operation-Performance-Employee (SCOPE) model. Organization and management among leaders and managers in China's leading hospitals are based on the SCOPE process, resulting in employees' well-being, patients' positive outcomes, and organizational excellence. In terms of hospital culture, while adhering to the Hippocratic Oath, the hospital is deeply influenced by traditional Chinese culture, which emphasizes "benevolence" and "love", leading all staff to adhere to "patient-centered care and service." In terms of operations management, a separate operations management department is responsible for hospital operations and performance assessment. As for employee development, the staff's sense of reverence for their profession is emphasized and a reasonable salary system and good practice environment are established to promote staff motivation.

Conclusion

The SCOPE model reveals the perspectives of leaders and managers in China's leading hospitals regarding organization and management under a Chinese cultural background. These findings can complement the existing literature on hospital management systems.

Lived experiences of Iranian nursing managers in organizing and confronting the COVID-19 pandemic

BACKGROUND

The prevalence of the new infectious disease is a global health issue and a threat to nurses and other health care workers. In addition to nurses who have been directly involved in the care of patients with coronavirus disease 2019 (COVID-19), nursing managers have also played a key role in the management and control of this disease. The present study aimed to investigate the lived experiences of nursing managers in organizing and confronting COVID-19 in Iran.

MATERIALS AND METHODS

This study was a qualitative research design conducted by descriptive phenomenology based on Husserl philosophy. Participants consisted of 32 nursing managers working in general public hospitals in East Guilan, north of Iran, selected using purposive sampling. In-depth and semi-structured interviews were used to collect data. Colaizzi's strategy was used to analyze the data. Coding was done with MAXQDA 2007 software. Lincoln and Guba trustworthiness criteria were used to achieve accuracy and reliability of the data.

RESULTS

Data analysis led to the emergence of a main theme called "Management in the COVID-19 Crisis" and three sub-themes: "Dealing with the unknown", "Managing deficiencies and assets" and "Structural challenges".

CONCLUSION

In this study the nursing managers experienced how to deal with the COVID-19 crisis. By examining the experiences of managers involved in the COVID-19 pandemic, a rich set of managerial experiences can be gathered that prepare them for other infectious diseases in the future.

Barriers and enablers of breastfeeding in mother-newborn dyads in institutional settings during the COVID-19 pandemic: A qualitative study across seven government hospitals of Delhi, India

Introduction

The COVID-19 pandemic disrupted newborn care and breastfeeding practices across most healthcare facilities. We undertook this study to explore the barriers and enablers for newborn care and breastfeeding practices in hospitals in Delhi, India for recently delivered mother (RDM)-newborn dyads during the first wave of the COVID-19 pandemic (2020) and inductively design a "pathway of impaction" for informing mitigatory initiatives during the current and future pandemics, at least in the initial months.

Materials and methods

We used an exploratory descriptive design (qualitative research method) and collected information from seven leading public health facilities in Delhi, India. We conducted separate interviews with the head and senior faculty from the Departments of Pediatrics/Neonatology (n = 12) and Obstetrics (n = 7), resident doctors (n = 14), nurses (labor room/maternity ward; n = 13), and RDMs (n = 45) across three profiles: (a) COVID-19-negative RDM with healthy newborn (n = 18), (b) COVID-19-positive RDM with healthy newborn (n = 19), and (c) COVID-19 positive RDM with sick newborn needing intensive care (n = 8) along with their care-giving family members (n = 39). We analyzed the data using grounded theory as the method and phenomenology as the philosophy of our research.

Results

Anxiety among clients and providers, evolving evidence and advisories, separation of the COVID-positive RDM from her newborn at birth, providers' tendency to minimize contact duration and frequency with COVID-positive mothers, compromised counseling on breastfeeding, logistic difficulties in expression and transportation of COVID-positive mother's milk to her baby in the nursery, COVID restrictions, staff shortage and unavailable family support in wards and nursery, and inadequate infrastructure were identified as major barriers. Keeping the RDM-newborn together, harmonization of standard operating procedures between professional associations and within and between departments, strategic mobilization of resources, optimization of human resources, strengthening client-provider interaction, risk triaging, leveraging technology, and leadership-in-crisis-situations were notable enablers.

Conclusion

The separation of the RDM and newborn led to a cascade of disruptions to newborn care and breastfeeding practices in the study institutions. Separating the newborn from the mother should be avoided during public health emergencies unless there is robust evidence favoring the same; routine institutional practices should be family centered.

New Kids on the Block? A Bibliometric Analysis of Emerging COVID-19-Trends in Leadership Research

The COVID-19 pandemic has resulted in unprecedented challenges for society. The effects on organizations have been drastic and such tough times have demanded new organizational solutions as well as strong and new forms of organizational leadership. Leadership scholars have accelerated their research efforts in the quest to identify what is needed to lead in these uncertain times. In this paper, we adopt a bibliometric review to unravel the emerging trends in leadership research in the wake of the COVID-19 pandemic, and in doing so, identify commonalities and divergences in these themes with respect to leadership approaches and assess potential avenues for future research. The findings reveal that research on the topic has emerged along six main clusters: (1) leadership and employee health during pandemic times, (2) public leadership, (3) leadership in health care, (4) leadership and diversity, (5) educational leadership, and (6) leadership and persuasive communication. The findings reveal that across these clusters, the pandemic has sparked research on leadership approaches that deal with change and uncertainty as well as those that are less hierarchical and person centered in nature. We also notice a novel attention to context. Rather than “new kids on the block,” these trends are largely continuations of established leadership theories and approaches that see their particular importance increase in this unprecedented situation. Finally, we outline some distinct avenues for further research with regard to leadership in COVID-19 times.

Empowered Stakeholders: Female University Students’ Leadership During the COVID-19-Triggered On-campus Evictions in Canada and the United States

The study of disaster-specific leadership of female university students has been largely neglected, especially during on-campus emergency eviction and evacuation. Based on the COVID-19-triggered, on-campus evictions across Canada and the United States, this cross-national partnership examined the out-of-province/state and international female university students’ leadership during the entire eviction process. Through in-depth interviews, this study revealed the female university students’ leadership behaviors during three stages: (1) pre-eviction: their self-preparedness formed an emotional foundation to support others; (2) peri-eviction: their attitude and leadership behavior enabled them to facilitate (psychologically and physically) their peers’ eviction process; and (3) post-eviction: they continued to support their peers virtually and raised the general public’s awareness regarding the plight of vulnerable and marginalized populations. This article argues that the female university students’ leadership that emerged during the eviction process became complementary to and even augmented the universities’ official efforts and beyond. This leadership represents empirical evidence that contributes to the existing literature on gender and leadership by demonstrating female youth as empowered stakeholders rather than as merely passive victims. Future studies could develop detailed stratification of gender and age dimensions in order to portray a more comprehensive picture of the younger generation’s leadership in hazards and disaster research and practice.