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Crisis leadership PRISMA 2009 flow diagram. Note. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Source publication
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 “pandemi...
Contexts in source publication
Context 1
... of these articles were opinion articles or commentaries without objective data. After the full-text review was conducted, 35 articles were found to meet the final inclusion criteria (see Figure 2). ...
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Citations
... The results of the present study can be used to reduce decision-making time in determining effective leadership styles in crises. Research had already identified specific competencies of effective leaders in healthcare organizations in crises such as enhancing communication [107] however specific leadership styles needed by SMEs were largely missing. The present study underscores the importance of leaders learning to be transformational by exemplifying a synergy of behaviors including individualized consideration, intellectual stimulation, inspirational motivation, idealized influence as well as to be directive by giving clear instructions to employees during crises. ...
Building on the emerging research on organizational resilience in crisis, we tested a model of transformational and directive leadership styles and their association with organizational resilience in a crisis via employees’ psychological capital. Three hundred and one small and medium sized enterprises in Kenya provided usable survey data. The hypotheses were tested using multilevel structural equation modelling (MSEM) technique. The results show that both transformational and directive leadership styles were significant and positive predictors of organizational resilience through the mediating role of employees’ psychological capital. From a practical perspective, as SMEs struggle to be resilient during crises, leaders should adopt effective leadership styles such as transformational and directive and also consider their employees’ psychological experience of a crisis.
... Previous research on crisis leadership has primarily focused on the skills and behaviours required to manage the relationships necessary to lead others [30]. However, the findings of this study indicate that the personal skills of the leader do not fully explain how trust between the team and the leader, or between different management levels, develops or can be sustained during a crisis. ...
... The personal attributes and skills required of the leader must be considered within a context in which the team has certain responsibilities, with organisational perspectives -including mandates and roles -being fundamental. Previous studies have highlighted the lack of research addressing the causal relationship between contextual factors, such as the task, team and individuals on the team [30]. In a crisis, political, structural and cultural contextual factors also need to be considered to align leadership competence with each crisis event [30]. ...
... Previous studies have highlighted the lack of research addressing the causal relationship between contextual factors, such as the task, team and individuals on the team [30]. In a crisis, political, structural and cultural contextual factors also need to be considered to align leadership competence with each crisis event [30]. ...
Background
Given the increasing trend of disasters, terrorist attacks, pandemics and other crises, crisis leadership is crucial for nurses who lead others and for those working in such situations. There is a need to define and explore the concept of trust as a component of crisis leadership in nursing.
This concept analysis aimed to explore the concept of trust in crisis leadership from a nursing perspective.
Methods
A hybrid concept analysis was conducted. The method consisted of three phases: (I) a theoretical phase relying on a structured literature search, including 11 scientific publications; (II) a field-work phase, in which qualitative thematic analysis of interviews with 30 nurses who had been deployed and/or had led others during crises, was conducted and (III) a final analytic phase, where the results from these data collections were merged.
Results
The analysis suggested that the fundamentals of trust included a perceived intention to do good, the capabilities of both the leader and the team and the perceived predictability of the leader’s behaviour. Trust was found to be built on a perceived forward-looking direction, self-trust and the personal attributes of the leader, such as ethical conduct, the ability to predict the development of crises and an intention to take responsibility and be honest. The social attributes of the relationship between the leader and the team included the intention not to leave anyone behind, loyalty and fostering a sense of belonging among team members. The organisational attributes included a clear organisational structure and clarity of mandate.
Conclusions
Trust is an essential component of crisis leadership that depends on a leader’s perceived intention to do good, predictability of the leader’s behaviour and the capabilities of both the leader and the team. The development of trust relies on the personal attributes of the leader, the social relationship between the leader and the team and organisational attributes. Nurses appointed to lead others during a crisis need to understand the fundamentals of trust as part of leadership in highly demanding situations. Thus, it can be argued that being a leader in a crisis situation requires distinct personal and professional attributes and skills compared to those used to meet routine demands.
... Other studies have emphasized communication as a crucial competency for effective management during health crises, including the COVID-19 pandemic (Ahti et al., 2023;Sriharan et al., 2022). Effective communication allows NMs to lead, motivate, supervise, guide, and train other nurses and healthcare professionals (Fowler et al., 2021), thereby enhancing staff performance. ...
Aim
To identify the essential competencies required of nurse managers in healthcare services during the COVID‐19 pandemic.
Background
Nurse managers play a vital role in healthcare services organization, requiring a diverse set of competencies. The increasing occurrence of epidemics in recent decades underscores the importance of understanding these competencies in pivotal junctures. The challenges faced during the COVID‐19 pandemic present valuable opportunities to recognize the competencies of nurse managers and guide their responsiveness in addressing future health crises.
Methods
A scoping review following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews guidelines was conducted. A comprehensive search was conducted across six databases (LILACS, BDENF, EMBASE, MEDLINE, SCOPUS, and Web of Science). Results were categorized according to the nurse manager competencies model by the American Organization for Nursing Leadership and were analyzed using the competing values framework model.
Results
Out of 2033 potentially relevant sources identified, 17 studies met inclusion criteria. A total of 52 competencies were identified and categorized into four thematic categories: (1) the ability to collaborate in times of crisis; (2) maintaining control during a crisis; (3) adapting to changes caused by the crisis; and (4) preserving competitiveness through the crisis.
Conclusions
The findings highlight communication, decision‐making, training, adaptability to change, and leadership as essential competencies required of nurse managers to address crises, such as pandemics.
Implications for nursing policy
This body of knowledge can serve as a reference point to enhance the response of nurse managers in the face of future health crisis scenarios. Additionally, it can serve as a framework for healthcare organizations to develop or improve their crisis management training programs.
... During the COVID-19 pandemic, it became clear that the need for leadership and leadership development is more important than ever. The leadership and policy failures during the COVID-19 pandemic are estimated at $125-200 billion in incremental costs to annual health care expenditures in United States alone (1). There have been several pandemics in the past 20 years and it is essential that these leadership failures are addressed for future pandemics (2). ...
... Crisis leadership in various pandemic situations, as per Sriharan et al.'s review, entails performing tasks such as preparation, planning, communication and collaboration (1). Healthcare leaders are responsible for identifying the crisis early, developing emergency preparedness protocols, monitoring crises, implementing protocols, allocating resources, and developing contingency plans (1). They are expected to provide empathy and awareness, inspire and influence decision-making, provide systems thinking and sense-making, develop tacit skills, and build political collaboration (1). ...
... Healthcare leaders are responsible for identifying the crisis early, developing emergency preparedness protocols, monitoring crises, implementing protocols, allocating resources, and developing contingency plans (1). They are expected to provide empathy and awareness, inspire and influence decision-making, provide systems thinking and sense-making, develop tacit skills, and build political collaboration (1). Although these are sensible traits to develop in healthcare leaders, leadership studies have moved beyond simply a laundry list of amiable traits toward a systems thinking approach. ...
... Tese include the improved uptake of virtual healthcare [17], expanded and extended scope of health professional practice [18][19][20][21], appropriate planning and resourcing of essential services [22,23], the importance of engaging with consumers, and appropriate culturally and linguistical public health approaches to underserviced communities [24][25][26][27][28]. Troughout the COVID-19 pandemic, rapid systematic reviews were conducted to synthesize evidence to inform the decision-making by public leaders. Recent published reviews on crisis leadership have focused on the event (natural crises [29] and organizational crises [30]), the leadership style (compassionate leadership [31]) and leadership elements [32,33], the leadership competencies [34], and the roles that leaders play in a crisis [35] and post-crisis [36]. Te bibliometric analysis of existing literature found a knowledge gap in the process view of crisis leadership and the contextualization of the crisis [37], as well as the importance of understanding how decisions are made [38]. ...
... Public health has a broader view of socioeconomic determinants and drivers than some of the conventional clinical medicine in general and has as its core principle the promotion and protection of health through coordinated partnership. Public healthcare leaders draw on tasks, people, and adaptive competencies infuenced by political, structural, and cultural contexts [33]. All 194 member states of the World Health Organization (WHO) are currently negotiating an amendment to the existing international agreement and a new international future pandemic prevention, preparedness, and response instrument [39]. ...
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 parallel, healthcare managers had to adapt their behaviours to continuously handle unexpected events and anticipate and respond rapidly to pandemic-induced challenges experienced by the frontlines (De La Garza & Lot, 2022;Hossny et al., 2022;Ree et al., 2022). Managers' capacity to quickly adapt to their dynamic surroundings has been identified as key to successful crisis management (Sriharan et al., 2022). ...
... This is consistent with previous research showing that absence of managers during COVID-19 led to lack of trust in leaders (Ellis et al., 2023a) in addition to additional layers of stress, confusion and worry (Jacobsson et al., 2022). Also, in line with our findings, the study of Sriharan et al. (2022) showed that physically present managers during the pandemic were perceived by staff as empathetic and caring in addition to building trusting relationships with employees. This was fundamental to involve staff in collective responses during the pandemic (Sriharan et al., 2022). ...
... Also, in line with our findings, the study of Sriharan et al. (2022) showed that physically present managers during the pandemic were perceived by staff as empathetic and caring in addition to building trusting relationships with employees. This was fundamental to involve staff in collective responses during the pandemic (Sriharan et al., 2022). Staff in our study especially highlighted the importance of their frontline managers' presence and support as they communicated, collaborated and involved staff in decisions. ...
A resilient healthcare system is key to responding to sudden crises, such as the coronavirus disease 2019 (COVID‐19) pandemic. Homecare services have been an important platform of healthcare delivery during the pandemic, and healthcare staff on the frontlines of homecare have been confronted with major challenges requiring adaptation to sustain high quality healthcare services. Managers' capacities to adapt to disruptions and challenges are important for an adequate response to challenges on the frontlines. To explore healthcare staff's perspectives on managers at different managerial levels (meso‐level) handling of the COVID‐19 pandemic in Norwegian homecare services. A qualitative multiple case study was designed including four cases. A case was defined as a homecare service within a Norwegian municipality (public organization). Data were collected through 16 interviews with healthcare staff. Interviews were conducted by using a semi‐structured interview guide. Healthcare staff reported their managers as proactive, prepared and responded quickly. Present and supportive managers that provided effective and targeted information, and involved staff in decision‐making were key to handling the pandemic in Norwegian homecare services. Our results underscore the interaction between healthcare staff and managers at different managerial levels as essential for quickly react, adapt, and resiliently respond to disruptions like the COVID‐19 pandemic. Organizations need to have the flexibility to interact across levels and encourage managers to apply strategies for collaboration and staff involvement, especially during a crisis.
... The crisis underscored the need for leaders capable of fostering collaboration, driving innovation under pressure, and communicating effectively with healthcare professionals and the public. The successful navigation of these challenges demonstrated the importance of strong leadership in ensuring the resilience and adaptability of healthcare systems in the face of a global health emergency (Arslan, Golgeci, Khan, Al-Tabbaa, & Hurmelinna-Laukkanen, 2021;Santra & Alat, 2022;Sriharan et al., 2022). ...
This review paper examines the profound impacts of the COVID-19 pandemic on healthcare management, highlighting lessons learned and proposing strategies for future preparedness. It explores the immediate challenges healthcare systems face, such as resource allocation and staff shortages. It discusses the rapid adaptations and innovations that emerged, including the expansion of telehealth and digital health technologies. The paper also reviews policy and management adjustments. It applies theoretical frameworks like organizational change, crisis management, and health systems resilience to understand these changes. Key findings emphasize the importance of resilience, flexibility, and innovation in healthcare management. Recommendations for practice and policy focus on enhancing public health infrastructure, investing in digital health, and fostering international cooperation. The paper concludes with directions for future research, including the evaluation of digital health interventions and strategies to address healthcare disparities, underscoring the need for a robust, adaptive, and equitable healthcare system in the post-pandemic world. Keywords: Covid-19 Pandemic, Healthcare Management, Digital Health Technologies, Crisis Management Theory, Healthcare System Resilience.
... Crisis preparedness is critical for crisis management in all organizations (2). The rst cases of COVID-19 were detected in Wuhan, Hubei province in China, in December 2019 (3) and in Iran on February 19, 2020 rst case was detected in two people residing in Qom (4). As of April 20th, 2023, it is reported that 145,571 cases were died in Iran and 5,272 in China (5). ...
Background: Availability of medical infrastructures, the ability to comprehend the transmission of a disease, the application of control strategies and proper implementation of logistic policies are vital for successful management of an epidemic in a country but all of them are under the influence of the health and management policies of countries. Thus, the present study aimed to compare the strategies used by Iranian and Chinese nurses for management plan of patients with COVID- 19.
Methods: The present study was conducted based on the conventional content analysis method and Graneheim & Lundman approach. The participants were recruited by purposeful sampling and based on inclusion criteria from the nurses working in the COVID-19 wards of Shariati hospital in Tehran of Iran and Haikou hospital in Hainan of China. The data were collected by conducting semi-structured, in-depth, one-to-one interviews until reaching data saturation. Then the differentiation of the strategies used in the two countries was investigated.
Results: In-depth interviews with 9 Chinese and 10 Iranian nurses were done. “managers as key element to overcoming the crisis” as the main category, 6 categories and 22 subcategories were excluded from Iranian interviews. “Action to Control Crisis” as the main category, 8 categories and 19 subcategories were excluded from Chinese interviews.
Conclusion: Nursing managers in China have given more importance to the process of training and preparing nurses to take care of patients with Covid-19 and reduce the transmission of infection between Health care workers. However, nursing managers in Iran have focused more on using measures to compensate for the shortage of nurses, limiting the days of hospitalization of patients and daily monitoring of nurses' performance and ventilator settings of patients.
... This adaptation ensures effective targeting and addresses the actual post-crisis health priorities. Essential to these assessments were demographic surveys conducted at the administrative level, requiring a deep understanding of the local social, geographic, and political intricacies (22). Addressing these complexities is crucial to avoid inaccuracies in population size estimation (23). ...
Background
On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation’s public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region.
Methods
Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP’s contributions to the public health response during the initial 4 months of the conflict (April–July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires.
Results
A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response.
Conclusion
The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.
... The reviewed studies advocate for a comprehensive ethical framework for leadership in public health crises. While individual studies address specific aspects of crisis management (e.g., communication, stakeholder engagement, resource allocation), there is a lack of integration across these areas in existing models (38). This review contributes by emphasizing that ethical principles and operational considerations must be addressed concurrently by public health leaders (39). ...
Leadership teams are crucial during public health crises, as they are responsible for balancing public safety with individual rights. Effective decision making and ethical considerations are essential in addressing health emergencies and minimizing societal impacts. While various strategies exist in public health leadership, their wide variation often poses challenges in maintaining consistency in achieving both immediate and long-term goals. This study evaluates public health leadership during crises, focusing on administrative actions, ethical decision-making, and strategies to balance public welfare and individual liberty in health emergencies. A systematic review of articles published since 2010 in PubMed, Scopus, and Google Scholar was conducted per PRISMA guidelines. From 200 papers reviewed, 120 met inclusion criteria, with 13 highly relevant articles selected for qualitative analysis of leadership effectiveness and ethical frameworks. The results reveal that adaptive leadership promotes crisis response by facilitating effective communication, coordination, and timely decision making. Proactive risk assessment of key issues, instigating stakeholder communication and prioritizing resources are some of the key strategies identified. However, organizational hierarchies and dilemmas over ethical enforcement of related policies are main challenges. Crisis leadership requires evidence based ethical decision-making balancing public safety with individual rights. Improving crisis preparedness and resilience requires enhanced collaboration and adaptive leadership across sectors. Future research should also explore how certain leadership models affect crisis response outcomes.
