Supporting Health Care Resilience Through "Reflexive Spaces" in Home Care Services: A Multiple Embedded Case Study

Area of Science:

• Healthcare Management
• Organizational Psychology
• Public Health

Background:

• The COVID-19 pandemic presented unprecedented challenges to homecare services.
• Effective knowledge sharing and adaptation are crucial for healthcare resilience.

Purpose of the Study:

• To explore how managers facilitated collective reflection and knowledge sharing ("reflexive spaces") in homecare during the COVID-19 pandemic.
• To understand the contribution of these spaces to pandemic adaptations.
• To discuss the role of these spaces in fostering healthcare resilience.

Main Methods:

• A multiple embedded case study design was employed.
• Data collection involved interviews with 16 healthcare staff and 21 managers across 4 Norwegian municipalities.
• Reflexive thematic analysis was used for data analysis.

Main Results:

• Two key themes emerged: arenas for reflection, communication, and dialogue; and establishing new solutions through collective reflection facilitated by managers.
• Managers initiating dialogue and reflection arenas were vital for sharing knowledge on pandemic challenges.
• Collaborative reflection by managers and staff led to tactical and resilient responses.

Conclusions:

• Managers played a pivotal role in facilitating "reflexive spaces" across different responsibility levels.
• "Reflexive spaces" mediated knowledge and understanding across the healthcare system.
• Integrating "reflexive spaces" into daily practice helps balance demands, capacity, and respond to crises and everyday challenges.