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Area of Science:

  • Public Health
  • Health Systems Management
  • Epidemiology

Background:

  • Historical pandemics like 1918 influenza and H1N1 outbreaks highlight persistent global unpreparedness.
  • The coronavirus disease 2019 (COVID-19) pandemic further exposed critical deficiencies in U.S. public health preparedness.
  • Recurring failures underscore the need to identify and implement effective pandemic response strategies.

Purpose of the Study:

  • To investigate leadership practices contributing to successful COVID-19 pandemic responses.
  • To identify underlying principles and practices for enhancing future pandemic preparedness.
  • To learn from senior leaders' experiences in managing catastrophic health events.

Main Methods:

  • Recruited 14 senior leaders (61%) from a multisite, multicountry integrated health system using maximum variation sampling.
  • Conducted individual recorded interviews (approx. 20 minutes) based on Appreciative Inquiry and critical incident reporting.
  • Utilized iterative consensus coding to identify six major themes: self- and situation awareness, teamwork, readiness, inspirational leadership, internal communication, and external communication.

Main Results:

  • Organizational culture, shared cognition, and historical context significantly influence system-wide responses to pandemics.
  • Individual leadership decisions are important, but broader organizational factors shape overall effectiveness.
  • Effective responses depend on more than just individual leader actions.

Conclusions:

  • Inadequate preparation for novel events and unidirectional communication are risk factors for chaotic and ineffective pandemic responses.
  • Senior leaders must integrate clinical needs with humanistic values and purpose for optimal outcomes.
  • Prioritizing situation awareness and organizational culture can enhance the quality, timeliness, and effectiveness of future pandemic preparedness and response.