Frontline Healthcare Workers' Reflections on Operationalizing the COVID-19 Pandemic Response: A Qualitative Study

The COVID-19 pandemic provided opportunities to learn from healthcare workers involved in implementing pandemic plans within healthcare settings. This study explores healthcare workers' reflections on the first 3 years of the COVID-19 pandemic and their experiences activating health service pandemic plans.

A qualitative exploratory descriptive study design was used to explore through focus groups' frontline healthcare workers' experiences related to emergency response planning, operationalizing the pandemic response plan, the workforce mindset, and re-evaluation of the organizations' response once the crisis had abated. Thematic analysis guided by Braun and Clark's six-steps was used to identify themes.

Thirty-two healthcare workers participated in 10 focus group discussions. The following six key themes were identified and explored (1): unprepared emergency response systems and processes, (2) adaptive crisis management under pressure, (3) the evolving reality of the pandemic response and embedding the basics, (4) leadership styles and communication challenges when managing a crisis, (5) psychological challenges of leading the workforce during a prolonged crisis, and (6) organizational preparedness for future pandemics.

Healthcare workers were required to respond rapidly to maintain safety and meet healthcare needs, with little understanding of the organization's pandemic plan. This study provides an opportunity to learn from the experiences of healthcare workers in integrating the frontline perspective into the design and execution of emergency response plans, to enhance workforce sustainability and organizational preparedness.