JMIR Publications

ABSTRACT

Background:

Since the World Health Organization declared COVID-19 a global pandemic, health systems and health system leaders have faced unprecedented challenges through the various stages of the crisis. Canada and other health systems were largely ill-prepared to handle this crisis. The longevity of the pandemic has profoundly affected healthcare systems and compounded the rates of negative psychological outcomes in health systems leaders and staff rates of emotional exhaustion and burnout.

Objective:

The purpose of this study is to investigate the experiences of health system leaders and nurses during COVID-19 and to develop recommendations to inform pre-, during-, and post-crisis leadership strategies and practices for health system leaders, which address leader and nurses’ psychological health and wellbeing, as well as organizational resilience

Methods:

A 3-year multi-method approach will be adopted and will include a qualitative exploratory inquiry informed by Geerts’ 4-stage framework of imperatives for health system leaders to guide data collection and analysis. We will then conduct semi-structured individual interviews with health system leaders in three provinces in Canada and hold focus group interviews (FGIs) with nurses from the same organizations. Data from the interviews and FGIs will be integrated to determine how health system leaders promoted their own health and how their leadership shaped nurses’ psychological health and contributed to building organizational resilience. We will also explore the influence of gender on approaches and results. We will engage knowledge users using a nominal group technique in a one-day forum to discuss how findings can be applied in professional contexts. We will conduct a thematic analysis of the aggregated data to identify and analyze themes (patterns of meaning) to provide an interpretive explanation of health system leaders’ experiences and organizational resilience during COVID-19 pandemic, and how the leaders promoted nurses’ psychological health and wellbeing.

Results:

The protocol has been reviewed and approved by the University of Manitoba Institutional Review Board (IRB), University of Alberta IRB and McMaster University Ontario IRB. Data collection began in September 2023 with individual interviews which will be followed by FGIs beginning September 2024 and concluding with data integration and the nominal group technique in early 2026.

Conclusions:

The findings will support practices that health system leaders can implement to foster their own and nurses’ psychological health and wellbeing and build organizational resilience. The benefits of this study aim to include evidence for effective health system leadership and support for nurses, crisis preparedness, and lessons from the pandemic to address leadership practices to operationalize the imperatives within the four stages of the crisis model.