Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement

doi:10.1001/jamanetworkopen.2021.20295

. 2021 Jul 1;4(7):e2120295.

doi: 10.1001/jamanetworkopen.2021.20295.

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement

Jaason M Geerts^{1

2}, Donna Kinnair³, Paul Taheri⁴, Ajit Abraham^{5

6}, Joonmo Ahn⁷, Rifat Atun⁸, Lorena Barberia^{9

10}, Nigel J Best¹¹, Rakhi Dandona^{12

13}, Adeel Abbas Dhahri¹⁴, Louise Emilsson^{15

16

17

18}, Julian R Free¹⁹, Michael Gardam^{20

21}, William H Geerts²², Chikwe Ihekweazu²³, Shanthi Johnson²⁴, Allison Kooijman^{25

26}, Alika T Lafontaine^{27

28}, Eyal Leshem^{29

30}, Caroline Lidstone-Jones³¹, Erwin Loh^{32

33}, Oscar Lyons³⁴, Khalid Ali Fouda Neel³⁵, Peter S Nyasulu³⁶, Oliver Razum³⁷, Hélène Sabourin^{38

39}, Jackie Schleifer Taylor^{40

41}, Hamid Sharifi⁴², Vicky Stergiopoulos^{43

44}, Brett Sutton^{45

46}, Zunyou Wu^{47

48

49}, Marc Bilodeau⁵⁰

Affiliations

¹ Research and Leadership Development, Canadian College of Health Leaders, Ottawa, Ontario, Canada.
² Bayes Business School, University of London, London, United Kingdom.
³ Royal College of Nursing, Marylebone, London, United Kingdom.
⁴ Yale School of Medicine, New Haven, Connecticut.
⁵ Barts Health NHS Trust, Royal Hospital, London, United Kingdom.
⁶ Staff College: Leadership in Healthcare, London, United Kingdom.
⁷ Department of Public Administration, Korea University, Seoul, Republic of Korea.
⁸ Global Health Systems, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
⁹ Department of Political Science, University of São Paulo, São Paulo, Brazil.
¹⁰ Solidarity Research Network for Public Policies and Society, Observatorio COVID-19 Brazil.
¹¹ United Nations Mission in South Sudan, UN House, Juba, South Sudan.
¹² Public Health Foundation of India, Gurugram, India.
¹³ Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle.
¹⁴ Royal Infirmary Hospital Edinburgh, Edinburgh, United Kingdom.
¹⁵ Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
¹⁶ Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
¹⁷ Vårdcentralen Värmlands Nysäter and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden.
¹⁸ Medicine and Health, Örebro University, Örebro, Sweden.
¹⁹ University of Lincoln, Brayford Pool, Lincoln, United Kingdom.
²⁰ Chief Executive Officer, Health PEI, Charlottetown, Canada.
²¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
²² Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
²³ Nigeria Centre for Disease Control, Jabi, Abuja, Nigeria.
²⁴ School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
²⁵ World Health Organization Patients for Patient Safety, Geneva, Switzerland.
²⁶ Patients for Patient Safety Canada, Edmonton, Alberta, Canada.
²⁷ Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
²⁸ Canadian Medical Association, First Nations Health Authority, Indigenous Physicians Association of Canada, West Vancouver, British Columbia, Canada.
²⁹ Institute for Travel and Tropical Medicine, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
³⁰ School of Medicine, Tel Aviv University, Tel Aviv, Israel.
³¹ Indigenous Primary Health Care Council, Toronto, Ontario, Canada.
³² Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia.
³³ St Vincent's Health Australia, East Melbourne, Australia.
³⁴ Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
³⁵ College of medicine, King Saud University, Riyadh, Saudi Arabia.
³⁶ Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
³⁷ School of Public Health, Bielefeld University, Bielefeld, Germany.
³⁸ Canadian Association of Occupational Therapists, Nepean, Ontario, Canada.
³⁹ Organizations for Health Action, Ottawa, Ontario, Canada.
⁴⁰ London Health Sciences Centre, London, Ontario, Canada.
⁴¹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
⁴² HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
⁴³ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁴⁴ Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴⁵ Department of Health, Melbourne, Victoria, Australia.
⁴⁶ Monash University School of Public Health and Preventive Medicine, Melbourne, Australia.
⁴⁷ China Center for Disease Control and Prevention, Beijing, China.
⁴⁸ Division of HIV Prevention, National Center for AIDS/STD Control and Prevention, Beijing, China.
⁴⁹ Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles.
⁵⁰ Surgeon General, Canadian Armed Forces, Ottawa, Ontario, Canada.

PMID: 34236416
DOI: 10.1001/jamanetworkopen.2021.20295

Free article

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement

Jaason M Geerts et al. JAMA Netw Open. 2021.

Free article

. 2021 Jul 1;4(7):e2120295.

doi: 10.1001/jamanetworkopen.2021.20295.

Authors

Affiliations

¹ Research and Leadership Development, Canadian College of Health Leaders, Ottawa, Ontario, Canada.
² Bayes Business School, University of London, London, United Kingdom.
³ Royal College of Nursing, Marylebone, London, United Kingdom.
⁴ Yale School of Medicine, New Haven, Connecticut.
⁵ Barts Health NHS Trust, Royal Hospital, London, United Kingdom.
⁶ Staff College: Leadership in Healthcare, London, United Kingdom.
⁷ Department of Public Administration, Korea University, Seoul, Republic of Korea.
⁸ Global Health Systems, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
⁹ Department of Political Science, University of São Paulo, São Paulo, Brazil.
¹⁰ Solidarity Research Network for Public Policies and Society, Observatorio COVID-19 Brazil.
¹¹ United Nations Mission in South Sudan, UN House, Juba, South Sudan.
¹² Public Health Foundation of India, Gurugram, India.
¹³ Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle.
¹⁴ Royal Infirmary Hospital Edinburgh, Edinburgh, United Kingdom.
¹⁵ Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
¹⁶ Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
¹⁷ Vårdcentralen Värmlands Nysäter and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden.
¹⁸ Medicine and Health, Örebro University, Örebro, Sweden.
¹⁹ University of Lincoln, Brayford Pool, Lincoln, United Kingdom.
²⁰ Chief Executive Officer, Health PEI, Charlottetown, Canada.
²¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
²² Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
²³ Nigeria Centre for Disease Control, Jabi, Abuja, Nigeria.
²⁴ School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
²⁵ World Health Organization Patients for Patient Safety, Geneva, Switzerland.
²⁶ Patients for Patient Safety Canada, Edmonton, Alberta, Canada.
²⁷ Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
²⁸ Canadian Medical Association, First Nations Health Authority, Indigenous Physicians Association of Canada, West Vancouver, British Columbia, Canada.
²⁹ Institute for Travel and Tropical Medicine, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
³⁰ School of Medicine, Tel Aviv University, Tel Aviv, Israel.
³¹ Indigenous Primary Health Care Council, Toronto, Ontario, Canada.
³² Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia.
³³ St Vincent's Health Australia, East Melbourne, Australia.
³⁴ Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
³⁵ College of medicine, King Saud University, Riyadh, Saudi Arabia.
³⁶ Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
³⁷ School of Public Health, Bielefeld University, Bielefeld, Germany.
³⁸ Canadian Association of Occupational Therapists, Nepean, Ontario, Canada.
³⁹ Organizations for Health Action, Ottawa, Ontario, Canada.
⁴⁰ London Health Sciences Centre, London, Ontario, Canada.
⁴¹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
⁴² HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
⁴³ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁴⁴ Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴⁵ Department of Health, Melbourne, Victoria, Australia.
⁴⁶ Monash University School of Public Health and Preventive Medicine, Melbourne, Australia.
⁴⁷ China Center for Disease Control and Prevention, Beijing, China.
⁴⁸ Division of HIV Prevention, National Center for AIDS/STD Control and Prevention, Beijing, China.
⁴⁹ Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles.
⁵⁰ Surgeon General, Canadian Armed Forces, Ottawa, Ontario, Canada.

PMID: 34236416
DOI: 10.1001/jamanetworkopen.2021.20295

Abstract

Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage.

Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic.

Evidence review: A literature search in PubMed, MEDLINE, and Embase revealed 10 910 articles published between 2000 and 2021 that included the terms leadership and variations of emergency, crisis, disaster, pandemic, COVID-19, or public health. Using the Standards for Quality Improvement Reporting Excellence reporting guideline for consensus statement development, this assessment adopted a 6-round modified Delphi approach involving 32 expert coauthors from 17 countries who participated in creating and validating a framework outlining essential leadership imperatives.

Findings: The 10 imperatives in the framework are: (1) acknowledge staff and celebrate successes; (2) provide support for staff well-being; (3) develop a clear understanding of the current local and global context, along with informed projections; (4) prepare for future emergencies (personnel, resources, protocols, contingency plans, coalitions, and training); (5) reassess priorities explicitly and regularly and provide purpose, meaning, and direction; (6) maximize team, organizational, and system performance and discuss enhancements; (7) manage the backlog of paused services and consider improvements while avoiding burnout and moral distress; (8) sustain learning, innovations, and collaborations, and imagine future possibilities; (9) provide regular communication and engender trust; and (10) in consultation with public health and fellow leaders, provide safety information and recommendations to government, other organizations, staff, and the community to improve equitable and integrated care and emergency preparedness systemwide.

Conclusions and relevance: Leaders who most effectively implement these imperatives are ideally positioned to address urgent needs and inequalities in health systems and to cocreate with their organizations a future that best serves stakeholders and communities.

PubMed Disclaimer

Cited by

Individual and Work Factors Associated with Psychosocial Health of Registered Nurses During the Covid-19 Pandemic: A Mixed Methods Study.
Witkoski Stimpfel A, Ghazal L, Goldsamt L, Vaughan Dickson V. Witkoski Stimpfel A, et al. J Occup Environ Med. 2022 Jun 1;64(6):515-524. doi: 10.1097/JOM.0000000000002495. Epub 2022 Jan 25. J Occup Environ Med. 2022. PMID: 35081585 Free PMC article.
Professional Quality of Life and Occupational Stress in Healthcare Professionals During the COVID-19 Pandemic in Greece.
Latsou D, Bolosi FM, Androutsou L, Geitona M. Latsou D, et al. Health Serv Insights. 2022 May 26;15:11786329221096042. doi: 10.1177/11786329221096042. eCollection 2022. Health Serv Insights. 2022. PMID: 35651953 Free PMC article.
Developing an evidence-informed model of long-term life care at home for older adults with medical, functional and/or social care needs in Ontario, Canada: a mixed methods study protocol.
Giosa JL, Saari M, Holyoke P, Hirdes JP, Heckman GA. Giosa JL, et al. BMJ Open. 2022 Aug 11;12(8):e060339. doi: 10.1136/bmjopen-2021-060339. BMJ Open. 2022. PMID: 35953249 Free PMC article.
[Primary care organization in pandemic times].
Coll Benejam T, Palacio Lapuente J, Añel Rodríguez R, Gens Barbera M, Jurado Balbuena JJ, Perelló Bratescu A. Coll Benejam T, et al. Aten Primaria. 2021 Dec;53 Suppl 1(Suppl 1):102209. doi: 10.1016/j.aprim.2021.102209. Epub 2021 Nov 19. Aten Primaria. 2021. PMID: 34802799 Free PMC article. Spanish.
Communication to promote and support physical distancing for COVID-19 prevention and control.
Ryan RE, Silke C, Parkhill A, Virgona A, Merner B, Hurley S, Walsh L, de Moel-Mandel C, Schonfeld L, Edwards AG, Kaufman J, Cooper A, Chung RKY, Solo K, Hellard M, Di Tanna GL, Pedrana A, Saich F, Hill S. Ryan RE, et al. Cochrane Database Syst Rev. 2023 Oct 9;10(10):CD015144. doi: 10.1002/14651858.CD015144. Cochrane Database Syst Rev. 2023. PMID: 37811673 Free PMC article. Review.

See all "Cited by" articles

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

001/WHO_/World Health Organization/International

LinkOut - more resources

Full Text Sources
- Ovid Technologies, Inc.
- Silverchair Information Systems
Other Literature Sources
- H1 Connect - Access expert opinions and insights on biomedical research.
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement

Affiliations

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement

Authors

Affiliations

Abstract

Similar articles

Cited by

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical