Nurse Managers Coping Strategies for Crisis Management: Qualitative Systematic Review

Stressor-related disorders are a growing issue for both the individual and the organizations. The aim of the study was to analyze the strategies used by nurse managers to face crises. A systematic review of the literature, including qualitative studies was performed. Data were analyzed using framework-based synthesis and summarized into domains. Quality was evaluated using the JBI QARI Checklist. 10 studies met the inclusion criteria. Data collection was based on interviews, followed by questionnaires and focus groups. Good communication, organizational commitment and emotional support were the principal domains. Institutions should support nurse managers to cope with stress and make suggestions for adaptations.

Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers

OBJECTIVE

To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses.

DESIGN

Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data.

RESULTS

Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality.

CONCLUSIONS

The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.

Crisis management competencies needed in a hospital setting during the COVID-19 pandemic: A qualitative study of nurse leaders

AIM

To describe the crisis management competencies needed in a hospital setting during the COVID-19 pandemic from the perspective of nurse leaders.

BACKGROUND

The COVID-19 pandemic generated many challenges for nurse leaders in hospitals, and management competencies are highlighted. However, there is little evidence available about nurse leaders' perceptions of the crisis management competencies needed in such situations.

METHODS

A qualitative, descriptive, semi-structured interview study of nurse leaders (n = 20) was conducted between June and October 2021 in one Finnish central hospital. The data were analysed using inductive content analysis.

RESULTS

The analysis yielded five main categories of crisis management competencies needed in a hospital setting during the pandemic: interactive communication competence, psychological resource management competence, systematic and proactive organising competence, active networking abilities and practices and change management approach in crisis management.

CONCLUSIONS

Nurse leaders need new and different crisis management competencies in hospital organisations. The COVID-19 pandemic changed the working culture of nurse leaders, as they faced challenges that needed knowledge and skills beyond their previous management competence.

IMPLICATIONS FOR NURSING MANAGEMENT

Additional training for nurse leaders in crisis management is needed. This training should reflect the competencies identified as necessary in crisis situations so that nurse leaders will be able to manage crisis situations effectively in future.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used in reporting the findings.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Why do democracies respond differently to COVID-19? A comparison of the United States and South Korea

Background

COVID-19 has posed severe challenges to crisis management in democracies. Different democracies respond to the crisis differently. This article proposes an analytical framework to explain why democracies respond differently to the public health crisis and how different contextual factors affect crisis response in democracies.

Methods

By comparing COVID-19 responses in the US and South Korea, this article conducts a comparative case study with a most similar system design. The two countries have been selected as cases because they are both developed democracies with a robust healthcare system. However, different contextual factors in the two countries have created different crisis responses by shaping different crisis leadership and political and social solidarity. This study collected data from different sources, including government documents, official websites, leaders' speeches, research reports, academic articles and news media. We tried to enhance the reliability of the data by comparing different data sources.

Results

We found that individual, institutional and cultural dimensions of contextual factors can influence different crisis responses of democratic countries by shaping crisis leadership and political and social solidarity. On the individual and institutional dimensions, leadership style and governance structure shape crisis leadership (sense making, decision making and coordinating, and meaning making), which in turn influences crisis management. On the cultural dimension, political and social solidarity measured by political polarization and social cooperation are shaped by cultural and social norms.

Conclusion

Our findings indicate that democracies require strong crisis leadership and a high degree of political and social solidarity to tackle public health crises. A centralized and coordinated system, as well as a political elite leadership style shaped by rich crisis response experience, expertise and high sensitivity to crises are conducive to crisis management. Fostering a cultural and social norm that facilitates state-society collaboration can promote crisis management. These findings provide valuable insights for decision-makers to effectively respond to future pandemics.

Assessing health care leadership and management for resilience and performance during crisis: The HERO-36

BACKGROUND

Whereas organizational literature has provided much insight into the conceptual and theoretical underpinnings of organizational leadership and management during emergencies, measures to operationalize related effective practices during crises remain sparse.

PURPOSE

To address this need, we developed the Healthcare Emergency Response Optimization survey, which set out to examine the leadership and management practices in health care organizations that support resilience and performance during crisis.

METHODOLOGY

We administered an online survey in April to May 2022 to health care administrators and frontline staff intimately involved in their hospital's emergency response during the COVID-19 pandemic, which included a sample of 379 respondents across nine rural and urban hospitals (response rate: 44.4%). We used confirmatory factor analysis and quantile regressions to examine the results.

RESULTS

Applying confirmatory factor analysis, we retained 36 items in our survey that comprised eight measures for formal and informal practices to assess crisis leadership and management. To test effectiveness of the specified practices, we regressed self-reported resilience and performance measures on the formality and informality scores. Findings show that informal practices mattered most for resilience, whereas formal practices mattered most for performance. We also identified specific practices (anticipation, transactional and relational interactions, and ad hoc collaborations) for resilience and performance.

PRACTICE IMPLICATIONS

These validated measures of organizational practices assess emergency response during crisis, with an emphasis on the actions and decisions of leadership as well as the management of organizational structures and processes. Organizations using these measures may subsequently modify preparedness and planning approaches to better manage future crises.

Hospital-Level COVID-19 Preparedness and Crisis Management in Czechia

Objectives: The COVID-19 pandemic exposed the inadequacy of pandemic preparedness mechanisms worldwide. This study gathered comprehensive data from Czech hospitals, identified possible weaknesses in important areas of crisis preparedness, and quantified changes performed to enhance crisis resilience of healthcare facilities. Methods: Drawing on literature review on pandemic preparedness and hospital crisis management and detailed interviews with hospital representatives, a questionnaire was designed and distributed by email among quality managers of all Czech hospitals. Statistical analysis of their responses was conducted using EZR software. Fisher's exact test and Kruskal-Wallis test, with post hoc testing, were used to assess statistical significance. Results: Achieving response rate of 31.9%, responses from 65 hospitals were analysed. New crisis management policies were necessary in 72.3% of responding hospitals. Furthermore, a majority of the respondents changes indicated the need for changes in policies on general pandemic, human resources and infrastructure and material preparedness. Conclusion: The COVID-19 crisis required significant alterations to previously established hospital crisis management protocols and establishment of new ones. The absence of a unified system for crisis preparedness was noted at hospital and national levels.

Navigating the Commonality of Healthcare Failures: COVID-19 and Conflict Zones

The weaknesses of healthcare systems have been sharply revealed amid the instability of the COVID-19 pandemic and the ongoing conflicts across the borders of different countries. One thing unites these two crises that appear to be separate: the incapacity of healthcare systems to provide for the most basic human requirements in emergency situations. With an emphasis on the roles of the United Nations and the World Health Organisation, we look into the similarities between healthcare failures in COVID-19 and conflict zones in this Editorial and offer possible solutions to improve the circumstances.

Reducing the negative impact of accidents associated with the release of dangerous substances to environment

Background

The article is concerned with an evaluation of the current state of emergency readiness of industrial companies in the event of dangerous substance leakage and with a presentation of textile sorbents used for the purposes of capturing an escaped substance.

Methods

A part of the article is concerned with the experimental designation of sorption capacity of hydrophobic, chemical, and universal sorption mats for chosen polar (water and alcohol) and non-polar (oil and gasoline) liquids. Experiments were realized according to Standard Test Method for Sorbent Performance of Adsorbents for use on Crude Oil and Related Spills, American Society for Testing and Materials (ASTM F726-17), type I. and Test methods for non-woven fabrics, European Union International Organization for Standardization (EN ISO 9073-6:2004). The aim of the article is an experimental designation of sorption capacity of textile sorption mats using two different methods, a comparison of the acquired results and a comparison of the acquired data with the data given by the manufacturer.

Results

Textile sorbents, which can, owing to their sorption ability, allow the elimination or mitigation of a negative impact of a possible accident in the company connected with an escape of a liquid dangerous substance were tested and compared with the established values. Based on the obtained results it is possible to state that sorption capacities of the chemical and universal mat for the substrate water are equal and consistent with the data given by the manufacturer. Textile sorption mats also have a comparable sorption capacity. The sorption capacity on the substrate gasoline is the same in all textile sorbents. The adsorption capacity per unit mass all type's sorbents was similar for non-polar liquids (gasoline was values from 6.41 to 6.57 and oil was values from 9.54 to 10.24).

Conclusion

The acquired results confirmed the universality of textile sorption mats for gasoline. Sorption capacities of the chemical and universal mat for the substrate water are equal and match the data given by the manufacturer. Textile sorption mats have a maximum sorption output up to 60 s, afterwards the sorption capacity values remain unchanged.

Tension between local, regional and national levels in Norway's handling of COVID-19

AIMS

This study aimed to explore the tension between local, regional, and national authorities evoked by some rural municipalities' decisions to impose local infection-control measures during the first weeks of the COVID-19 pandemic in Norway.

METHODS

Eight municipal Chief Medical Officers of Health (CMOs) participated in semi-structured interviews, and six crisis management teams participated in focus-group interviews. Data were analysed with systematic text condensation. Boin and Bynander's interpretation of crisis management and coordination and Nesheim et al.'s framework for non-hierarchical coordination in the state sector inspired the analysis.

RESULTS

Uncertainty in the face of a pandemic with unknown damage potential, lack of infection-control equipment, patient transport challenges, vulnerable staff situation and planning of local COVID-19 beds were some of the reasons for rural municipalities imposing local infection-control measures the first weeks of the pandemic. Local CMOs' engagement, visibility and knowledge contributed to trust and safety. Differences in perspectives between local, regional and national actors created tension. Existing roles and structures were adjusted, and new informal networks arose.

CONCLUSIONS

Strong municipal responsibility in Norway and the quite unique arrangement with local CMOs in every municipality with the legal right to decide temporary local infection-control measures seemed to facilitate a balance between top-down and bottom-up decision making. Tension between rural, regional and national actors that arose due to local infection-control measures, and the following dialogue and mutual adjustment of perspectives, led to a fruitful balance between national and local measures in Norway's handling of the COVID-19 pandemic.

Centralization and democratization: Managing crisis communication in health care delivery

BACKGROUND

Communication is an essential organizational process for responding to adversity. Managers are often advised to communicate frequently and redundantly during crises. Nonetheless, systematic investigation of how information receivers perceive organizational communication amid crises has remained lacking.

PURPOSE

The aim of this study was to characterize features of effective internal crisis communication by examining how information-sharing processes unfolded during the initial stage of the COVID-19 pandemic.

METHODOLOGY

Between June and August 2020, we conducted 55 semistructured interviews with emergency department workers practicing in a variety of roles. We analyzed interview transcripts following constructivist constant comparative methods.

RESULTS

Our findings revealed that at the onset of COVID-19 pandemic response, emergency department workers struggled with immense fear and anxiety amid high uncertainty and equivocality. Frequent and redundant communication, however, resulted in information delivery and uptake problems, worsening anxiety, and interpersonal tension. These problems were ameliorated by the emergence of contextual experts who centralized and democratized communication. Centralization standardized information received across roles, work schedules, and settings while decoupling internal communication from turbulence in the environment. Democratization made information accessible in a way that all could understand. It also ensured information senders' receptiveness to feedback from information receivers. Centralization and democratization together worked to reduce sensed uncertainty and equivocality, which reduced anxiety and interpersonal tension.

CONCLUSION

Establishing frequent and redundant communication strategies does not necessarily address the anxiety and interpersonal tension produced by uncertainty and equivocality in crises.

PRACTICE IMPLICATIONS

Centralization and democratization of crisis communication can reduce anxiety, improve coordination, and promote a safer workplace and patient care environment.

The Role of Vaccination Centers in a National Mass Immunization Campaign-Policymaker Insights from the German COVID-19 Pandemic Vaccine Roll-Out

During the COVID-19 vaccination campaign, Germany, like other high-income countries, introduced mass vaccination centers for administering vaccinations. This qualitative study aimed to examine the role that these novel, temporary government healthcare structures played in a mass immunization roll-out and how they can be optimally deployed. In addition, learnings for general emergency preparedness were explored. A total of 27 high-level policymakers responsible for planning and implementing the COVID vaccination campaign at the national and state level in Germany were interviewed in May and June 2022. The semi-structured interviews were analyzed using thematic analysis. Interviewees indicated that mass vaccination structures played an essential role with respect to controllability, throughput, accessibility and openness in line with the key success criteria vaccination coverage, speed and accessibility. In contrast to the regular vaccination structures (private medical practices and occupational health services), public administration has direct authority over mass vaccination centers, allowing for reliable vaccine access prioritization and documentation. The deployment of vaccination centers should be guided by vaccine availability and demand, and vaccine requirements related to logistics, as well as local capacities, i.e., public-health-service strength and the physician density, to ensure effective, timely and equitable access. Improvements to the capacity use, scalability and flexibility of governmental vaccination structures are warranted for future pandemics.

Navigating the Storm: An Exquisite Leadership Insight into Healthcare Management amidst the COVID-19 Pandemic

This article presents a reflective analysis of the role of public leadership within the context of crises, advocating for increased involvement of public health experts in crisis management. The study delves into the intricate dynamics that executives and board members exhibit when faced with crises. A primary focus of this research is the essential aspects that illuminate the engagement of public officials in the ongoing crisis, notably rapid decision-making and innovative thinking. The article underscores the paramount importance of leaders emphasizing values and mission while employing clear, meaningful, and empathetic communication. A comprehensive comprehension of public leadership emerges as a pivotal factor in crisis management, particularly when devising policy remedies for public health emergencies. The criticality of nurturing a new generation of healthcare CEOs and elevating the visibility of public health roles is underscored as an imperative for adeptly addressing the array of crises confronting us. This article broadens our insights into the multifaceted responsibilities of human resource management in both crisis response and recovery. Consequently, this endeavor facilitates the identification of evolving leadership roles essential for efficacious crisis management, fostering preparedness for prospective public health challenges.

Identification of behavioural changes in reporting adverse events early during COVID-19: An ambulatory care perspective in Israel

This study examined adverse event reporting centred on three significant dates in the months before the pandemic arrived in Israel. On these dates, broad media coverage exposed citizens and health care providers with indications about the forthcoming pandemic. The current study tracked whether parameters related to reporting adverse medical events provided early indications that a large crisis was unfolding. The method for analysing the data was based on a statistical test called Regression Discontinuity Design, which helped identify parameters related to medical reporting patterns which significantly changed. The examination indicated nurses' reports were unique in relation to others and indicated three phases: (1) upon declaration of the upcoming pandemic, there was a rise in reporting; (2) when the disease was named, there was moderation and maintenance in a steady quantity of reports, and finally, (3) when the first case arrived in Israel, a slight decrease in reporting began. Nurses' behaviours manifested as changes in reporting patterns. In this process of increase, moderation and decrease, it can be concluded that these are three stages that may characterise the beginning of a large event. The research method presented reinforces the need for forming tools by which significant events such as the COVID-19 pandemic can be identified quickly, and aid in proper planning of resources, optimise staffing and maximise utilization of the health systems.

Flood-Related Multimedia Benchmark Evaluation: Challenges, Results and a Novel GNN Approach

This paper discusses the importance of detecting breaking events in real time to help emergency response workers, and how social media can be used to process large amounts of data quickly. Most event detection techniques have focused on either images or text, but combining the two can improve performance. The authors present lessons learned from the Flood-related multimedia task in MediaEval2020, provide a dataset for reproducibility, and propose a new multimodal fusion method that uses Graph Neural Networks to combine image, text, and time information. Their method outperforms state-of-the-art approaches and can handle low-sample labelled data.

Analysis of Factors Affecting the Sustainable Success of Airlines During the COVID-19 Pandemic

The COVID-19 pandemic increased the risk of financial distress, bankruptcy, or both, in the airline industry. Whether airlines can survive or not during and/or after the pandemic is closely related to their decisions and actions which will enable their success by increasing their resilience. In crisis periods such as COVID-19, the decisions taken by airlines are strategically important for achieving sustainable success. Thus, it is critical to understand which factors are more important for airlines to shape their actions and make correct decisions. This paper investigates the sustainable success factors on which airlines should focus to provide resilience during the COVID-19 pandemic crisis. It provides a robust model using the interval type-2 fuzzy analytic hierarchy process (IT2FAHP) and interval type-2 fuzzy Decision Making Trial and Evaluation Laboratory (IT2FDEMATEL) to identify and rank success factors. The findings indicate that financial and operational factors are extremely important to ensure resilience for airlines. In addition, the results of the study reveal that operational factors and information sharing factors have an impact on financial factors and customer satisfaction.

Navigating Policy and Local Context in Times of Crisis: District and School Leader Responses to the COVID-19 Pandemic

Purpose: To examine how federal/state-level policy guidance and local context have influenced district and school leader responses to the COVID-19 pandemic, as well as how these external/internal factors might provide a window into K-12 crisis leadership and policy sensemaking more broadly. Research: Investigating two districts over two years (2020-2022), data gathered include 39 hours of interviews with K-12 leaders (n = 41) and teachers (n = 18), federal/state-level policy documents (N = 64) governing these districts, and school staff responses to the Comprehensive Assessment of Leaders for Learning survey (N = 111). Drawing theoretically upon sensemaking, crisis leadership/management, law/policy implementation, and organizational theory, these data were analyzed using both inductive and deductive coding over several phases. Findings: In tracing the confluence of federal/state-level guidance and local capacities, we find both influenced K-12 leaders' sensemaking and subsequent responses to COVID-19. However, districts that possessed adequate expertise and organizational resources were better positioned to respond to the crisis, whereas those lacking such capacities experienced increased anxiety/stress. Conclusion: We argue that the COVID-19 pandemic provides a new window into the critical external/internal factors influencing K-12 leader sensemaking and subsequent responses to crises more broadly. We also discuss the potential role intermediate service agencies might play in the development of a stronger crisis response infrastructure for associated districts and schools. Finally, we point out how principal preparation programs and professional development efforts could prospectively address such crisis-related challenges faced by K-12 leaders.

Are the good spared? Corporate social responsibility as insurance against cyber security incidents

Despite the increasing consensus that socially responsible behavior can act as insurance against externally induced shocks, supporting evidence remains somewhat inconsistent. Our study provides a clear demonstration of the insurance-like properties of corporate social responsibility (CSR) in preserving corporate financial performance (CFP), in the event of a data (cyber) breach. Exploring a sample of 230 breached firms, we find that data breaches lead to significantly negative CFP outcomes for low CSR firms, with the dynamic being particularly pronounced in consumer-sensitive industries. Further, we show that firms increase their CSR activities in the aftermath of a breach to recover lost goodwill and regain stakeholder trust. Overall, our results support the use of CSR as a strategic risk-mitigation tool that can curtail the consequences of data breaches, particularly for firms operating in consumer-centric environments.

Crisis Management Experience from Social Media: Public Response to the Safety Crisis of Imported Aquatic Products in China during the Pandemic

China's outbreak related to cold-chain aquatic product quality and safety in 2020 caused public panic and further led to a crisis in China's aquatic industry. This paper uses topic clustering and emotion analysis methods to text-mine the comments of netizens on Sina Weibo to study the main features of the public's views on the administration's crisis management measures and to provide experience for future imported food safety management. The findings show that for the imported food safety incident and the risk of virus infection, the public response had four types of characteristics: a higher proportion of negative emotion; a wider range of information demand; attention paid to the whole imported food industry chain; and a differentiated attitude towards control policies. Based on the online public response, countermeasures to further improve the management ability of imported food safety crises are proposed as follows: the government should pay active attention to the development trend of online public opinion; work more on exploring the content of public concern and emotion; strengthen the risk assessment of imported food and establish the classification and management measures of imported food safety events; construct the imported food safety traceability system; build a special recall mechanism for imported food safety; and improve the cooperation between government and media, enhancing the public's trust in policies.

The Use of Crisis Services Following the Mass School Shooting in Uvalde, Texas: Quasi-Experimental Event Study

BACKGROUND

Mass shootings result in widespread psychological trauma for survivors and members of the affected community. However, less is known about the broader effects of indirect exposure (eg, media) to mass shootings. Crisis lines offer a unique opportunity to examine real-time data on the widespread psychological effects of mass shootings.

OBJECTIVE

Crisis Text Line is a not-for-profit company that provides 24/7 confidential SMS text message-based mental health support and crisis intervention service. This study examines changes in the volume and composition of firearm-related conversations at Crisis Text Line before and after the mass school shooting at Robb Elementary School on May 24, 2022, in Uvalde, Texas.

METHODS

A quasi-experimental event study design was used to compare the actual volume of firearm-related conversations received by Crisis Text Line post shooting to forecasted firearm conversation volume under the counterfactual scenario that a shooting had not occurred. Conversations related to firearms were identified among all conversations using keyword searches. Firearm conversation volume was predicted using a seasonal autoregressive integrated moving average model trained on the 3 months of data leading up to the shooting. Additionally, proportions of issue tags (topics coded post conversation by volunteer crisis counselors at Crisis Text Line after the exchange) were compared in the 4 days before (n=251) and after (n=417) the shooting to assess changes in conversation characteristics. The 4-day window was chosen to reflect the number of days conversation volume remained above forecasted levels.

RESULTS

There was a significant increase in the number of conversations mentioning firearms following the shooting, with the largest spike (compared to forecasted numbers) occurring the day after the shooting (n=159) on May 25, 2022. By May 28, the volume reverted to within the 95% CI of the forecasted volume (n=77). Within firearm conversations, "grief" issue tags showed a significant increase in proportion in the week following the shooting, while "isolation/loneliness," "relationships," and "suicide" issue tags showed a significant decrease in proportions the week following the shooting.

CONCLUSIONS

The results suggest that the Uvalde school shooting may have contributed to an increase in demand for crisis services, above what would be expected given historical trends. Additionally, we found that these firearm-related crises conversations immediately post event are more likely to be related to grief and less likely to be related to suicide, loneliness, and relationships. Our findings provide some of the first data showing the real-time repercussions for the broader population exposed to school shooting events. This work adds to a growing evidence base documenting and measuring the rippling effects of mass shootings outside of those directly impacted.

Crisis Management Tasks in Dutch Nursing Homes During the COVID-19 Pandemic: A Longitudinal Interview Study

The COVID-19 pandemic hit long-term care, and particularly nursing homes hard. We aimed to explore how crisis management goals and tasks evolve during such a prolonged crisis, using the crisis management tasks as identified by Boin and 't Hart as a starting point. This longitudinal, qualitative study comprises 47 interviews with seven Dutch nursing home directors and a focus group. We identified two phases to the crisis response: an acute phase with a linear, rational perspective of saving lives and compliancy to centralized decision-making and an adaptive phase characterized by more decentralized decision-making, reflection, and competing values and perspectives. This study confirms the usability of Boin and 't Hart's typology of crisis management tasks and shows that these tasks "changed color" in the second phase. We also revealed three types of additional work in managing such a crisis: resilience work, emotion work, and normative work.

Did destructive leadership help create the conditions for the spread of Covid-19, and what are the early warning signs?

This research asks: 'were there any objectively identifiable signals in the words leaders used in the early stages of the Covid-19 pandemic that can be associated with ineffective management of the crisis?' We chose to focus on the leaders of the two English-speaking nations that fared worst and best in the pandemic, the United States and New Zealand. By way of background and in order to contextualise the research, we compared and contrasted Trump's and Ardern's leaderships using the toxic triangle framework of destructive leadership. We then focused on the leader behaviour element of the triangle by using computerised text analysis (CTA) to analyse Trump's and Ardern's public pronouncements during the critical early stages of the pandemic. Based on a similarity index (S), we identified linguistic markers associated with destructive leader behaviours and negative outcomes (Trump) and non-destructive leader behaviours and positive outcomes (Ardern). We discuss future applications of these linguistic markers for the diagnosis both of incumbent and potential leaders' responses to crises management.

Consequences of the Early Phase of the COVID-19 Pandemic for Home-Healthcare Recipients in Norway: A Nursing Perspective

Municipal home-healthcare services are becoming increasingly important as growing numbers of people are receiving healthcare services in their home. The COVID-19 pandemic represented a challenge for this group, both in terms of care providers being restricted in performing their duties and care receivers declining services for fear of being infected. Furthermore, preparedness plans were not always in place. The purpose of this study is to investigate the consequences for recipients of home healthcare in Norway of the actual level of COVID-19 infection spread in the local population, as observed by licensed nurses working in home-healthcare services. Approximately 2100 nurses answered the survey. The most common adverse consequences for home-healthcare recipients were increased isolation and loneliness, increased health concerns, and the loss of respite care services. An increased burden for relatives/next of kin and fewer physical meetings with service providers were frequently observed and reported as well. This study shows that there were more adverse consequences for service users in municipalities with higher levels of contagion than in those with lower levels of contagion. This indicates that the municipalities adapted measures to the local rate of contagion, in line with local municipal preparedness strategies.

Implementation of a Multimodal Interdisciplinary Massive Transfusion Protocol Educational Bundle Improves Knowledge and Self-Efficacy

PURPOSE

Critical events in the operative setting require rapid management to prevent adverse outcomes. This article describes a multimodal educational bundle that was designed and implemented to improve readiness to respond to crises involving significant blood loss. Intended outcomes of this project were to increase knowledge and self-efficacy of anesthesia providers and perioperative staff members related to the use of the massive transfusion protocol (MTP).

DESIGN

This is a quality improvement (QI) project.

METHODS

A two-part educational bundle consisted of pre-education and low-fidelity simulation (LFS) via computer-based training (CBT) modules followed by hands-on skills sessions. Anesthesia providers, registered nurses, and technicians in the operative suite completed the educational intervention. Knowledge and self-efficacy were measured pre-and-post intervention.

FINDINGS

After completing the educational bundle, the aggregated mean score on a knowledge test increased by 5.65%. Self-efficacy related to role-specific responsibilities and confidence regarding the team's ability to carry out the MTP significantly increased for all participants (n = 62).

CONCLUSIONS

This project serves as an example of how a multimodal educational bundle can improve knowledge, confidence, and readiness to respond to critical events. This model demonstrates how pre-education and LFS enable crisis management training to be readily accessible for an entire interdisciplinary team.

Crisis management: the perspectives of physicians working in family physician teams in Lithuania

AIM

To assess the opinions of physicians working in family physician teams regarding COVID-19 (threat perception, overall work satisfaction, patient satisfaction with services provided, patient access to services, and the need for new tools for service provision).

METHODS

An anonymous survey of physicians (N = 191) working in family physician teams. Questionnaires were distributed among family physicians with the permission of the managers of their institutions and were collected by the lead researcher within 1-8 weeks. The quantitative study was conducted from 21 June 2021 to 17 September 2021. In total, 398 questionnaires were distributed, yielding a response rate of 48%, or 9% of the total population. Thirty-nine primary health care institutions (PHCIs) were randomly selected for the study: 11 public and 28 private.

FINDINGS

Older respondents and those with more years of work experience strongly agreed that the COVID-19 pandemic threatened their lives and safety, as well as that of their colleagues. Work satisfaction decreased during the pandemic among older respondents, those with more years of work experience, and those who had been employed at their current institution for longer. Respondents with more work experience believed that patient satisfaction with the services provided by their family medical institution decreased. Older respondents with more work experience asserted that patient access to services decreased during the pandemic. Physicians working further away from urban centers indicated a greater need for new tools in the effort to provide consultations compared to city-based physicians.

CONCLUSIONS

The current health care crisis prompted by the COVID-19 pandemic is defined by the perception of threats to life and safety among physicians, an overall drop in their work satisfaction, decreased patient satisfaction with services provided, reduced patient access to services, and a greater need for new tools for providing consultations.

An Evaluation of a Web-Based Crisis Management Training Program for Nurse Managers: The Case of the COVID-19 Crisis

OBJECTIVE

The effective management of nursing services, the main power in patients' care and treatment in the front line of the fight against the COVID-19 pandemic, and nurse managers' effective leadership behaviors in the fight against the pandemic have been important key factors. It is thus critical to support nurse managers, strengthen them through training, and increase their competency so that they can successfully manage crises, disasters, or pandemics. This study aims to assess the effect of a web-based training program on the knowledge levels of nurse managers who worked during the COVID-19 pandemic.

METHODS

This is a randomized controlled experimental study. The study population consisted of the members of the Nurse Managers Association. The intervention group had 30 participants, and the control group had 31 participants in the final.

RESULTS

There was no statistically significant difference between the intervention and control groups' mean number of correct pre-test responses (P = 0.843). However, the intervention group's mean number of correct post-test responses was statistically significantly higher than the control group's after the web-based training program (P < 0.001).

CONCLUSIONS

Web-based training programs can effectively increase nurse managers' knowledge levels. Therefore, web-based training programs should be developed in ordinary times for the management of crisis situations.

Exploring customer concerns on service quality under the COVID-19 crisis: A social media analytics study from the retail industry

The COVID-19 pandemic has triggered a set of government policies and supermarket regulations, which affects customers' grocery shopping behaviours. However, the specific impact of COVID-19 on retailers at the customer end has not yet been addressed. Using text-mining techniques (i.e., sentiment analysis, topic modelling) and time series analysis, we analyse 161,921 tweets from leading UK supermarkets during the first COVID-19 lockdown. The results show the causes of sentiment change in each time series and how customer perception changes according to supermarkets’ response actions. Drawing on the social media crisis communication framework and Situational Crisis Communication theory, this study investigates whether responding to a crisis helps retail managers better understand their customers. The results uncover that customers experiencing certain social media interactions may evaluate attributes differently, resulting in varying levels of customer information collection, and grocery companies could benefit from engaging in social media crisis communication with customers. As new variants of COVID-19 keep appearing, emerging managerial problems put businesses at risk for the next crisis. Based on the results of text-mining analysis of consumer perceptions, this study identifies emerging topics in the UK grocery sector in the context of COVID-19 crisis communication and develop the sub-dimensions of service quality assessment into four categories: physical aspects, reliability, personal interaction, and policies. This study reveals how supermarkets could use social media data to better analyse customer behaviour during a pandemic and sustain competitiveness by upgrading their crisis strategies and service provision. It also sheds light on how future researchers can leverage the power of social media data with multiple text-mining methodologies.

Impact of the COVID-19 Pandemic on CSR Activities of Healthcare Providers

(1) Background: Corporate social responsibility (CSR) is important for every company that cares for sustainable structures. Healthcare providers especially have made social responsibility their goal. However, crises such as the COVID-19 pandemic impacted different activities within the healthcare sector including CSR and its monitoring. However, theory-driven CSR research within the healthcare sector is scarce and monitoring requires a structured understanding of the processes. Therefore, the objective of this study was to investigate the CSR practices and activities which healthcare providers have implemented in an exemplified country namely Germany and the effect of the pandemic in this process. (2) Methods: Participants were sampled based on their field of care (general, psychiatric, or rehabilitation), the type of organization (public, private, or non-profit), and group membership. A total of 18 healthcare providers were initially recruited, out of which nine participated in the interviews. They represent companies with yearly revenue of between EUR 110 million and EUR 6 billion, and have between 900 and 73,000 employees. (3) Results: CSR-related activities were postponed due to times of crisis. There was a necessity to rapidly digitalize processes. Frequent and precise communication turned out to be important for keeping employees' well-being, motivation, and satisfaction levels high. Environmental efforts were counteracted by new hygienic requirements and a shift in priorities. Many study participants expressed the hope that after the pandemic, newly established methods, processes, and structures (e.g., digital meetings, quicker and more inclusive communication) would be maintained and developed further. (4) Conclusions: The pandemic has been challenging and at the same time, these challenges also created opportunities to strike a new path using the learnings to overcome future health-related or economic crises.

Frontline Physician Perspectives on Their Experiences Working During the First Wave of the COVID-19 Pandemic

BACKGROUND

During the first wave of the COVID-19 pandemic physicians worked on the front lines, immersed in uncertainty. Research into perspectives of frontline physicians has lagged behind clinical innovation throughout the pandemic.

OBJECTIVE

To inform ongoing and future efforts in the COVID-19 pandemic, we conducted a qualitative exploration of physician perspectives of the effects of policies and procedures as well as lessons learned while caring for patients during the height of the first wave in the spring of 2020.

DESIGN

A confidential survey was emailed to a convenience sample. Survey questions included demographic data, participant role in the pandemic, and geographic location. Eleven open-ended questions explored their perspectives and advice they would give going forward. Broad areas covered included COVID-19-specific education, discharge planning, unintended consequences for patient care, mental health conditions to anticipate, and personal/institutional factors influencing workforce well-being amid the crisis.

PARTICIPANTS

We received fifty-five surveys from May through July 2020. Demographic data demonstrated sampling of frontline physicians working in various epicenters in the USA, and diversity in gender, race/ethnicity, and clinical specialty.

APPROACH

Inductive thematic analysis.

KEY RESULTS

Four themes emerged through data analysis: (1) Leadership can make or break morale; (2) Leadership should engage frontline workers throughout decision-making processes; (3) Novelty of COVID-19 led to unintended consequences in care delivery; and (4) Mental health sequelae will be profound and pervasive.

CONCLUSIONS

Our participants demonstrated the benefit of engaging frontline physicians as important stakeholders in policy generation, evaluation, and revision; they highlighted challenges, successes, unintended consequences, and lessons learned from various epicenters in the first wave of the COVID-19 pandemic. There is much to be learned from the early COVID-19 pandemic crisis; our participants' insights elucidate opportunities to examine institutional performance, effect policy change, and improve crisis management in order to better prepare for this and future pandemics.

The results of a Foresight exercise: Outcome from a NO-FEAR internal evaluation

The challenges that the health systems face in the last years increased exponentially. No matter if we are talking about the impact of the COVID-19 pandemic or the Russian military action in Ukraine, the European health ecosystem is facing new problems. In the light of these uncertainties, we assessed which could be the next trends that can impact the healthcare systems, in order to better prepare and adapt to the new contexts.

Using two foresights exercises (FSE), one in 2018 and the second one in 2022, we had identified the most important trends in the political, economic, social, technological, security, environmental and medical sectors that could have an impact on health.

Fifty-three people participated in the first FSE and 40 in the second one. The respondents identified cyber security, an increased reliance on digital technologies for communications, CBRNE management of the patients, centrally coordinated attacks, demographic aging, reduced economic resources, violence against emergency medical staff and the increased need and demand for psychosocial support as the most important trends. Moreover, they considered that wars, hybrid threats, the fake news, pandemics and the influence of artificial intelligence could impact the healthcare systems.

Many of the trends identified in 2018 as having a possible impact on the health system proved to be relevant four years later. Therefore, we consider the FSE a relevant tool in foreseeing the main areas that could have an impact on health and its results could guide the preparedness for the future.

Regional Intergovernmental Organization Response to COVID-19: The Impact of Neoliberalism on Bureaucratic Autonomy

COVID-19 is a transboundary crisis that crosses political boundaries and affects critical infrastructure. Given the ongoing nature of COVID-19, it is vital to recognize the factors that impact an organization's ability to respond to crises. In this article, we use the concept of bureaucratic autonomy discussed by Bauer and Ege (2016) to examine the response of four regional intergovernmental organizations. We find here that neoliberalism as a dominating global ideology has transformed the autonomy of action dimension into autonomy of finance, with the focus on enabling private firms through adjusting incentive structures, rather than taking direct action. Organizations that lack this autonomy become the benefactors of other dominant neoliberal financing institutions, thus furthering the entrenchment of neoliberalism and neoliberal finance. JEL Classification: F53, F55, P16.

A narrative review on drug development for the management of antimicrobial- resistant infection crisis in Japan: the past, present, and future

INTRODUCTION

Antimicrobial resistance (AMR) is a major threat to global health requiring continuous development of new antimicrobial agents. Antimicrobial research and development (R&D) should be promoted in the pharmaceutical industry and academia to ensure sustainable patient access to new treatment options and reduce the global AMR burden.

AREAS COVERED

This review describes the historical challenges in novel antimicrobial drug development in Japan, current national efforts to promote the development, and proposals to effectively manage future AMR pandemics. Literature searches were performed in the PubMed database (from inception to January 2022).

EXPERT OPINION

R&D activities in the antimicrobial space in Japan have been insufficient due to multiple factors, including unfavorable cost-profit balance and differences in regulatory requirements between Japan and Western countries. However, the situation is improving with the implementation of the Japanese AMR action plan, drug R&D programs led by the Japan Agency for Medical Research and Development, and efforts of regulatory agencies in the United States, Europe, and Japan in aligning and expediting the clinical development process. Further actions during the interpandemic period will strengthen antimicrobial R&D, including international and interdisciplinary collaboration, continued funding and investment with the national government's leadership, and fostering of new-generation academic research leaders.PLAINLANGUAGE SUMMARYEvery year, many people suffer and die of antimicrobial-resistant infections worldwide. New treatment options are required to tackle antimicrobial-resistant infections; however, pharmaceutical companies have not been very active in developing antimicrobial agents in the last two decades. This was mainly due to the difficulty in discovering new and effective compounds and insufficient funds being spent on drug discovery. In addition, differences in drug development requirements between the United States (US), Europe, and Japan have made it difficult for Japanese pharmaceutical companies to develop antimicrobial agents that can be used in all regions in a timely manner. In the last decade, several measures have been taken to re-activate antimicrobial research and development in the pharmaceutical industry, as well as in academia, in Japan. These measures include a national action plan to combat antimicrobial-resistant infections and research support programs led by the Japan Agency for Medical Research and Development. Regulatory authorities in the US, Europe, and Japan have initiated efforts to expedite the development of drugs to treat infections. Moreover, pathways for accelerated regulatory review have been established to reduce the time taken for new drugs to be approved, and this has already been applied to several new anti-infective drugs. To combat the coronavirus disease 2019 (COVID-19) pandemic, the development of novel vaccines and antiviral drugs has been accelerated with unprecedented speed. Additional actions, such as international research collaboration programs and investment in new antimicrobial development, may help promote antimicrobial research and development activities in Japan.

Institutional Network Relationship of Chinese Public Crisis Governance System-Based on the Quantitative Comparative Analysis of Policies during SARS and COVID-19

After experiencing many public crisis events, such as SARS in 2003 and COVID-19 in 2020, the Chinese public crisis governance system has been improved from its initial state. The distribution structure and cooperation network among various government departments in China have become more complex. How to accurately clarify the relationship between the various departments in the existing governance system has become an important issue of the Chinese public crisis governance system. Based on the perspective of networked research, this article examines the network relationship between institutions in the Chinese public crisis governance system from the two dimensions of network centrality and network density. Using the bibliometric method to use public policies released in 2003 and 2020 as data samples and the two large-scale institutional reforms in 2003 and 2018 as the time nodes, this paper conducts a comparative analysis of the institutional network relationship of the Chinese public crisis governance system during different periods. The research shows that the network relationship among institutions in the Chinese public crisis governance system has changed from a centralized type to a diverse type; there is a trend of expansion in network relations; the legalization of governance networks is strengthened and the core of the network is transformed into the direct leadership of the Party Committee; and the overall network structure is experiencing a rational evolution.

Managerial Perception of Risk in an Organization in a Post-COVID-19 Work Environment

The COVID-19 pandemic drew the attention of all industries and organizations to the importance of comprehensive preparation for various types of crises and disruptions. Without proper risk management for crisis situations, it is impossible to talk about organizational resilience, maintaining organizational continuity, or ensuring the company's ability to protect workers' lives and health in a crisis. While the COVID-19 pandemic is rapidly reshaping the work environment, significant challenges related to risk management are emerging. The purpose of this research paper is to examine the impact of a pandemic on the risk perception in an organization by managers of all three levels (strategic, operational, and line level) and to examine the impact of broadly understood risk management on organizational performance. For the examination of operational risk perception, empirical research was conducted in Polish enterprises. The methodology of the survey is based on a questionnaire of operational risk and risk management perception in a post-COVID-19 work environment. According to the survey results, risk management was generally perceived better than the level of operational risk, compared to the period before the pandemic. Therefore, a substantial improvement in risk management during the crisis allowed the surveyed organizations to cope with the pandemic, and even slightly enhance their performance. Organizations have been able to achieve their goals mainly by slightly reducing risk appetite and lowering the tolerable risk level threshold. Even so, organizations have improved their ability to adapt and seize opportunities.

COVID-19 policies and hoteliers' responses in Japan

This study aims to identify the hoteliers' crisis management practices during COVID-19 and analyse the relationship between each practice and government policy. Through in-depth interviews with five hotel chains, common crisis management practice patterns, factors that lead to differences in crisis management practices and the influences of policies on these practices were identified. The findings show strong and complicated relationships between policy and hoteliers' crisis management practices. Although many crisis management practices were encouraged by the government, some practices were not influenced by the policy and others were indirectly impeded. Hoteliers are not only passively affected by government policies, but respond actively to them as well as demonstrate their own initiative in response to the crisis.

COVID-19 management in Iran and international sanctions

Iran has one of the highest death rates from COVID-19 among Middle Eastern countries. In addition to having a better disease registration system compared to neighboring countries, many factors including economic conditions, have played an important role in increasing the number of mortality rate. This is while that during the Corona pandemic, Iran has been undergo severe sanctions by the United States, that has faced this country with a severe economic crisis. Considering the role of sanction on the country's health management in our study, we examined Iran's management plans against the Corona pandemic and the effect of sanctions on it. Quarantine and corona restrictions, on the one hand, and international sanctions, on the other hand, have put double pressure on the Iranian government. Although drugs and basic medical equipment are exempted from economic sanctions, direct and indirect effects of the sanctions have limited Iran's banking system and created widespread restrictions in the fields of trade, production, and investment. Fortunately, despite the sanctions, many hospitals had an appropriate performance in line with the health promotion program. It is obvious that economic sanctions have severe and harmful effects on public health and have led to poor health consequences in Iran, but attention to planning, standards and improving the quality of the hospital is an important issue in Corona management. Despite multiple mutations, this virus is likely to face with a more dangerous virus in the world future. Now, it is time to take appropriate management measures to remove these sanctions by relying on international solutions and interactions.

How Did Corona Crisis Managers in Germany Make Sense of the Psychosocial Situation?

Alongside its immediate consequences for physical health, the current Coronavirus pandemic and the associated containment measures have led to multiple psychosocial consequences for the population. While virus containment is the main motive of crisis management, there is, so far, little evidence on how crisis management actors consider findings about the psychosocial state of the German population. This paper therefore examines the role of psychosocial consequences within the work of crisis management organizations during the Corona pandemic in Germany. Against the theoretical background of the sensemaking concept, 14 qualitative interviews were conducted with decision-makers from municipal and state administrations, public health departments, aid organizations, and critical infrastructure organizations. Our results indicate that crisis managers perceive aspects related to the psychosocial situation as relevant, but in a very selective way. They use different and often non-scientific sources to acquire knowledge about the psychosocial consequences. In sum, these aspects do not play a major role in decision-making processes. We argue that the perception and processing of psychosocial consequences depend in particular on the organizational context such as goals, plausibility assumptions, identity conceptions, and problem frames. In order to extend theoretical models of psychosocial crisis management, more detailed knowledge of sensemaking processes in crisis management organizations is necessary.

Usage of sorbents for diminishing the negative impact of substances leaking into the environment in car accidents

Background

Car accidents are often accompanied by dangerous substances leaking into the environment. A proper reaction to the leaking substances, utilizing appropriate sorbents, is necessary for diminishing the negative impact of such events. Sorbents as substances of initial intervention in car accidents (as well as industrial and ecological accidents) are a crucial tool for solving crises connected with dangerous substances escaping into the environment. The risk resulting from the given realities is described in detail in the introduction of the article.

The goal

The goal is describing elements of crisis management in dangerous substance leakage and an analysis of sorption resources for quick and efficient interception of leaking substances, water, ethanol, oil, and gasoline in particular, as a reaction to such events.

Methods

The quality of a sorption resource is determined by a parameter called the sorption capacity, which has been established according to the ASTM F716-18 standard. Loose nature-based sorbents (peat) and synthetic silicate-based SiO₂, Al₂O₃, Fe₂O₃, and polypropylene-based ones were observed. The research has been realized on a water, oil, gasoline, and ethanol sorbate. Each experiment was repeated three times.

The results

The results attest to the diversity of sorption capacity in comparing nature-based, silicate-based, and polypropylene-based sorption materials. The highest sorption capacity values were reached with the Sorb 4 sample, which is based on 66% of silica and 18% of alumina. The stated ratio is important, because the Sorb 3 sample contains 85% of silica and 6% of alumina and its absorption capacity values are significantly lower.

A machine learning algorithm to analyse the effects of vaccination on COVID-19 mortality

The coronavirus disease 2019 (COVID-19), with new variants, continues to be a constant pandemic threat that is generating socio-economic and health issues in manifold countries. The principal goal of this study is to develop a machine learning experiment to assess the effects of vaccination on the fatality rate of the COVID-19 pandemic. Data from 192 countries are analysed to explain the phenomena under study. This new algorithm selected two targets: the number of deaths and the fatality rate. Results suggest that, based on the respective vaccination plan, the turnout in the participation in the vaccination campaign, and the doses administered, countries under study suddenly have a reduction in the fatality rate of COVID-19 precisely at the point where the cut effect is generated in the neural network. This result is significant for the international scientific community. It would demonstrate the effective impact of the vaccination campaign on the fatality rate of COVID-19, whatever the country considered. In fact, once the vaccination has started (for vaccines that require a booster, we refer to at least the first dose), the antibody response of people seems to prevent the probability of death related to COVID-19. In short, at a certain point, the fatality rate collapses with increasing doses administered. All these results here can help decisions of policymakers to prepare optimal strategies, based on effective vaccination plans, to lessen the negative effects of the COVID-19 pandemic crisis in socioeconomic and health systems.

Crisis management in practice: a dynamic process intertwined with daily work performance

This paper explores how a social services unit in Sweden coped with the large influx of unaccompanied children during the refugee situation in 2015. Crisis management is approached using social practice theory to examine how everyday work practices and their constituent resources informed personnel's management of the chaotic circumstances. The research data consist of practice-based interviews with managerial staff from social services and operational staff at homes for unaccompanied children, as well as manuals and printed routines. The analysis demonstrates that they coped with the challenges posed by the refugee situation by adopting competences, mobilising meanings, and adapting material resources belonging to different practices of everyday work. The paper concludes by emphasising the importance of studying crisis management from a practice-based perspective as a complement to framing it as a static asset of organisations-governed by institutionalised practices-which has implications for defining what constitutes crisis management and who can become crisis managers.

The role of local governments in South Korea's COVID-19 response

Research on COVID-19 responses has largely focused on national governments. Meanwhile, the crisis management literature has noted that such "transboundary crises" require collaborative responses. What role can local governments play? How do citizen perceptions matter? We look for answers in South Korea that has been considered a model case for managing COVID-19. We use data from policy briefs, news reports, and local government websites to show that local governments successfully implemented national initiatives while modifying them to fit local needs and also actively planned and executed local initiatives to address needs that the central government did not address. Based on 2020 national survey data (N = 16,258), we find that COVID-19 cases and deaths are linked to citizen perceptions of vulnerability to COVID-19 and its effect on wellbeing, but not to evaluations of other residents' responses (e.g. following mask mandates, social distancing) or local government responses.

Challenges in Burn Care during the COVID-19 Pandemic-A Scoping Review

Objective: The aim of this review is to map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, in order to enable future strategies with regard to the most effective measures in burn care during pandemics and to detect possible gaps in knowledge. Background: The coronavirus disease 2019 (COVID-19) pandemic had a major impact on economies, social interactions, and health systems worldwide. Burn units all over the world face a new challenge in maintaining the care of acute burn wounds and follow-up treatments while dealing with constantly changing regulations. Infrastructural changes, the establishment of efficient triage systems, protective measures, personnel resources, in addition to the maintenance of efficient patient care and the guarantee of supply chains, are challenging tasks to be addressed. This review provides an overview of recent developments regarding different strategies and methods used by burn units worldwide to safely overcome the COVID-19 pandemic outbreak. Methods: A scoping review of the literature was conducted using the electronic databases PubMed and Google Scholar. Publications were screened for the following key terms: burns, burn injuries, thermal injuries, burn center, burn unit, burn ward, in combination with COVID-19, COVID-19 pandemic, SARS-CoV-2, Corona, and Coronavirus. Articles dealing with the management of burn units during the pandemic were further analyzed and included. Results: Of the 136 publications, 10 were considered relevant to the key question and were included in the present review. Results were divided into six major topics, such as infrastructural and personnel management, triaging, severe burns and emergencies, elective surgeries, patient and visitor management, and outpatient management. Conclusion: Only a few studies about managing burn units during the COVID-19 pandemic have been published. Personnel resources and equipment needed to be redistributed to cope with country-specific challenges during the COVID-19 pandemic and to maintain adequate burn care. Since all of these articles refer to the period of the initial outbreak, a lack of clinical studies exists regarding the prevention measures taken by burn units during the COVID-19 pandemic. In addition, we identified gaps in knowledge about the impact of implemented measures on burn patient outcomes in the published literature. Further studies are mandatory in order to provide generally applicable guidelines regarding COVID-19 prevention measures at a burn unit.

Case Report: A Functional Approach to Deal With Sexual Harassment Within Families

Abuse is followed by multiple short- and long-term psychological consequences. Researchers suggest a significant need to design a culturally relevant and competent treatment plan specifically for the Asian context. This research presents an account of therapeutic strategies that were employed to manage the complaints of sexual harassment and associated psychological challenges. This case report dealt with a 16-year-old girl who was self-referred to the psychologist with complaints of getting sexually harassed by her brother-in-law, difficulty in managing academic challenges, communication gap with parents, and difficulty in handling her anger for the past 7 years. The assessment modalities used with the client were Behavioral Observation, Clinical Interview, Baseline Charts, School Children Problem Scale to rule out emotional-behavioral problems, the Adult-Child Interaction Test, and Downward Arrow Technique for cognitive assessment. The management plan was based on trauma-focused cognitive behavioral therapy (TF-CBT) and constituted of goals, such as having self-protection awareness from harassment, reducing the fear and unexplained emotions of grief, increasing self-esteem, designing a proper schedule for studies, and developing good communication ability. Post-assessment showed that anger reduced to 40%, communication gap with parents reduced to 50%, fear of harassment reduced to 40%, and self-image improved up to 40%. Sessions were based on 9 in-person meetings.

Early Nurse Management Experiences from Finnish COVID-19 Hubs: An In-Action Review

Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within Greater Helsinki dedicated to caring for all ambulatory patients with possible COVID-19 symptoms. The study objectives were to make PHC crisis response contributions known and to provide an in-action review (IAR) of crisis response efforts. Nurse managers from the four COVID-19 hubs in Greater Helsinki were interviewed using thematic pair interviews. The data were analyzed inductively using thematic analysis, by which four main themes emerged: (1) capacity development led to a state of flux, (2) infection prevention control (IPC) was critical, (3) management of staff was essential in facilitating crisis response, and (4) respondents’ personal experiences. The state of flux stressed the provision of PHC services, but quick developments in telemedicine eased that burden. Conversation surrounding IPC was extensive, though discrepancies suggest that global efforts to standardize IPC practices must begin locally. Leadership was adjusted to accommodate for the crisis, especially regarding the motivation of staff. A vision to aspire toward in crisis recovery is needed.

Impacts and Lessons Learned of the First Three COVID-19 Waves on Cross-Border Collaboration in the Field of Emergency Medical Services and Interhospital Transports in the Euregio-Meuse-Rhine: A Qualitative Review of Expert Opinions

Background

In the Euregio-Meuse-Rhine (EMR), cross-border collaboration is essential for resource-saving and needs-based patient care within the emergency medical service (EMS) systems and interhospital transport (IHT). However, at the onset of the novel coronavirus SARS-COV-2 (COVID-19) pandemic, differing national measures highlighted the fragmentation within the European Union (EU) in its various approaches to combating the pandemic. To assess the consequences of the pandemic in the EMR border area, the aim of this study was to analyze the effects and “lessons learned” regarding cross-border collaboration in EMS and IHT.

Method

A qualitative study with 22 semi-structured interviews was carried out. Experts from across the EMR area, including the City of Aachen, the City region of Aachen, the District of Heinsberg (Germany), South Limburg (The Netherlands), and the Province of Limburg, as well as Liège (Belgium), took part. The interviews were coded and analyzed according to changes in cross-border collaboration before and during the pandemic, as well as lessons learned and recommendations.

Results

Each EU member country within the EMR area, addressed the pandemic individually with national measures. Cross-border collaboration between regional actors was hardly or not at all addressed at the national level during political decision- or policymaking. Previous direct communication at the personal level was replaced by national procedures, which made regular cross-border collaboration significantly more difficult. The cross-border transfer regulations of patients with COVID-19 proved to be complex and led, among other things, to patients being transported to hospitals far outside the border region. Collaboration continues to be seen as valuable and Euregional emergency services including hospitals work well together, albeit to different degrees. The information and data exchange should, however, be more transparent to use resources more efficiently.

Conclusion

Effective Euregional collaboration of emergency services is imperative for public safety in a multi-border region with strong economic, cultural, and social cross-border links. Our findings indicate that existing (pre-pandemic) structures which included regular meetings of senior managerial staff in the region and a number of thematic working groups were helpful to deal with and to compensate for the disruptions during the crisis. Regional cross-border agreements that are currently based on mutual but more or less informal arrangements need to be formalized and better promoted and recognized also at the national and EU level to increase resilience. The continuous determination of synergies and good and best practices are further approaches to support cross-border collaboration especially in preparation for future crises.

Facilitators and Barriers for Effective Staff Work in Swedish National Governmental Crisis Response to the COVID-19 Pandemic

OBJECTIVES

The coronavirus disease (COVID-19) crisis response in Sweden was managed foremost by a collaboration of several national agencies. Normally, their strategical and operational collaboration is limited, but the pandemic required new and unfamiliar collaborations. This study aimed to clarify the facilitators and barriers of perceived effective staff work within and between 4 national agencies.

METHODS

A qualitative study of 10 participants with leading roles within the 4 national agencies' crisis organization was conducted via snowball sampling. The participant interviews were conducted between August and November 2020 and analyzed using content analysis.

RESULTS

Four categories emerged from the analysis: individual characteristics, intra-agency organization, interorganizational collaboration, and governmental directives. Subcategories crystallized from the data were analyzed and divided into factors for facilitating or to function as barriers for effective staff work.

CONCLUSION

Individual factors such as attitude and approach were important for perceived effective staff work as well as clear mandates and structure of the organization. Barriers for perceived effective staff work include lack of network, the complexity of the mission and organizational structures, as well as lack of preparations and unclear mandates. Although flexibility and adaptability are necessary, they cannot always be planned, but can be incorporated indirectly by selecting suitable individuals and optimizing organizational planning.

Crisis Management As An Important Starting Point For Preventing A Pandemic

The COVID-19 disease pandemic, representing a worldwide problem, has moved the world population into a position it has not experienced since World War II. However, there is one difference: the problem has stricken not only Europe but the whole American continent, Asia and Africa. Solution to the problem can be divided into two levels, namely medical and social. At the social level, the only solution is crisis management, or simply prevention and crisis activities carried out by representatives of the governments, and the willingness of citizens to follow specific regulations. However, a combination of the estimate of risk and efficient regulations in compliance with medical care must pursue the sole aim, namely to stabilise and stop the spread of the coronavirus. One part of crisis management is represented by the proper documentation of particular procedures and the drawing of conclusions for the future. This paper is the result of conducting an institutional project at the University of Security Management in Košice, and characterizes the position of the crisis management and rescue units in solving the pandemic in the Slovak Republic. In addition, the paper compares starting points of crisis management and measures taken by selected countries, and identifies the problem of the crisis management both at state and individual levels in Slovakia.

Management Strategies During the COVID-19 Pandemic Crisis: The Experiences of Health Managers from Iran, Ardabil Province

OBJECTIVE

The coronavirus disease 2019 (COVID-19) outbreak is the most threatening public health challenge in the 21th century, and more than 200 countries are affected. Considering that Iran was one of the first countries influenced by the COVID-19 pandemic, this study aimed to explain the crisis management strategies during the COVID-19 pandemic in Ardabil province.

METHODS

This study used a qualitative method using content analysis in which 12 health-care managers or decision-makers involved in the management of the COVID-19 crisis were recruited through purposeful sampling. In-depth, semi-structured interviews were used to collect data, which continued until data saturation.

RESULTS

Data analysis led to nine categories, including prior preparation for the COVID-19 crisis; challenges and management of workforce shortages; benefiting from the participation of volunteer staff; challenges and strategies for physical space, supplies, and personal protective equipment (PPE); designation of referral centers for COVID-19; protocolized patient transport; benefiting from donations and charity support; management of information about COVID-19; and learning from the prior stages of crisis.

CONCLUSION

This study revealed that, in critical situations, managers use multiple and, to some extent, unique strategies for decision-making and crisis control. Therefore, the health system can use the findings of the current study for proper response to similar crises and training of future managers.

Promoting remote workers' psychological health: Effective management practices during the COVID‐19 crisis

The aim of this study was to identify specific management practices that promote the psychological health of remote workers in the context of the COVID‐19 crisis. A two‐round Delphi study was conducted among 28 teleworkers and 22 managers. A list of 60 specific management practices was presented and participants had to identify whether each one could be used in the current remote working context and, if so, how useful it was to promote psychological health at work. Results indicate that most specific management practices usually used in a face‐to‐face setting can also be used in a remote context (85%). Practices that show consideration, establishing work structure, and allowing flexibility were also identified as the most useful to promote remote workers' psychological health during the pandemic. This study contributes to the advancement of knowledge about specific management practices, remote working, and crisis management. It also suggests specific practices that managers can adopt to promote the psychological health of their employees during a period of crisis, even while managing from a distance.

Surviving the coronavirus pandemic and beyond: Unlocking family firms’ innovation potential across crises

In this research note, we examine Finnboat, a traditional Finnish family firm, from the interrelated perspectives of crisis behavior and innovation. The firm under study has endured three major crises: the economic recession of the 1990s, the 2008–2009 financial crisis, and the coronavirus pandemic. Our study shows that Finnboat has undertaken only very modest, if any, innovations during stable periods but has conducted a series of radical business-model and technology innovations, triggered by the different crises. This finding implies that during crises, a risk-averse family firm can productively engage into risk-taking and innovative behavior, effectively engaging in a “preference reversal.” We also find evidence of a deliberate accumulation of slack resources during periods of calm, which are mobilized to back up innovation and renewal efforts when a crisis hits. Our findings highlight family firms’ potential to endure crises by adopting a temporal separation logic to the risk-aversion vs. risk-taking paradox, and relatedly, by strategically managing the resource portfolio. Based on the case study, we suggest several research directions, approaches, and methodologies for studying family firm behavior and change during and in-between crises.