Perceptions of postoutbreak management by management and healthcare workers of a Middle East respiratory syndrome outbreak in a tertiary care hospital: a qualitative study

Al Knawy, Bandar Abdulmohsen; Al-Kadri, Hanan M F; Elbarbary, Mahmoud; Arabi, Yaseen; Balkhy, Hanan H; Clark, Alex

This perceived poor communication created additional confusion that led to low coordination of IC instructions from both infection control and the nursing teams. Consequently, some health 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Learning from crises helps manage these better in future via identifying gaps and fostering comprehensive system improvements and effective management. 17 However, learning from major events is challenging because each event is comparably rare and occurs in different contexts. As these events are also complex, 18 qualitative as well as quantitative research 10 is useful for generating insights and lessons to inform future outbreak control. 18 Useful lessons gleaned from this study of MERS-CoV crisis management (Table 3) concur with other research. It is not just the actions of staff, leaders and decision-makers that contributed to successful management, but also the mutual trust that accrues via the delegation of responsibilities, team management, coordination, tasks distribution, role clarification, and communication. 19, 20 This reflects the practice of collective leadership -defined as "a dynamic leadership process in which defined leaders, or set of leaders, selectively utilize skills and expertise within a network, effectively distributing elements of the leadership role as the situation or problem at hand requires. 21 This research corroborates others work which identifies that a number of different strands of management contribute to success, particularly, the benefits of centralized yet inclusive meetings during which senior decision-makers and frontline HCWs share knowledge and learning 22 from different parts of the organization. 23 24 25 Other key lessons for crisis management arising from this study arose from the weaknesses around the media management during the outbreak which adversely affected reported staff morale and anxiety. 26 Such challenges are not unusual. 27 Large health institutions managing major crises should have a dedicated media center or representative capable of implementing a well-designed and coordinated media crisis plan to aid communication, address questions and proactively act to protect the reputation of the organization and its staff.