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

Process evaluation is an appropriate qualitative method to generate insights from key stakeholders on contributions to, and factors affecting key outcomes or processes, in organizations or interventions. 14, 15 Within this method, a case study approach with embedded units was used to identify the influence of the various associated attributes on strategic decisionmaking and collective leadership practices within the organization. Collective leadership was 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". 16 Interview transcripts were analyzed using a manual iteration process to determine common themes -once common initial key aspects of the outbreak management had been identified via a preliminary analysis. For each interview, codes, sub-themes, and themes were then identified and subsequently tested and refined in a cyclical process by two of the investigators. We moved back and forth between the interviews to ensure the finalized analysis was completed.