THE IMPACT OF MANAGING GOVERNMENT HEALTHCARE SYSTEMS DURING CRISIS PERIODS ON DECISION-MAKING PROCESSES, LEADERSHIP, AND BURNOUT AMONG HEALTHCARE SYSTEM MANAGERS: A QUALITATIVE STUDY

Hanan Moussa

Abstract


Public healthcare systems have faced increasingly complex realities in recent decades, characterized by the growing frequency and intensity of crises, including pandemics, national emergencies, extraordinary healthcare demands, resource shortages, and persistent systemic challenges. These situations require healthcare system managers to operate in environments characterized by high levels of uncertainty, time pressure, and the need to make decisions with broad implications for patients, employees, and the overall functioning of healthcare organizations (World Health Organization [WHO], 2020). Managing healthcare systems during crisis periods is not based solely on operational management capabilities but requires an integration of effective leadership, organizational flexibility, adaptive capacity, and rapid decision-making under conditions of incomplete and constantly changing information. Research in crisis management emphasizes that the ability of healthcare systems to cope with unexpected events depends significantly on managers’ ability to lead change, maintain organizational communication, and develop systemic resilience (Boin et al., 2016). Despite extensive knowledge regarding healthcare leadership and burnout among healthcare professionals, a research gap remains regarding the experiences of healthcare system managers who occupy key positions in decision-making and organizational management during crisis periods. In particular, there is limited understanding of how increased managerial demands influence decision-making processes, leadership styles, and burnout levels among senior healthcare managers. The aim of this study is to examine the impact of managing government healthcare systems during crisis periods on decision-making processes, leadership, and burnout among healthcare system managers. The study is based on a qualitative interpretive approach (Interpretivist Approach) using semi-structured in-depth interviews with 30 managers within the public healthcare system, including hospital managers, department directors, nursing managers, and senior healthcare executives. Data analysis using thematic analysis identified five major themes: decision-making under conditions of uncertainty, adaptive leadership during crisis periods, managerial and emotional responsibility burden, organizational support as a protective resource, and burnout alongside the development of professional resilience. The findings contribute to understanding the relationship between job demands and organizational resources according to the Job Demands–Resources Model (JD-R), which suggests that high workload and insufficient resources may increase burnout, whereas organizational support and professional resources may strengthen coping abilities and resilience (Bakker & Demerouti, 2017). This study provides theoretical and practical contributions to the field of healthcare systems management by emphasizing the need to develop crisis leadership capabilities, strengthen managerial support mechanisms, and establish organizational policies that promote resilience and protect the professional well-being of healthcare system managers.

Keywords


healthcare systems management; crisis management; healthcare leadership; decision-making; professional burnout; job demands–resources model (JD-R); organizational resilience; qualitative research

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References


Bakker, A. B., & Demerouti, E. (2017). Job demands–resources theory: Taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273–285.

https://doi.org/10.1037/ocp0000056

Bass, B. M. (1985). Leadership and performance beyond expectations. Free Press. Retrieved from https://books.google.ro/books/about/Leadership_and_Performance_Beyond_Expect.html?id=NCd-QgAACAAJ&redir_esc=y

Boin, A., & ’t Hart, P. (2010). Organising for effective emergency management: Lessons from research. Australian Journal of Public Administration, 69(4), 357–371.

https://doi.org/10.1111/j.1467-8500.2010.00694.x

Boin, A., Hart, P., Stern, E., & Sundelius, B. (2016). The politics of crisis management: Public leadership under pressure (2nd ed.). Cambridge University Press. Retrieved from https://books.google.ro/books/about/The_Politics_of_Crisis_Management.html?hl=tr&id=sbStAQAAQBAJ&redir_esc=y

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

https://doi.org/10.1191/1478088706qp063oa

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications. Retrieved from https://books.google.ro/books/about/Qualitative_Inquiry_and_Research_Design.html?id=gX1ZDwAAQBAJ&redir_esc=y

Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The job demands–resources model of burnout. Journal of Applied Psychology, 86(3), 499–512.

https://doi.org/10.1037/0021-9010.86.3.499

Dirani, K. M., Abadi, M., Alizadeh, A., Barhate, B., Garza, R. C., Gunasekara, N., Ibrahim, G., & Majzun, Z. (2020). Leadership competencies and the essential role of human resource development in times of crisis: A response to COVID-19 pandemic. Human Resource Development International, 23(4), 380–394.

https://doi.org/10.1080/13678868.2020.1780078

Ghorbani, S., Yıldırım, F., Bicer, A. A., Zavadskas, E. K., Antucheviciene, J., & Rostamzadeh, R. (2026). A Hybrid MCDM Framework for Overcoming Barriers in the Covid-19 Vaccine Supply Chain. Transformations In Business & Economics, 25(1 (67)), 482-506.

Ghorbani Golzari Nezhad, S., Shaye Sani, M. M., & Mirhoseini, S. A. (2017). Framework for X-engineering in supply chain management. International Journal of Economic Research, 14(4), 115-123.

Greenberg, N., Docherty, M., Gnanapragasam, S., & Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ, 368, m1211.

https://doi.org/10.1136/bmj.m1211

Heifetz, R. A., Grashow, A., & Linsky, M. (2009). The practice of adaptive leadership: Tools and tactics for changing your organization and the world. Harvard Business Press. Retrieved from https://books.google.ro/books/about/The_Practice_of_Adaptive_Leadership.html?id=86OJwyvGzCoC&redir_esc=y

Kahneman, D. (2011). Thinking, fast and slow. Farrar, Straus and Giroux. Retrieved from https://books.google.ro/books/about/Thinking_Fast_and_Slow.html?id=ZuKTvERuPG8C&redir_esc=y

Klein, G. (1998). Sources of power: How people make decisions. MIT Press. Retrieved from https://books.google.ro/books/about/Sources_of_Power.html?id=nn1kGwL4hRgC&redir_esc=y

Lengnick-Hall, C. A., Beck, T. E., & Lengnick-Hall, M. L. (2011). Developing a capacity for organizational resilience through strategic human resource management. Human Resource Management Review, 21(3), 243–255.

https://doi.org/10.1016/j.hrmr.2010.07.001

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications. Retrieved from https://books.google.ro/books/about/Naturalistic_Inquiry.html?id=2oA9aWlNeooC&redir_esc=y

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111.

https://doi.org/10.1002/wps.20311

Northouse, P. G. (2022). Leadership: Theory and practice (9th ed.). SAGE Publications. Retrieved from https://books.google.ro/books/about/Leadership.html?id=6qYLEAAAQBAJ&redir_esc=y

Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). SAGE Publications. Retrieved from https://books.google.ro/books/about/Qualitative_Research_Evaluation_Methods.html?hl=tr&id=-CM9BQAAQBAJ&redir_esc=y

World Health Organization. (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. World Health Organization. Retrieved from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

World Health Organization. (2020). Strengthening the health system response to COVID-19: Recommendations for the WHO European Region. World Health Organization. Retrieved from https://www.who.int/europe/tools-and-toolkits/strengthening-the-health-system-response-to-covid-19




DOI: http://dx.doi.org/10.46827/ejphs.v9i2.269

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