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

Jaason M. Geerts*, Donna Kinnair, Paul Taheri, Ajit Abraham, Joonmo Ahn, Rifat Atun, Lorena Barberia, Nigel J. Best, Rakhi Dandona, Adeel Abbas Dhahri, Louise Emilsson, Julian R. Free, Michael Gardam, William H. Geerts, Chikwe Ihekweazu, Shanthi Johnson, Allison Kooijman, Alika T. Lafontaine, Eyal Leshem, Caroline Lidstone-JonesErwin Loh, Oscar Lyons, Khalid Ali Fouda Neel, Peter S. Nyasulu, Oliver Razum, Hélène Sabourin, Jackie Schleifer Taylor, Hamid Sharifi, Vicky Stergiopoulos, Brett Sutton, Zunyou Wu, Marc Bilodeau

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage. Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic. Evidence Review: A literature search in PubMed, MEDLINE, and Embase revealed 10910 articles published between 2000 and 2021 that included the terms leadership and variations of emergency, crisis, disaster, pandemic, COVID-19, or public health. Using the Standards for Quality Improvement Reporting Excellence reporting guideline for consensus statement development, this assessment adopted a 6-round modified Delphi approach involving 32 expert coauthors from 17 countries who participated in creating and validating a framework outlining essential leadership imperatives. Findings: The 10 imperatives in the framework are: (1) acknowledge staff and celebrate successes; (2) provide support for staff well-being; (3) develop a clear understanding of the current local and global context, along with informed projections; (4) prepare for future emergencies (personnel, resources, protocols, contingency plans, coalitions, and training); (5) reassess priorities explicitly and regularly and provide purpose, meaning, and direction; (6) maximize team, organizational, and system performance and discuss enhancements; (7) manage the backlog of paused services and consider improvements while avoiding burnout and moral distress; (8) sustain learning, innovations, and collaborations, and imagine future possibilities; (9) provide regular communication and engender trust; and (10) in consultation with public health and fellow leaders, provide safety information and recommendations to government, other organizations, staff, and the community to improve equitable and integrated care and emergency preparedness systemwide. Conclusions and Relevance: Leaders who most effectively implement these imperatives are ideally positioned to address urgent needs and inequalities in health systems and to cocreate with their organizations a future that best serves stakeholders and communities.

Original languageEnglish
Article numbere2120295
JournalJAMA network open
Issue number7
StatePublished - 2021


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