학술논문

Leading primary care under the weight of COVID-19: how leadership was enacted in six australian general practices during 2020.
Document Type
Article
Source
Australian Journal of Primary Health. 2024, Vol. 30 Issue 1, p1-14. 14p.
Subject
*LEADERSHIP
*STAKEHOLDER analysis
*INTERVIEWING
*PHYSICIANS' attitudes
*PRIMARY health care
*QUALITATIVE research
*DESCRIPTIVE statistics
*COMMUNICATION
*THEMATIC analysis
*COVID-19 pandemic
*SECONDARY analysis
*LONGITUDINAL method
Language
ISSN
1448-7527
Abstract
Background: The COVID-19 pandemic challenged health care delivery globally, providing unique challenges to primary care. Australia's primary healthcare system (primarily general practices) was integral to the response. COVID-19 tested the ability of primary health care to respond to the greater urgency and magnitude than previous pandemics. Early reflections highlighted the critical role of leaders in helping organisations negotiate the pandemic's consequences. This study explores how general practice leadership was enacted during 2020, highlighting how leadership attributes were implemented to support practice teams. Methodology: We performed secondary analysis on data from a participatory prospective qualitative case study involving six general practices in Melbourne, Victoria, between April 2020 and February 2021. The initial coding template based on Miller et al.'s relationship-centred model informed a reflexive thematic approach to data re-analysis, focused on leadership. Our interpretation was informed by Crabtree et al.'s leadership model. Results: All practices realigned clinical and organisational routines in the early months of the pandemic – hierarchical leadership styles often allowing rapid early responses. Yet power imbalances and exclusive communication channels at times left practice members feeling isolated. Positive team morale and interdisciplinary teamwork influenced practices' ability to foster emergent leaders. However, emergence of leaders generally represented an inherent 'need' for authoritative figures in the crisis, rather than deliberate fostering of leadership. Conclusion: This study demonstrates the importance of collaborative leadership during crises while highlighting areas for better preparedness. Promoting interdisciplinary communication and implementing formal leadership training in crisis management in the general practice setting is crucial for future pandemics. COVID-19 posed unique challenges to primary health care in Australia and globally. Leaders played a critical role in navigating the impacts of the pandemic, although minimal opportunities were created to foster emergent leaders. Hierarchical leadership styles allowed rapid responses, yet the impact of power imbalance affected the wider team morale. Our study demonstrates the importance of promoting interdisciplinary communication and the need for formal leadership training to be implemented in Australian general practices, to allow for better preparedness for future pandemics. [ABSTRACT FROM AUTHOR]