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Context: The COVID-19 pandemic has placed unprecedented stress on health care systems worldwide. The global scale of the outbreak and its unpredictable nature has put a significant leadership burden on health care leaders and decision-makers. Predefined emergency preparedness plans are no longer working. Evidence-based guidelines and crisis communication plans are insufficient. There is an increased amount of pandemic fatigue among the general population. Businesses are suffering. A financial crisis is looming. Health systems leaders need new leadership behaviors and mindsets to help them lead during the next phases of this dynamic crisis as well as in future pandemics. Despite a proliferation of perspectives on the topic, given the novelty of the situation there is no aggregated resource distilling the evidence about how to lead under crisis conditions. Objective: The aim of this paper is to systematically examine evidence from research on public health crisis leadership to determine what competencies are explicitly needed to better respond to pandemics like COVID-19. Specifically, we sought to map and assess published studies on pandemics (a) to characterize core competencies required to lead in the health sector during a pandemic, and (b) to identify contextual enablers and barriers to leading during a crisis. Methods: We conducted a rapid review using the methodological framework of Arksey and O'Malley (2005), the World Health Organization Rapid Review Guide, and the Joanna Briggs Institute 2020 guide to scoping reviews (Peters et al., 2020; Tricco et al., 2017). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SR) guided our reporting of study findings. Data Sources: We performed a systematic and comprehensive search of MEDLINE (via Ovid), EMBASE, PsycINFO, Business Source Premier, and Canadian Business & Current Affairs for studies published between 2003 (since SARS) and July 28, 2020. Study Selection, Extraction, and Synthesis: We selected all empirical articles (quantitative, qualitative, and mixed methods) that discussed crisis leadership during a pandemic. Data Synthesis: The literature search identified 8,044 citations. A review of abstracts led to the retrieval of 749 full-text articles for assessment, of which 30 were selected for review. Conclusions: Our findings show that crisis leadership competencies commonly fall under three categories of leadership capacity: task, people, and adaptive. In pandemic-related leadership literature, task-related behaviors such as preparing and planning, establishing collaborations, and crisis communication often receive more attention. Our analysis revealed that during a crisis, people-oriented capacities and adaptive capacities are equally important for leaders to successfully lead in a dynamic situation shaped by structural, political, and cultural contextual factors. [ABSTRACT FROM AUTHOR]

It has become increasingly clear that health care organizations must collaborate in profound ways with one another, as well as with community service organizations and a range of other stakeholders, in order to achieve the goals of improved outcomes, enhanced patient experience, and controlled costs. As a result, the challenge of "integrated care" has grown in profile and attention. The purpose of this symposium is to examine potential contributions from management theory to the conceptualization of the scale and spread of integrated care, and to generate novel insights for management theory in return. The symposium includes researchers currently working in Canada and the United States, and speakers will be addressing management theory for scale and spread in ways that are relevant across these and other health system contexts. Each speaker will be given 10 minutes to succinctly respond to the following 2 questions: 1. Briefly describe a theoretical concept or perspective that you see as being particularly valuable for the study of the scale and spread of integrated care. 2. Assuming that the current paradigm of scale and spread for integrated care is flawed in some way(s), what do you think this concept adds to the discussion? Following brief presentations of each panelist's responses to these 2 questions, the moderator will take audience questions. The moderator will encourage discussion on the relative value of theory at macro, meso, and micro levels of analysis for understanding the system-wide adoption of integrated care, and new insights for management theory. [ABSTRACT FROM AUTHOR]

Providing care for increasingly medically and socially complex populations is a well-recognized challenge that necessitates coordinating services across multiple sectors and organizations. There is a need to re-organize how care is delivered to align with coordination efforts, in the form of inter-organizational networks. However, substantial gaps remain in our understanding of how to effectively implement these networks, and what leadership approaches will facilitate successful implementation. Drawing on distributed leadership theory, we examine how leadership is enacted in Health Links networks, a care coordination initiative in Ontario, Canada. We conducted a qualitative multiple case study of three Health Links. 30 leaders and frontline providers participated in hour-long, semi-structured interviews. We find that distributed leadership was enacted across all cases, and ranged from highly distributed models with numerous strategic partners, to less strongly distributed approaches that were primarily directed by the lead organization's vision and leadership. In all cases, the lead organization's influence was critical to the network's perceived successful implementation. When effectively leveraging its role, the lead organization empowered partners to enact distributed leadership across their network. However, strong variability was seen in the capacity of each lead organization to harness their power and position, resulting in mixed experiences of implementation. [ABSTRACT FROM AUTHOR]