• Samuel T Edwards, Amanda Johnson, Brian Park, Patrice Eiff, GuzmanCirila Estela VasquezCEVRelationships in Equity, Leadership and Team Effectiveness (RELATE) Lab, Department of Family Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA., Leah Gordon, Cynthia Taylor, and Anaïs Tuepker.
• Relationships in Equity, Leadership and Team Effectiveness (RELATE) Lab, Department of Family Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA. edwarsam@ohsu.edu.
• J Gen Intern Med. 2024 Feb 1; 39 (2): 239246239-246.

BackgroundCOVID-19 presented numerous challenges to primary care, but little formal research has explored the experience of practice leaders and their strategies for managing teams as the crisis unfolded.ObjectiveDescribe the experience of leaders in US primary care delivery organizations, and their strategies for leading teams during COVID-19 and beyond.DesignQualitative study using semi-structured interviews performed between 9/15/2020 and 8/31/2021.ParticipantsPurposive sample of 17 clinical leaders in a range of US primary care organizations.ApproachAn iterative grounded review of interview transcripts was performed, followed by immersion/crystallization analysis.Key ResultsEarly in the pandemic, practice leaders reported facing rapid change and the need for constant decision-making, amidst an environment of stress, fear, and uncertainty, but this was buffered by a strong sense of purpose. Later, leaders noted the emergence of layered crises, and evolving challenges including fatigue, burnout, and strained relationships within their organizations and with the communities they serve. Leaders described four interrelated strategies for supporting their teams: (1) Being intentionally present, physically and emotionally; (2) Frequent and transparent communication; (3) Deepening and broadening relationships; (4) Increasing adaptive decision-making, alternating between formal hierarchical and flexible participatory processes. These strategies were influenced by individual leaders' perceived autonomy, which was impacted by the leader's specific role, and organizational size, complexity, and funding model.ConclusionsAs the burnout and workforce crises have accelerated, the identified strategies can be useful to leaders to support teams and build organizational resilience in primary care moving forward.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

15 keywords...

hide…