How Norwegian homecare managers tackled COVID-19 and displayed resilience-in-action: Multiple perspectives of frontline-staff

A resilient healthcare system is key to responding to sudden crises, such as the coronavirus disease 2019 (COVID-19) pandemic. Homecare services have been an important platform of healthcare delivery during the pandemic, and healthcare staff on the frontlines of homecare have been confronted with major challenges requiring adaptation to sustain high quality healthcare services. Managers' capacities to adapt to disruptions and challenges are important for an adequate response to challenges on the frontlines. To explore healthcare staff's perspectives on managers at different managerial levels (meso-level) handling of the COVID-19 pandemic in Norwegian homecare services. A qualitative multiple case study was designed including four cases. A case was defined as a homecare service within a Norwegian municipality (public organization). Data were collected through 16 interviews with healthcare staff. Interviews were conducted by using a semi-structured interview guide. Healthcare staff reported their managers as proactive, prepared and responded quickly. Present and supportive managers that provided effective and targeted information, and involved staff in decision-making were key to handling the pandemic in Norwegian homecare services. Our results underscore the interaction between healthcare staff and managers at different managerial levels as essential for quickly react, adapt, and resiliently respond to disruptions like the COVID-19 pandemic. Organizations need to have the flexibility to interact across levels and encourage managers to apply strategies for collaboration and staff involvement, especially during a crisis.