Crisis Management Tasks in Dutch Nursing Homes During the COVID-19 Pandemic: A Longitudinal Interview Study

Med Care Res Rev. 2023 Jun;80(3):318-327. doi: 10.1177/10775587221150477. Epub 2023 Feb 1.


The COVID-19 pandemic hit long-term care, and particularly nursing homes hard. We aimed to explore how crisis management goals and tasks evolve during such a prolonged crisis, using the crisis management tasks as identified by Boin and 't Hart as a starting point. This longitudinal, qualitative study comprises 47 interviews with seven Dutch nursing home directors and a focus group. We identified two phases to the crisis response: an acute phase with a linear, rational perspective of saving lives and compliancy to centralized decision-making and an adaptive phase characterized by more decentralized decision-making, reflection, and competing values and perspectives. This study confirms the usability of Boin and 't Hart's typology of crisis management tasks and shows that these tasks "changed color" in the second phase. We also revealed three types of additional work in managing such a crisis: resilience work, emotion work, and normative work.

Keywords: COVID-19 pandemic; crisis management; nursing homes; resilience.

MeSH terms

  • COVID-19*
  • Humans
  • Nursing Homes
  • Pandemics
  • Qualitative Research
  • Skilled Nursing Facilities