In the eye of the storm: Hospital leaders' resilience during the COVID-19 pandemic.

Background: Although hospital leaders were already at a high risk for psychological and physical illnesses long before the pandemic, the COVID-19 pandemic exacerbated this situation.

Purpose: Recognizing the crucial role of leaders in organizational crises and building on the conservation of resources theory, our study examines how hospital leaders cope with difficulties that endure over an extended period of time. By using the COVID-19 pandemic as an example for prolonged adversity in hospitals, we provide insight into the different responses to a given adversity and further expand knowledge about the role of time in crisis and for resilience.

Methodology/approach: Qualitative expert interviews were conducted with 44 hospital leaders in Austria between December 2020 and November 2021. For data analysis, we used a hybrid approach, consisting of both deductive and inductive coding.

Results: By extending Bardoel and Drago's (2021) conceptual approach on acceptance and strategic resilience, our empirical study shows that during enduring adversity, hospital leaders use both types of resilience. The choice between them and their suitability depends on both the duration of exposure and severity of the adversity.

Conclusion: Our findings further show that when immediately confronted with adversity, leaders tend to rely on resource-preserving acceptance resilience, whereas when dealing with enduring adversity, leaders are more likely to use resilience-enhancing strategic resilience.

Practical implications: Even though leaders rely on both types of resilience, our findings also imply that if opportunities to build strategic resilience are limited, higher burnout and turnover rates might be the consequence.