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Table 2 Summary of results by theme

From: Systematic review of experiences and perceptions of key actors and organisations at multiple levels within health systems internationally in responding to COVID-19

Professional level Organisational level Local system level
Front-line staff asked to adapt to COVID-19 and exhibit resilience
Staff experienced shifting roles and increased workload to respond to COVID-19
Staff stress and burnout exacerbated by fear of contagion and lack of suitable protective measures, including PPE
Some healthcare staff less recognised, especially home care workers
Examples of innovative initiatives include telehealth and community engagement
Introduced psychological support programmes for workforce
Recognition of otherwise ´unseen´ workers
Emphasised open or engaging leadership
Use of cross-functional teams to support care coordination
Reflection on how COVID-19 relation information shared within and beyond organisation                                                   COVID-19 seen as ‘catalyst’ for overcoming typical barriers to change
System-wide training to mitigate stress
Safeguarding working conditions
Source of external public resources and finance, but concern about sustainability
Enabled coordination of relationships across organisations
Updating of regulations and contracting needed to support service-level changes (e.g. introduction of telemedicine)