Lessons Learned from COVID-19 Epidemic Management from the Perspective of Managers: A Qualitative Study


Learned lessons
Qualitative study

How to Cite

Hadinejad, Z., Araghian Mojarad, F. ., & Yaghoubi, T. . (2022). Lessons Learned from COVID-19 Epidemic Management from the Perspective of Managers: A Qualitative Study. Iranian Red Crescent Medical Journal, 24(9). https://doi.org/10.32592/ircmj.2022.24.9.2212


Background: Coronavirus will not be the first and the last pandemic in the world. Problem-solving and crisis management methods are determined by the ways in which people, statesmen, and experts treat various fields.

Objectives: The present qualitative study was conducted pursuing the goal to illustrate COVID-19 epidemic management learned lessons from the perspective of the managers of the educational and medical centers of Mazandaran University of Medical Sciences, Sari, Iran, in 2022.

Methods: This qualitative study was conducted based on a content analysis type in Mazandaran University of Medical Sciences and its subdivisions (hospitals and educational centers). The data were collected using semi-structured interviews, and interview coding was performed manually by the researcher. To increase the study accuracy, the methods proposed by Lincoln and Goba (1998) were used with such criteria as validity, reliability, verifiability, and transferability.

Results: In total, 15 managers (8 men and 7 women) in the age range of 32-70 years participated in this study and underwent deep and semi-structured interviews. Initially, 1079 semantic units and 85 subcategories were extracted. After reducing, removing, and integrating being conducted at various stages of data analysis, 3 themes and 12 categories were extracted. The present study themes are made up of "Management Challenges", "Personnel Challenges", and "Social Challenges".

Conclusion: One of the factors for promoting quality in planning is benefiting from the prior learned experiences and lessons. Taking advantage of the consulting team, the intra-organizational and extra-organizational coordination, optimally benefitting from the human workforce, paving the ground for virtual training for health system staff, and elevating the quality of public information are critical in the effective management of COVID-19.



Zhan C, Tse CK, Fu Y, Lai Z, Zhang H. Modeling and prediction of the 2019 coronavirus disease spreading in China incorporating human migration data. PloS One. 2020;15(10):1-17. doi: 10.1371/journal.pone.0241171. [PubMed: 33108386]

Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020;92(4):401-2. doi: 10.1002/jmv.25678. [PubMed: 31950516]

Villela DAM. The value of mitigating epidemic peaks of COVID-19 for more effective public health responses. Sci ELO Brasil. 2020.

Kang YJ. Lessons learned from cases of COVID-19 infection in South Korea. Disaster Med Public Health Prep. 2020;14(6):818-25. doi: 10.1017/dmp.2020.141. [PubMed: 32378503]

Guan Wj, Ni Zy, Hu Y, Liang Wh, Ou Cq, He Jx, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. [PubMed: 31986264]

Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506-17. doi: 10.1016/S2213-2600(20)30161-2. [PubMed: 32272080]

Organization WH. weekly epidemiological update on COVID-19. 2022.

Ahmadi A, Fadaei Y, Shirani M, Rahmani F. Modeling and forecasting trend of COVID-19 epidemic in Iran until May 13, 2020. Med J Islam Repub Iran. 2020;34:27. doi: 10.34171/mjiri.34.27. [PubMed: 32617266]

Meskarpour Amiri M, Shams L, Nasiri T. Identifying and categorizing the dimensions of Iran's health system response to the Covid-19 pandemic. J Mil Med. 2020;22(2):108-14. doi: 10.30491/JMM.22.2.108.

Ashrafi Rizi H, Kazaempour Z. The challenges of information service related to the COVID-19 crisis. J Mil Med. 2020;22(2):207-9. doi: 10.30491/JMM.22.2.207.

Ashrafi Rizi H, Kazempour Z. Information typology in coronavirus (COVID-19) crisis; a commentary. Arch Acad Emerg Med. 2020;8(1):1-3. [PubMed: 32185370]

Jalali Farahahni A, Ebrahimnia M, Hosseini Zijoud SR. Non-governmental and voluntary groups, collaborators in the fight against COVID-19. J Mil Med. 2020;22(2):98-9. doi: 10.30491/JMM.22.2.98.

Repici A, Maselli R, Colombo M, Gabbiadini R, Spadaccini M, Anderloni A, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020;92(1):192-7. doi: 10.1016/j.gie.2020.03.019. [PubMed: 32179106]

Oh J, Lee JK, Schwarz D, Ratcliffe HL, Markuns JF, Hirschhorn LR. National response to COVID-19 in the Republic of Korea and lessons learned for other countries. Health Syst Reform. 2020;6(1):1753464. doi: 10.1080/23288604.2020.1753464. [PubMed: 32347772]

Wu H, Soe MM, Konnor R, Dantes R, Haass K, Dudeck MA, et al. Hospital capacities and shortages of healthcare resources among US hospitals during the coronavirus disease 2019 (COVID-19) pandemic, National Healthcare Safety Network (NHSN), March 27–July 14, 2020. Infect Control Hosp Epidemiol. 2021;1-4. doi: 10.1017/ice.2021.280. [PubMed: 34167599]

Rathnayake S, Dasanayake D, Maithreepala SD, Ekanayake R, Basnayake PL. Nurses’ perspectives of taking care of patients with Coronavirus disease 2019: A phenomenological study. PloS One. 2021;16(9):1-17. doi: 10.1371/journal.pone.0257064. [PubMed: 34478482]

El Bcheraoui C, Weishaar H, Pozo Martin F, Hanefeld J. Assessing COVID-19 through the lens of health systems’ preparedness: time for a change. Global Health. 2020;16(1):1-5. doi:10.1186/s12992-020-00645-5. [PubMed: 33213482]

Shiri T, Azimi N. A comparative study of qualitative content analysis and hermeneutics. Sociol Res. 2012;5(15):79-99.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001. [PubMed: 14769454]

Strubert Speziale H, Alen J, Carpenter D. Qualitative Research in Nursing. Philadelphia: Williams & Wilkings; 2003.


Castro Conde BA, Lopez Mourino VL, Sanz Falque I, Lopez Castro J. COVID 19 and the new challenges in health management: The pilot experience of the internal medicine department of a regional hospital. J Healthc Qual Res. 2021;36(1):54-5. doi: 10.1016/j.jhqr.2020.11.001. [PubMed: 33358445]

Madani S, Abedini A, Kiani Y, Kiani A. Intra-hospital and inter-hospital trans-portation methods for patients with Covid-19. J Med Counc Islam Repub. 2021;39(1):17-22.

Rassouli M, Ashrafizadeh H, Shirinabadi Farahani A, Akbari ME. COVID-19 management in Iran as one of the most affected countries in the world: advantages and weaknesses. Front Public Health. 2020:510. doi: 10.3389/fpubh.2020.00510. [PubMed: 33072688]

Etemadi M, Olyaeemanseh A, Tadayon MM, Rostami E, Shiri M, Fazaeli A, et al. Psychometric analysis of health system resilience scale and assessing it in the face of Covid-19 crisis in Iran. Iran J Epidemiology. 2020;16(1):4-19.

Nazari M, Movahed E, Soltaninejad M. Survey hospitals preparedness and resilience in crisis COVID-19 in the south of kerman province, Iran. Iran J War Public Health. 2021;13(1):57-61. doi: 10.29252/acadpub.ijwph.13.1.57.

Mirzaei S, Dehghan Chenari H, Gholi Nataj M, Norouzinia RA, Nasiriani K, Eftekhari A, et al. The readiness of hospitals affiliated to yazd university of medical sciences after the third peak of corona in the COVID-19 epidemic. J Mar Med. 2021;3(4):34-40. doi: 10.30491/3.4.34.

Tune SNBK, Islam BZ, Islam MR, Tasnim Z, Ahmed SM. Exploring the knowledge, attitudes, practices and lived experiences of frontline health workers in the times of COVID-19: a qualitative study from Bangladesh. BMJ Open. 2022;12(1):1-10. doi: 10.1136/bmjopen-2021-051893. [PubMed: 35017240]

Jebelli B, Varahram M, Soltanifard Razlighi M, Palizdar M, Ghazanchaei E. Management strategies to control the COVID-19 crisis in masih daneshvari hospital, Tehran, Iran. J Mil Med. 2020;22(6):616-22. doi: 10.30491/JMM.22.6.616

San Juan NV, Clark SE, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, et al. Training and redeployment of healthcare workers to intensive care units (ICUs) during the COVID-19 pandemic: a systematic review. BMJ Open. 2022;12(1):1-12. doi: 10.1136/bmjopen-2021-050038. [PubMed: 34996785]

Khankeh H, Farrokhi M, Roudini J, Pourvakhshoori N, Ahmadi S, Abbasabadi Arab M, et al. Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study. BMC Public Health. 2021;21(1):1-9. doi: 10.1186/s12889-021-11973-5. [PubMed: 34686165]

De Kock JH, Latham HA, Leslie SJ, Grindle M, Munoz SA, Ellis L, et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. 2021;21(1):1-18. doi: 10.1186/s12889-020-10070-3.

Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, et al. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev. 2020;11(11):1-164. doi: 10.1002/14651858.CD013779. [PubMed: 33150970]

van der Goot WE, Duvivier RJ, Van Yperen NW, de Carvalho Filho MA, Noot KE, Ikink R, et al. psychological distress among frontline workers during the COVID-19 pandemic: A mixed-methods study. PloS One. 2021;16(8):e0255510. doi: 10.1371/journal.pone.0255510. [PubMed: 34351970]

Imani Jaajarmi H. Social impacts of the spread of coronavirus in Iranian society. Social Impact Assessment. 2020;1(2):87-103.

Nasirzadeh M, Aligol M. Assessmentof knowledge, attitude, and factors associated with the preventive behaviors of COVID-19 in Qom, Iran, in 2020. Qom Univ Med Sci J. 2020;14(7):50-7. doi: 10.29252/qums.14.7.50.

Sahebi A, Golitaleb M, Aliakbari F, Yousefi K, Sheikhbardsiri H. The knowledge, attitudes, and practice (KAP) of the Iranian public towards COVID-19: a systematic review. Emerg Med J. 2021;6(4):186-93. doi: 10.5603/DEMJ.a2021.0033.