Gautier L. auteur aut IRD Noda S. auteur aut IRD Chabrol Fanny auteur aut IRD David P. M. auteur aut IRD Duhoux A. auteur aut IRD Hou Renyou auteur aut IRD Oliveira S. R. D. auteur aut IRD Traverson Lola auteur aut IRD Zinszer K. auteur aut IRD Ridde Valéry auteur aut IRD text journalArticle eng text/pdf born digital access In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals' governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hospital cases from four countries on different continents: Brazil, Canada, France, and Japan. Our study examined how governance strategies (e.g., special task forces, communications management tools, etc.) were perceived by hospital staff. Key findings from a total of 177 qualitative interviews with diverse hospital stakeholders were analyzed using three categories drawn from the European Observatory on Health Systems and Policies framework on health systems resilience during the COVID-19 pandemic: 1) delivering a clear and timely COVID-19 response strategy; 2) coordinating effectively within (horizontally) and across (vertically) levels of decision-making; and 3) communicating clearly and transparently with the hospital's diverse stakeholders. Our study gleaned rich accounts for these three categories, highlighting significant variations across settings. These variations were primarily determined by the hospitals' environment prior to the COVID-19 crisis, namely whether there already existed a culture of managerial openness (including spaces for social interactions among hospital staff) and whether preparedness planning and training had been routinely integrated into their activities. specialized Comparative health systems hospital governance multiple case study resilience BRESIL CANADA FRANCE JAPON 056 052 9 2 2173551 [9 ] 2023 2328-8604 https://www.documentation.ird.fr/hor/fdi:010088054 10.1080/23288604.2023.2173551 2328-8604 [F B010088054] https://www.documentation.ird.fr/hor/fdi:010088054 https://www.documentation.ird.fr/intranet/publi/2023-07/010088054.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2023-07-06 2026-06-12 fdi:010088054 fre