Against the background of government measures - decision-making and moral leadership of healthcare executives

The Corona era is a special time, also for healthcare executives. They are faced with complex issues that require fast and adequate decision-making, in an arena full of uncertainty and diverse stakeholders. As we enter the post-acute phase of the crisis, a pressing question for the future is what we can learn from this crisis. Therefore, the central question of this project is: "What do the experiences of healthcare executives during the corona crisis teach us about good governance, especially in times of crisis? How can these insights about good governance be used for the further professionalization of healthcare executives and used by healthcare executives, government and other stakeholders in preparation for future crises and issues? " During the acute phase of the corona crisis there was a lack of knowledge, information and resources. The course of the crisis was by no means predictable. Well-known authors in the field of leadership and crisis management propose - given the specific nature of this crisis - an adaptive leadership style (Macpherson & 't Hart 2020): iterative and tailor-made intervention, evaluation and learning (see also Heifetz et al. 2017). Learning focuses on dealing with the daily issues that arise during crises. Also, ethicists in the media called for more reflection on the ethical issues raised by the crisis (including Baart 2020, De Lange 2020). Macpherson & 't Hart also make a plea for another, more in-depth, form of learning: "They need to personally undertake critical reflective and diagnostic work". It is precisely this critical and reflective practice that is the object of this research. Research into the reflective and normative practice of healthcare management in times of crisis requires descriptive research. It also requires an interpretive approach, in which the knowledge that is inherent in the actions of healthcare executives - the knowledge in action (Hajer & Cook 2003) - is unlocked, so that it can be strategically deployed and is questionable and transferable. Reflective knowledge is the knowledge that arises through reflection on the events that happen to people and is focused on their own way of dealing with them (Schön 1983). Such reflection turns people into knowledgeable agents, capable of understanding and give meaning to the drastic events of this time (Giddens 1984; Sewell 1992; Leca and Naccache 2006; Cooney 2007). Sharing the deep, internalized knowledge made available in this way with peers (peer group learning) helps to build a strong community of practice of knowledgeable agents (Van der Scheer 2013). Sharing and questioning this knowledge with and by other relevant agents (professionals, supervisors, patients) contributes to a learning process at the level of the sector as a whole (sector learning). The study has a qualitative interpretative research design. First, data is collected through 31 semi-structured interviews with healthcare executives and experts, from all sub-sectors in health care (e.g. hospitals, nursing homes, mental healthcare). Second, insights from the interviews are deepened with focus groups of healthcare executives. Third, enrichment sessions are organized with a broad group of stakeholders (professionals, institutions, experts, patients) to reflect on the findings of the interviews and focus groups. The results of the three research phases are described in a concise research report, which will be widely shared with the professional field, to promote the practice of governance in the form of 'actionable knowledge.