Rudy PRAMONO, Ni Putu Ayu Paramitha WEDHASARI, Leni Meipina GINTING
Perinatal Journal - 2026;34(2):269-281
The COVID-19 pandemic has highlighted the importance of leadership in maintaining hospital resilience, but existing qualitative findings remain fragmented and have not been integrated into a unified conceptual model. To address this gap, this study used qualitative meta-synthesis to integrate the results of 12 studies examining hospital leadership during the pandemic. A systematic literature search was conducted across five major databases such as Scopus, Web of Science, PubMed, Science Direct, and ProQuest with inclusion criteria focusing on qualitative studies on leadership, organizational resilience, and healthcare worker experiences. All eligible articles were assessed for quality using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist (2018). Data were then extracted and analyzed using a combination of Noblit & Hare's meta-ethnography and thematic synthesis, which enabled researchers to translate concepts, compare themes across studies, and develop a flow of argument that led to new theoretical constructs. The analysis identified four layers of resilience-oriented leadership: (1) adaptive and empathetic leadership behaviors, (2) psychological factors and organizational culture, (3) structural support and systemic governance, and (4) sustainable organizational resilience outcomes. These findings establish a new conceptual model that expands theories of transformational leadership and crisis management by emphasizing the integration of empathy, systemic coordination, and data-driven decision-making as the foundation of hospital resilience. Practically, this study offers guidance for developing resilience-based leadership training, enhancing collaborative governance, and creating a culture of continuous learning in healthcare organizations. The key novelty of this research lies in the integration of emotional, organizational, and systemic dimensions within a single, integrated framework.
