Improving management of vaccine supply chains: A multi-methods evaluation of vSTEP in Zambia.

BACKGROUND: Equipping supply chain professionals at all levels of the health care systems with essential leadership and management skills is essential to achieving global immunization targets. Numerous and diverse professional development initiatives have been established to support vaccine supply chain managers in Gavi-eligible countries. However, COVID-19 catalyzed rapid innovation in approaches to support leadership development in times of rapid change, and systematic evaluation of these approaches can inform future workforce development strategies to ensure resilient health systems. Therefore, we sought to evaluate outcomes and short-term impact of the fully virtual Strategic Training Executive Program 2.0 (vSTEP 2.0) program in Zambia on participant engagement, skill development, and application of new skills to improve supply chain performance. METHODS: We used a multi-method design to describe the outcomes and short-term impact of vSTEP 2.0 at three levels: (1) delegate response to the training experience (including participation, completion, and satisfaction); (2) delegate change in leadership skill (including achievement of learning objectives and change in competencies); and (3) application of new skills to impact supply chain performance. RESULTS: The program achieved high levels of engagement and an 83% graduation rate despite the length and rigor of the program. High satisfaction was evidenced by positive feedback from delegates on the quality and relevance of the program, especially in the context of COVID response (100% would "definitely" recommend). Delegates demonstrated significant growth in all domains of leadership competencies and applied their learnings to address a complex challenge in supply chain performance in their home organization. DISCUSSION: These findings demonstrate a strong appetite for leadership development support among vaccine supply chain professionals, especially in times of rapid change such as during the COVID response. These results also demonstrate the feasibility and impact of a fully virtual model for leadership development, with implications well beyond the COVID-19 pandemic.

The role of leadership in times of systems disruption: a qualitative study of health and social care integration.

OBJECTIVES: To understand whether and how effective integration of health and social care might occur in the context of major system disruption (the COVID-19 pandemic), with a focus on how the initiative may overcome past barriers to integration. DESIGN: Rapid, descriptive case study approach with deviant case sampling to gather and analyse key informant interviews and relevant archival documents. SETTING: The innovation ('COVID-19 Protect') took place in Norfolk and Waveney, UK, and aimed to foster integration across highly diverse organisations, capitalising on existing digital technology to proactively identify and support individuals most at risk of severe illness from COVID-19. PARTICIPANTS: Twenty-six key informants directly involved with project conceptualisation and early implementation. Participants included clinicians, executives, digital/information technology leads, and others. Final sample size was determined by theoretical saturation. RESULTS: Four primary recurrent themes characterised the experiences of diverse team members in the project: (1) ways of working that supported rapid collaboration, (2) leveraging diversity and clinician input for systems change, (3) allowing for both central control and local adaptation and (4) balancing risk taking and accountability. CONCLUSIONS: This rapid case study underscores the role of leadership in large systems change efforts, particularly in times of major disruption. Project leadership overcame barriers to integration highlighted by prior studies, including engaging with aversion to clinical/safety risk, fostering distributed leadership and developing shared organisational practices for data sharing and service delivery. These insights offer considerations for future efforts to support strategic integration of health and social care.