Amidst contemporary developments, societies, institutions and organisations have been exposed to increasing complexity and uncertainty in a highly interconnected world. These developments place significant demands on leaders, who must be prepared to manage a wide spectrum of crisis dynamics—from climate change to pandemics. While some organisations, or specific units within them, routinely operate under crisis conditions—such as emergency departments, acute care units, fire and rescue services, the military and the police—other organisational units encounter such conditions far less frequently (Hannah et al., 2009; Larsson et al., 2025).
However, in the event of a major crisis, most organisations must transition from a stable, routine state to a crisis‑management mode, and subsequently return to a more normalised state once the acute phase has passed (Hannah et al., 2009; Larsson et al., 2025). Previous reviews of crisis management have highlighted a lack of knowledge concerning how managerial transitions occur during a major crisis (Hannah et al., 2009; Wu et al., 2021). Therefore, this study examines how managerial roles evolve across the different stages of a major crisis (the COVID‑19 pandemic) in a regional hospital in Sweden.
