Year 2021
October 2021


Abstract Title
Exploring healthcare workers adaptation to rapid organisational change under COVID-19 in Singapore hospital settings: bridging workforce morale and systems operational safety and functioning



National University of Singapore1, Tan Tock Seng Hospital2 

Background & Hypothesis

The current study explored job demands and stressors faced by healthcare workers (HCWs) during the COVID-19 pandemic and to identify resources mitigating these. Analysis delineates positive and negative narratives of HCWs relating to living with rapid organisational changes and effects on (1) ‘Heart ware’: or morale and commitment toward delivering optimal healthcare. And (2) ‘Hardware’: their experiences of these changes, adapting to them, and growing COVID-19 implementation strategies.


An anonymous online survey conducted from late June to August 2020 collected ‘e-diary entries, including comments, poems and multimedia data shared by HCWs during the Circuit Breaker in Singapore. N=663 submissions from nine healthcare institutions across Singapore participated as did all professional cadres and range of nationalities. Themes were organised according to heart ware and hardware and under which circumstances these were made worse or improved.


Dominant themes, crushing morale or HCW ‘heart ware’, were primarily defined by the cumulative experience of burnout or feeling overworked; feeling under-appreciated; as well as feeling unprepared & unsupported. 

On the flipside, morale was commonly said to be boosted by having engaging leadership, and working within a supportive team.

Strategies that worked particularly well were described, as were areas for improvement.

Discussion & Conclusion

Our findings suggest that safeguarding HCWs’ morale is driven by organisational factors, and leadership is key. The tertiary care system itself needs enough elasticity and a large enough workforce to ensure that adequate respite and rest can be taken, self-care prioritised and organizational culture built to promote and endorse this.