Organizational decision-making during COVID-19: A qualitative analysis of the organizational decision-making system in the United States during COVID-19

This study sought to understand COVID-19-related organizational decisions were made across sectors. To gain this understanding, we conducted semi-structured interviews with organizational decision-makers in North Carolina about their experiences responding to COVID-19. Conventional content analysis was used to analyse the context, inputs, and processes involved in decision-making. Between October 2020 and February 2021, we interviewed 44 decision-makers from the following sectors: business (n = 4), community non-profit (n = 3), county government (n = 4), healthcare (n = 5), local public health (n = 5), public safety (n = 7), religious (n = 6), education (n = 7) and transportation (n = 3). We found that during the pandemic, organizations looked to scientific authorities, the decisions of peer organizations, data about COVID-19, and their own experience with prior crises. Interpretation of inputs was informed by current political events, societal trends, and organization mission. Decision-makers had to account for divergent internal opinions and community behaviour. To navigate inputs and contextual factors, organizations decentralized decision-making authority, formed auxiliary decision-making bodies, learned to resolve internal conflicts, learned in real time from their crisis response, and routinely communicated decisions with their communities. In conclusion, aligned with systems and contingency theories of decision-making, decision-making during COVID-19 depended on an organization's ‘fit’ within the specifics of their existing system and their ability to orient the dynamics of that system to their own goals.