Table 3.

Quotes for theme 2 and subthemes: ED team engagement in guideline development

Engaged ED teams	ED team decision-making abilities: “I think that the day we decided to make our own decisions, applied to our [ED], for our people, it was good for team spirit – and I’m not just talking about us, with the nurses, I’m talking about all the ED staff. And those were probably the best decisions in the context of the information that we had.” (Physician)
	Each team has their role: “There’s no certainty that the decisions will always be perfect, but you have to accept that it can’t always be perfect, and that some people can make mistakes. And our infection prevention and control team, they made a lot, a lot of adjustments, and some smaller things didn’t go as well. But if you look at the big picture, I think we have serious people who are trying to make the best decisions possible, and that’s what’s most important. Those people work very, very hard and I admire them. So, I trust these people who give us recommendations.” (Physician)
Decisions	Decisions based on the best scientific knowledge: “I trust my colleagues in public health, and I trust that they will make all the best decisions, at the moment that they are making them, and these are not easy decisions because these are exceptional situations. I just don’t know whether their messages and decisions will be entirely communicated to the government who, after that, gives us the message. And I feel like the border’s become blurrier and blurrier in the last few weeks.” (Physician)
Management strategies	Transparency: “But what is sad, is the lack of transparency. When I do something, I can explain to you why I’m doing what I’m doing and that’s OK. But here, they’d come and “the procedural mask is OK for everyone” and the next day “no, no, it will be the N-95.” But why was the procedural mask OK yesterday and now it’s the N-95? (…) I still don’t have answers to those questions. And when you ask higher up, the only thing they say is “Pouah!” and they ignore you. I’m sorry, but, in life, when you ask me to do something, there’s a reason behind it. I am not a robot; I am a human being.” (Nurse)
	Positive communication strategies: “There was some kind of information transfer, a sort of “COVID hierarchy”, going from our chief, to our leaders, and now it’s everyone on the floor who’s familiar with the measures. I thought it was magnificent.” (Physician) “I think communication was great. I think, from a managerial level, so our direct managers, I think they've done really, really well being supportive and providing that information as soon as it's available. You know? Just being empathetic, like oh, we realise there's changes all the time, and I think they've been great. And I think most people recognize that that responsiveness and those changes are required.” (Social worker)
	Advantages/limits of “top-down” decisions: “On the one hand, it has its advantages, it simplifies things when one person upstairs decides everything but, on the other hand, it takes away a lot of the day-to-day adjustments we can do downstairs.” (Physician) “It’s been very frustrating because you’re usually just waiting for the dust to settle for another email to come out to tell you they’re going to change it all again because they didn’t think of some glaring obvious thing that someone will see the first time they go to do something.” (Nurse) “There are rules that are applied homogeneously everywhere, in one shot. So, they chose the easiest management method for them, but not necessarily for the employees. It’s like: “everyone is full-time starting now.” But in the emergency department, we had twelve nurses who weren’t doing much and were taking care of one patient, while there were people overworked on the wards. Because it’s hard to modulate decisions during a pandemic: it’s one complete and total decision for everyone.” (Nurse)