Abstract
BACKGROUND: There is a research gap in explaining the health system’s role in responding to pandemics and other health emergencies within a systematic framework. This study aims to present a systematic model for health systems to respond to health emergencies in the workplace, drawing on national and international experiences of the COVID-19 pandemic, with a focus on Iran as a case study. METHODS: This study employed a qualitative, content analysis approach, utilizing a triangulation method to collect and analyze data. Data were gathered through document review and semi-structured interviews, and analyzed using inductive and deductive content analysis techniques. The trustworthiness of the findings was assessed using five criteria, including credibility, transferability, dependability, confirmability, and stability. RESULTS: The resulting systematic model consists of 45 subthemes, 22 themes, seven dimensions, and four domains. At the domain and subdomain levels, the health system should, during the planning phase, develop a documented plan that understands the context of workplaces in the health emergency and includes leadership commitment and workplace participation. During the operational phase, the health system should implement measures to control the emergency while providing necessary support. During the checking phase, the health system should evaluate performance in the context of the emergency. In the acting phase, the health system should continuously improve its response based on feedback. CONCLUSION: Health systems, along with other workplace stakeholders, play a critical role in a systematic feedback loop during health emergencies. The proposed model, customized for specific contexts, can serve as a framework for health systems to respond effectively to workplace health emergencies. Future research should focus on testing the model in diverse settings, with an emphasis on both qualitative and quantitative assessments of its effectiveness and efficiency. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13693-7.