 Our study found that hospitals' governance strategies varied significantly depending on their pre-COVID-19 environment. In particular, those hospitals which had a culture of managerial openness and routinely planned and trained for emergencies were better able to quickly adapt to the COVID-19 crisis. This suggests that hospitals should consider investing in such practices beforehand to ensure they are ready to respond to any future crises. This article was offered by Laura Gauthier, Shinichiro Noda, Fanny Chabral, and others.