By Ted A James, MD, MHCM
May 5, 2020
The disruptive nature of the global pandemic has created a rapidly changing environment with long-lasting implications for health care far beyond the immediate crisis.
It is unlikely that we will simply revert back to normal; new ways of thinking will be required and the ability to adapt to new realities and prepare for an unknown future will mean the difference between success and failure. The challenge calls leaders to navigate uncertainty while restructuring care in an abruptly transformed health system.
Big Picture Thinking
“…a good leader creates a bottom-up culture of observation to accurately perceive today in order to predict tomorrow.” – Gary Burnison
Despite the critical pace of events, leaders need to take time to step back and reflect. Elite athletes know that focusing on the bigger picture during the game allows them to make the right moves under pressure. Employing a collaborative leadership model and delegating appropriately gives leaders space to plan for the future.
Keep your situational awareness high at all times. Assess the situation from multiple viewpoints, both inside and outside of the organization. Listen, seek input, and be open to ideas, especially those from the front lines. Have systems in place to gather data as events unfold. The more information you collect, the more accurate your understanding of the big picture will be.
Pay attention to your emotional state, which may impact your ability to process information and make appropriate decisions. Taking a few minutes to pause, breathe, and become aware of your thoughts provides clarity and focus for long-term strategic thinking.
Supporting and Empowering the Team
“We shall not fail or falter; we shall not weaken or tire. Neither the sudden shock of battle, nor the long-drawn trials of vigilance and exertion will wear us down. Give us the tools, and we will finish the job.” – Winston Churchill
Keeping a big picture perspective also means leading by your core values and principles. In health care, this always means taking care of people first (i.e., patients, health care workers, and their families). People must come before any other resource or financial consideration.
Recognize the sacrifice, suffering, and loss people are facing. Go out of your way to show your appreciation and offer support. Have resources in place to deal with stress. Monitor workloads and allow people to replenish. Create opportunities to connect with individuals and bring people together. Once people feel safe and supported, they can focus fully on the task at hand.
Teams will need to improvise and make corrective decisions in real-time. Be transparent with goals and avoid micromanaging. By encouraging autonomy and innovation, you give people the confidence to respond fluidly when unanticipated circumstances arise.
Leading for the Future
Leaders need to move out of a reactive mode into a proactive future-planning state. Ask what success would look like three, six, or even twelve months from now. Have designated teams and committees that focus on long-term recovery strategies.
As new methods of care are developed (e.g., resuming patient-care services while practicing social distancing), prepare to preemptively address potential failures before adverse events occur. Consider where and how things may go wrong and what level of impact that might have.
Don’t be constrained by prior experience, policies, or traditions. There are no predefined rules for addressing the new reality, and traditional approaches will likely be ineffective. Be willing to deconstruct old paradigms and build new ones. What works today may not work tomorrow, so be prepared with contingency plans and adjust accordingly.
The presence of a leader is vital to hope. Now is not the time to retreat unseen to the command center. Leaders should be visible. For instance, it was inspiring to see our hospital president (a non-clinician) on the in-patient units supporting the doctors and nurses.
Leaders also foster confidence and hope by maintaining a calm demeanor, conveying realistic optimism, and celebrating every small win. Hope helps people persevere through adversity
This crisis will bring much suffering and loss. It will undoubtedly change us. It will force us to consider who we are and what we value. It will reveal the real leaders among us. My hope is that during these difficult and uncertain times, we discover the best version of ourselves.
- Hershkovich et al., Effective medical leadership in times of emergency: a perspective, Oded Disaster Mil Med. 2016
- Ronald A. Heifetz, Marty Linsky. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Harvard Business Press, May 2009.
- Nancy Koehn. Real Leaders Are Forged in Crisis. Harvard Business Review, April 2020.
- Eric J. McNulty, Leonard Marcus. Are You Leading Through the Crisis … or Managing the Response? Harvard Business Review, March 2020.
- Wendy K. Dean. COVID-19 Is Making Moral Injury to Physicians Much Worse: Commentary. Medscape, April 2020.
Dr. Ted James is a medical director and vice chair at BIDMC/Harvard Medical School. He is an alumnus of the Harvard Health Care Management program and is involved internationally in leadership development and health care transformation. He also teaches through the HMS Office of Executive Education.
Dr. James blogs about health care transformation. To see more of his posts, click on his name in the tags below.
*The content provided is not advice and is intended for information purposes only. OPINIONS EXPRESSED BY OUR GUEST AUTHORS ARE VALUABLE TO US AT LEAN FORWARD, BUT DO NOT REPRESENT OFFICIAL POSITIONS OR STATEMENTS FROM HARVARD MEDICAL SCHOOL.