By David B. Friend, M.D., MBA
As the COVID-19 pandemic shifts into a new normal, healthcare organizations – hospitals and care facilities, nursing homes, payers, providers – are on the front lines to ensure that this transition succeeds. Healthcare leaders will be just as important in leading the way in this transition as they have been in fighting the pandemic these past months. The following lessons, rooted in experience, can move healthcare organizations safely and successfully through this time of adversity.
- OPEN YOUR EARS. Encourage people to tell you what you need to hear, not what you want to hear. Acknowledge individuals’ clinical experience in identifying the risks faced and the requirements for moving ahead in terms of personnel, equipment, testing capabilities, capacity and other needs. Reopening full healthcare operations on this scale is something that has never been attempted, so leaders must institute a strong listening culture to know what is really going on.
- AVOID PARALYSIS FROM TOO MUCH ANALYSIS. The best organizations allow decisions to be made in an appropriate timeframe at the level closest to the problem. Knowledge of COVID-19 grows daily, for instance, and this can incapacitate decision-makers. In healthcare, a good, timely response usually is better than a slow, perfect one, and decisions about timing, staffing and other factors need to reflect localized realities.
- DECISION-MAKING IS A TEAM SPORT. Reopening full operations during a pandemic is too complicated for any one person to be on top of everything, so it is critical to have multidisciplinary teams with clinical, financial, operational, data analytical and regulatory knowledge to provide a wide range of input into each issue. A strong team is vital to navigating such a complex endeavor.
- GENERATE POWER THROUGH ACCURATE DATA. The best decisions usually are as fact-based as possible, so only accurate data can lead to meaningful information and a true understanding of the problem. Combining an awareness of the facts on the ground with wisdom, experience and judgement will lead to the best possible decisions. New data will be offered regarding treatments, vaccines, behaviors and outcomes, and it is crucial to verify its accuracy before it is incorporated into decisions.
- INTEGRITY MATTERS. You cannot evaluate the quality of decisions necessarily by outcomes alone; you also must evaluate them based on the ethical standards that helped shape them. The best leaders have a sense of true north as their guide, which is essential when making decisions that literally mean life or death
- FIRST, DO NO HARM. While it is tempting to take action based on what can go right, it is more important to understand what can go wrong in transitioning from a lockdown to an open situation. In healthcare, the top goal is to ensure that patients survive. In transitioning facilities to a post-lockdown scenario, managing for the downside usually ensures that the upside will take care of itself.
- IMPROVISE, ADAPT AND OVERCOME. This is a way of life for the US Marine Corps, one of the world’s best at succeeding in chaos. Most plans become obsolete at the moment of crisis because, by definition, it is the unplanned-for event that causes crises. In reopening facilities, it is important to be resourceful in the face of uncertainty, unafraid to explore different ideas to see what works and willing to ignore sunk costs in pursuit of the right path.
- BE BRAVE. You cannot lead effectively if you are scared. However, bravery is not the absence of fear; instead, it is the ability to move forward despite being afraid. Bravery and fear are both highly contagious, but great leaders spread bravery and overcome fear. The frontline practitioners dealing with COVID-19 are a model for decision-makers everywhere in this transition.
- RESERVE THE RIGHT TO GET SMARTER. Embrace the right to change your mind when the facts change. Transitions rarely get everything right the first time. It is critical to acknowledge mistakes and keep working the problem.
- GIVE CREDIT, TAKE BLAME. Leaders need to share credit when things go right. Even more importantly, they need to take responsibility when things go wrong. In spite of the best planning, the transition to a reopened society inevitably will see failures; they need to be owned and fixed, not denied.
In the hours before D-Day, General Dwight D. Eisenhower gave a resounding message of confidence to the troops. Later, he wrote a note in case the invasion failed, saying that the troops had done all that could be done and that “If any blame or fault attaches to the attempt it is mine alone.” No finger-pointing or scapegoating, just true leadership – the kind that will enable us to successfully reopen America’s health operations.
Dr. David Friend is Chief Advisor of Restructuring at SCALE Physician Group and has served as a CEO, board member and advisor for corporations, hospitals and healthcare firms. He is on the Board of Fallon Health of Massachusetts and the Advisory Board of the University of Pennsylvania’s LDI Institute.