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"Prepare for the worst thing you can possibly imagine. It’s like having money in a savings account for a rainy day."
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Pandemic Leadership Lessons for Any Organization

By Jo Ann Endo | Tuesday, September 22, 2020
Pandemic Leadership Lessons for Any Organization Photo by Mika Baumeister | Unsplash

In mid-January of this year, Michael Dowling started hearing news that concerned him. The Northwell Health President and CEO and IHI Board Chair was getting reports from China and Italy about a mysterious new virus. Out of an abundance of caution, Northwell called its management and disaster management team together to prepare for the potential of a not-yet-named novel coronavirus reaching New York.

It wasn’t long, of course, before Northwell and other health care providers were at the epicenter of the COVID-19 pandemic.

In a new book he has co-authored with Charles Kenney, Leading Through a Pandemic: The Inside Story of Humanity, Innovation, and Lessons Learned During the COVID-19 Crisis, Dowling shares hard-won leadership lessons. While Northwell is New York’s largest health system, many of the lessons Dowling and his team learned can be applied by any organization in any health care setting in the world.

Here are some of the key lessons Dowling shared in a recent interview:

  • Choose leaders who are team players. One of the most important overriding lessons we’ve learned [during the pandemic] is about organizational culture. Do you have a collaborative culture? Are people willing to unify around a cause when something extreme happens? This requires having the right people in the right places and the right leadership. If you have leaders who are not team players, get rid of them. Leadership is about unifying people. It’s about being positive. It’s about collaboration. I’m fortunate to have a great team here [at Northwell] that all work for one another and fight together in [times of crisis].

  • Focus on supporting the health, morale, and well-being of your staff. Staff need to feel safe and secure. They need to know their leaders care about them. An important part of that is providing support services for employees, such as Employee Assistance Programs and behavioral health programs that help them deal with stress and anxiety. During the initial surge, we provided childcare and rented hundreds of hotel rooms for employees who didn’t want to go home and possibly expose their children or other family members to the virus.
  • Create a culture of preparedness. Every hospital should have a disaster preparedness infrastructure. Everyone in an organization should know exactly what to do when a major crisis happens. People should understand their roles and be in the right place. COVID-19 is bigger than anything we’ve ever faced, but preparedness is important to deal with any kind of crisis. It could be a pandemic, a mass-casualty event like an airplane crash, a terrorist attack, or a weather-related disaster such as a hurricane or flood. Prepare for the worst thing you can possibly imagine. It’s like having money in a savings account for a rainy day.
  • Communicate, communicate, communicate. When you’re in a crisis, communication is key, especially to the frontline staff. You can’t overdo it and, as often as possible, you do it in-person. I’ve walked the floors of every hospital [in our system], every ICU, and every COVID unit during this crisis because it’s important for staff to know that the CEO and other leaders understand, first-hand, what they’re dealing with. You have to make sure you communicate the truth in a way that inspires and keeps morale high.
  • Set up a robust clinical decision-making process. Know how to bring your best clinical minds together to provide the best advice in any kind of a crisis. [During the initial surge], we had a clinical advisory group made up of our key clinicians from various disciplines. On a day-to-day basis, this group used the best evidence and the most recent experiences to issue quality guidelines, standards of care protocols, and advisories to staff across the whole organization. This ensured that everyone was current on the latest thinking about how to deal with COVID. Remember, at the very beginning, we didn’t know an awful lot about the virus. We learned something new all the time and the continuous communication of the current guidelines was a big part of our quality improvement effort. It’s also consistent with the way we work on a regular basis.
  • Cultivate good relationships with your vendors. If you develop strong, long-term relationships with your vendors, when you call them during a crisis asking for PPE, beds, syringes, and other necessary supplies, they’re going to deliver because they know you pay your bills on time, you do good work, and most importantly, they trust you. If there’s no relationship or trust, you’re going to run into problems.
  • To learn more leadership lessons from IHI Strategic Partner Northwell Health and others, join us at the IHI Forum 2020 (December 6-9), a four-day virtual conference.

    Jo Ann Endo, MSW, is IHI’s Senior Managing Editor, Digital Content & Blog.

    You may also be interested in:

    How Improvement Science Can Meet the Moment (or Miss the Mark)

    What Past Disasters Can Teach Us About Supporting Staff During COVID-19

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