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COJ Nursing & Healthcare

Resilient & Inclusive Healthcare Leadership Black Swans, COVID-19, and Beyond

“It’s not the Strongest of the Species that Survive, or the most Intelligent, But the one most Responsive to Change”

Peter Kalina*

Associate Professor of Radiology, Mayo Medical School, USA

*Corresponding author: Peter Kalina, Associate Professor of Radiology, Mayo Medical School, Minnesota, USA

Submission: April 10, 2020;Published: April 16, 2020

DOI: 10.31031/COJNH.2020.06.000634

ISSN: 2577-2007
Volume6 Issue2


The consensus leadership model enhances inclusion within healthcare organizations. Stakeholders have an opportunity to provide their input, and be heard prior to implementation of a decision, strategy or plan that directly involves them. People want to understand how, and especially why, a decision is made.

Fostering inclusion means collaborating with, and engaging your diverse team. Empower your team to provide opposing viewpoints so as to leverage collective knowledge, perspectives, experience and skills. Don’t do it alone. It’s ok to say, “I don’t know.” After all, large groups are smarter than even an elite few, no matter how brilliant the few are. Groups are better at solving complex problems, and coming to better decisions. The result is the best possible, aligned decision. Aligned teams own their decision, support it, and are committed to it; as if they made the decision themselves. They agree to act, even if they don’t completely agree with each other or the decision. Voting polarizes; creating winners & losers; an us vs. them mentality such that only those voting with the majority “own” the decision [1-4].

Others now have an opportunity to undermine the effort. Alignment behind a shared commitment requires more effort, but strengthens the team, asking members to work toward a “Best” decision. Objections and alternatives are discussed until everyone is invested in the final solution [4]. Consensus leadership has limitations. It’s harder to get things done, decisions take longer, and leaders may appear indecisive. Of course, there is no playbook on how to be an effective, resilient and inclusive leader in unprecedented times during black swan events. All can agree on some basic desired values and traits [5].

Most, if not all of these, are already hopefully in place (given the need for familiarity in times of upheaval, not drastic style changes). Leaders should communicate frequently; even if they don’t always have all the facts; which they will not [6]. Frequent communication about what people want, and need to hear about builds trust, fuels engagement and helps preempt the spread of misinformation. It may be best to limit communication regarding that which cannot be controlled [7].

Leaders should be: calm, stable, educated (regarding the current situation), focused, trustworthy (do what you say you will do), visible, decisive (when prompt action is required, the enemy of good is better!), assertive, enthusiastic, eloquent, transparent, deliberate, confident, consistent, nimble, flexible (allow new information to refine and revise your current thinking), open-minded, adaptive, strategic, authentic, available, honest, credible, optimistic, clear, creative, realistic, positive, specific, willing to ask difficult questions, willing to make difficult decisions (even when based on limited information) [8].

Without a playbook, all we know is that realities will change, and tomorrow will make different demands than yesterday. Even with a playbook, situations are fluid; changes will be needed. Balance short and long range strategies [9]. Long-term plans become obsolete quickly requiring contingencies. This

unprecedented level of disruption and uncertainty deeply impacts people. Recognize, acknowledge and address your employees’ personal and emotional concerns. Their priorities will shift to ensuring that their family’s feel safe, and stay healthy. Empower them to be creative in how they work so as to minimize unnecessary risk. Employee loyalty to the organization and its mission and commitment to persevere during challenging uncertain times requires believing a leader is competent, supportive, compassionate, empathetic, and genuinely cares about their well-being [10].

Acknowledge the economic impact to your employees and the organization. Decreased volumes and revenue will impact everyone’s financial bottom-line. Strategies and solutions to reduce expenses should be tempered and selective, so as to avoid the unintended consequences of over adjusting and creating greater disruption than necessary. An organizations purpose, mission and culture, must remain steadfast despite challenging times; serving as a guide to make the best decisions under pressure. Long-term brand protection must trump short-term revenue loss concerns [11].

The “New normal,” post COVID-19 future will see the breaking of long-standing traditions, many perpetuated by the (agonizing!) phrase, “that’s how we do things around here!” There will be a welcome and necessary disruption of the status quo. Local autonomy, including flexible management of work flow (how, when and where we work) will be optimized for greater efficiency and enhanced employee wellness. New staffing models with altered workforce deployment will include acceleration of the much-needed, inevitable and highly anticipated remote work and virtual learning. Less travel will be needed to conduct business or support excellence in education. Reducing costs via a smaller physical footprint will reduce long-term costs. There will be greater efficiency and prioritization in utilizing our resources, both human and capital [12].

The necessity of change and operating differently creates potential opportunities during a time of tremendous volatility. Healthcare leaders are in a position to help shape what the landscape will look like, rather than simply adapting to it. They can help their organization move forward beyond the task of recovering and regaining the status quo. Aim to emerge even stronger than before; aim to thrive not just survive.

The personal and economic volatility significantly impacting our colleagues and our workplaces in these unprecedented times will have lasting and far reaching effects. These clearly require new ways of leading. Traditional leadership styles and strategies taught in MBA programs will not to address the ambiguity and rapid-fire changes we are witnessing. No previous training, no prior strategic planning knowledge, no prior operational experience, and no former decision-making skillset has prepared anyone for the uncertainty surrounding what this complex new reality presents us with. Listen to multiple sources. Welcome opinions and viewpoints that differ from yours. In addition to your own team and local stakeholders, confer with outside leaders for even greater additional insights. We don’t always need to reinvent the wheel. These tactics will help you adapt to the rapidly changing environment, best analyze your situation, and consider the full breadth of potential strategies and solutions.

Leaders will need a very clear vision. They will need to laser focus on their organization’s mission, culture and core values. Optimizing strategies to navigate, recover from, and take advantage of these circumstances will require focusing on an organization’s strengths (and understanding potential weaknesses). Courage is needed to make difficult decisions regarding bold strategies. This will certainly involve some degree of risk. In addition, your decisions will not occur without a healthy dose of criticism; and plenty of “Monday morning quarterbacking.”

Crises and black swan events happen. When they do, they reveal a leader’s character. Consider them opportunities to redefine the industry through innovative business models and shape future trends to create value for your loyal patients.


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© 2020 Peter Kalina. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.