"Anyone can lead when the plan is working..."

The Canadian writer Robin Sharma said, "Anyone can lead when the plan is working.  The best lead when the plan falls apart."  Former heavyweight boxing champion, Mike Tyson would agree and would offer, "Everyone has a plan until they get punched in the mouth."  Well, if I could summarize what the last 19 months have felt like, I think "getting punched in the mouth" fits perfectly!

I came across a really good article by Paul Kempinski, Presidet and CEO of Children's Mercy in Kansas City, Missouri in this past month's issue of the Journal of Healthcare Management.  It's called, "The culture imperative: Preserving your organization's soul" - I believe every leader in health care should read this article!  Kempinski was still relatively new in his role (16 months) when the COVID-19 pandemic was declared in March, 2020, and one of the discussions was whether to modify their new 5-year strategic plan, which had been approved by the hospital Board just one day prior to the official pandemic declaration.  

Here is what Kempinski said, "Our plan was toast, at least for the moment.  Overnight, we sent 2,300 employees home to work.  Over the next few weeks, our surgical and outpatient volumes dropped more than 70%.  Our emergency department and urgent care volumes decreased 57% and 67%, respectively.  Admissions slid 32%.  We were losing $1 million a day, every day, for nearly 3 months."  

Children's Mercy's experience was not unique.  Almost every other children's hospital experienced the same decrease in volumes, as hospitals deferred elective surgeries and admissions.  In addition, with everyone working remotely and going to school remotely, children were just not getting sick.

Rob Lane, MD, the physician-in-chief at Children's Mercy spoke up during one of the executive leadership meetings, "When we get through this, we want our employees to look back on the pandemic and say, 'Our organization cared for us.  It had to make tough decisions.  We didn't always agree, but we got through this, and our collective soul and our culture remained intact.'"

Every decision that Children's Mercy's executive leadership team made during the early crisis days of the pandemic were guided by their mission, vision, and core values (which, incidentally, they had just updated and re-committed to).  Kempinski goes on to say, "It has been said that adversity does not build character in an individual; it reveals it.  The same is true for organizations."  Confronting a crisis was not the time to abandon their mission, vision, and core values.  Instead, the crisis reaffirmed them - they remained the North Star for the way forward.

The American author and social activist Grace Lee Boggs said, "Finding the leaders of the future is a question of recognizing those people who give leadership in a crisis."  With that in mind, there is another article that I highly recommend, published a few months ago in Nursing Administration Quarterly by Drs. Renee Thompson and Mitchell Kusy ("Has the COVID pandemic strengthened or weakened health care teams?").  Both authors suggest that teams confronting a crisis should conduct a "purpose audit" - in other words, focus on the mission, vision, and core values!  

There's a lot to unpack in this article too (and I want to come back to it again in the next post).  However, they found that the leaders who were most successful at keeping their teams together and becoming stronger in the crisis could be characterized by five behaviors:

1. They were honest about what they didn't know ("They admitted that they did not have all the answers and were learning just like their staff.  They told the truth and increased the frequency of their communication.").

2. They were visible and "got dirty" first (see also "Leaders eat last"; "The leaders who managed to successfully lead their teams through the crisis made visibility a priority.").

3. They continued to address any incidents of disruptive behaviors (Unfortunately, almost every organization, particularly those in health care, have witnessed an increase in disruptive behaviors.  The most effective leaders addressed these behaviors quickly and told their teams, "It's not okay for you ro behave this way.").

4. They focused on the present ("Leaders reminded their teams that they had control over today and to focus today on doing the best that they could for their patients and for each other.").

5. They showed their team they cared about them ("Leaders who strengthened their teams took the time to show they cared by giving them permission to express emotions and encouraging them to talk.").

Pope Francis wrote in his book, Let Us Dream: The Path to a Better Future, "The basic rule of a crisis is that you don't come out of it the same.  If you get through it, you come out better or worse, but never the same."  I believe that if we don't lose sight of our mission, vision, and values - our purpose, to use another term - we will not only come out of this crisis, but we will also emerge as stronger and better organizations.