Healthcare Leadership During COVID-19

It’s likely that no sector of the economy was more upended by the pandemic than the nation’s healthcare systems. That level of disruption—from managing through financial losses brought on by canceled elective care to adapting to patients and their physicians meeting remotely—holds potential for long-term consequences, both lessons and opportunities, for the industry and its leaders.

As Dr. Omar Lateef, CEO of Chicago’s Rush University Medical Center, framed the requirements and challenges of the future: “We don’t yet know what the new normal will look like. This is going to change our society and healthcare. The next phase is going to require a whole different level of open-mindedness. Leaders will have to be agile, honest, and transparent. Flexibility will be essential, and that’s not currently an inherent strength of the healthcare system.”

Healthcare leaders crafting plans for the future can glean insights from experts who are studying the industry through both a current and forward-looking lens. There are certainly opportunities for growth post-crisis, but mindsets and strategies will likely look very different from those of the past.

Flexibility Starts with Collaboration

Experts sharing strategies for healthcare leadership in the New England Journal of Medicine point to what they identify as challenges to current health care systems: firmly structured hierarchies and silos of information that proved too rigid in the face of the COVID-19 crisis. Increased flexibility will be required in order to thrive in the “next normal." The answer for that likely will be collaboration and a willingness to decentralize authority, energize a broader network and dig deep into the needs of both staff and patients.

Consultants at McKinsey echo that advice and point out that the pandemic has created an environment where boards and CEOs have an unparalleled opportunity to make a positive impact, on both their organizations and communities. Their warning: don’t squander the opportunity. Flexibility for these leaders will be the ability to act, innovate and execute at a scale and speed that was previously unheard-of. As the pandemic unfolded, the healthcare system showed potential to do just that. Across the country, projects that were scheduled to take months, or even years, were producing results in just a few days or weeks.

The need for speed and flexibility may also have an impact on critical functions such as governance and the CEO’s spending authority. During the height of the pandemic, many boards passed emergency resolutions granting CEOs more purchasing authority in order to react quickly when sourcing hard-to-find—and often even harder-to-compete-for—supplies and equipment.

New Roles for Digital Transformation

Senior executives—from hospitals to physician groups—will be called on to provide leadership in order to implement changes in care delivery. Among those changes is telehealth, a digital delivery tool that is showing increasing consumer acceptance and even preference. As evidence, a survey by McKinsey shows that pre-pandemic, just 11% of consumers used telehealth. That number rose to 46% now using telehealth as a replacement for canceled in-office visits. For providers, that response increased by 50 to 175 times the number of patients accessing telehealth compared to before the pandemic.

For some patients, telehealth simply isn’t an option, but concerns over their safety are still paramount. When patients must be examined or treated inside a hospital, video technology is also offering new levels of patient and staff safety by limiting person-to-person contact.

For example, at the Cleveland Clinic, the usual practice of making rounds in hospital wards with a crowd of doctors gathered at the patient bedside is being replaced. The medical teams now do virtual rounds with only a single doctor in the room and others taking part via videoconference outside. “Managing this pandemic has taught us a lot about how to keep patients and caregivers safe,” Dr. James Merlino, the Clinic’s Chief Transformation Officer told the Wall Street Journal. “As we turn society back on and get patients in for the care they need, we know we can protect them.”

There are still many uncertainties on the horizon. On one hand more than half a dozen pharmaceutical companies and universities are in clinical trials for a COVID-19 vaccine, yet the infection curve remains volatile in pockets of the country. In response, leaders should prepare their teams for virtual healthcare as it becomes a more firmly embedded patient preference.

Opportunity Brings Challenges

Many of the opportunities for change and innovation provided by the pandemic experience come with considerable cost. The challenge for leaders will be finding ways for already stressed budgets to accommodate digital transformation.

The American Hospital Association took an in-depth look at the financial pressures imposed on the healthcare system by the pandemic. They looked at the effect of COVID-19 hospitalization costs; the effect on revenue of canceled or skipped service; the costs associated with the purchase of personal protective equipment; and the cost of additional support for workers—such as child care—provided by some hospitals. Richard Pollack is president and CEO of the AHA and oversaw the study. He says, “America’s hospitals and health systems have stepped up in heroic and unprecedented ways to meet the challenges caused by COVID-19. However, the fight against this virus has created the greatest financial crisis in history for hospitals and health systems.”

Becoming a Learning Leader

Along with stresses on budgets come other new challenges for healthcare leaders. The creators of Harvard University’s executive leadership program for healthcare executives point out a key challenge in the C-suite in hospitals and physician groups. Those leaders typically come to their positions with deep medical expertise, but have a learning opportunity when it comes to human factors leadership such as motivating diverse teams, engaging stakeholders and delivering coordinated care—not to mention running a productive business.

These experts suggest four foundations for building leadership capacity:

1. Understand your strengths and weaknesses, with an awareness of what your teams need from you. Make sure all know that you are invested in their success as much as your own.
2. Build situational awareness to cope with a crisis scenario that is likely embedded with many unknowns; ask probing questions and expand understanding.
3. Focus on connectivity and how silos of activity can—and must be—integrated.
4. Increase collaborative interactions while de-emphasizing competitive ones.

Across the nation there are many resources for healthcare leaders in search of insights and skills including these and others:

• American College of Healthcare Executives
• University of Chicago Booth School
• Northwestern University Kellogg School of Management
• University of Illinois School of Public Health
• University of Cincinnati Lindner College of Business
• UCLA /Johnson & Johnson Health Care Executive Program
• TH Chan School of Public Health at Harvard University

Leading to the New Normal

It is clear no segment of the U.S. economy has been impacted as much—or more than—the healthcare field. And while change is coming to many corners of the industry, there is also a constant: the role hospitals and physician groups play in building and maintaining healthy communities. Leaders in institutions large and small will be called on for not only a duty to care but also a responsibility to collaborate across all sectors of their organization, to energetically pursue innovation and to remain nimble in the face of what is likely to be a business horizon full of unknowns. As you consider the new normal for your organization, there are experts to help—from finance to technology to skill-building. Consider taking advantage of all.