Physician leadership during the COVID-19 pandemic: an emphasis on the team, well-being and leadership reasoning

Abstract

BackgroundThe COVID-19 pandemic impacted many aspects of normal operations in academic medicine. While effective leadership is always important, the intensity and urgency of COVID-19 challenged academic medicine leaders to find new ways to lead their institutions and manage their own experiences of the pandemic.MethodsSixteen physician leaders from Michigan Medicine took part in semistructured interviews during April and May 2020. Participants were asked open-ended questions about the attributes and techniques that were important to effectively lead during a crisis. The authors analysed the interviews using thematic analysis.ResultsParticipants described three overarching themes of leadership during the COVID-19 pandemic: (1) bringing together a diverse team with clear, shared goals; (2) using a range of strategies to tend to their teams’—as well as their own—well-being; and (3) engaging in leadership reasoning as a way of learning from others and reflecting on their own actions to inform their future leadership practice.ConclusionThe results of this study reveal several salient themes of crisis leadership during the COVID-19 pandemic. The findings also highlight the role of leadership reasoning, a reflective practice employed by leaders to understand and improve their leadership skills. This finding presents leadership skill development as part of lifelong learning in medicine. Findings may be incorporated into best practices and preparations to inform future healthcare leaders.

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic

“…To succeed, alignment around a shared purpose and common objectives is required, as well as leaders releasing some control and establishing and maintaining high levels of trust among key stakeholders. 5,[19][20][21][22]…”

“…Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic time to reflect on and appropriately communicate their own struggles, whether to colleagues or to a trusted confidant, and considering sharing the workload more widely. 9,21 Those experiencing burnout or who are feeling overwhelmed should be afforded rest, receive support, or be allowed to transition to other roles with grateful acknowledgment of their contributions. 43 Outstanding performers should be prioritized for promotion and succession planning that is rooted in equity, diversity, and inclusivity that reflects the local communities being served.…”

“…Actively preparing for future emergencies in the recovery stage is vital 2,5,12 and it begins with introspective analyses and debriefs of individual, departmental, organizational, and interorganizational performance during the earlier stages of the pandemic. 9,21,49,57 5 as well as leadership best practices. 49 Leaders should commit to actioning and resourcing these suggestions because implementing lessons from past pandemic experiences has been shown…”

“…49 This may involve sourcing creatively when supply is thin; however, operating without the requisite resources causes tremendous anxiety among staff and can jeopardize their safety and effectiveness. 5,21,43,59 JAMA Network Open | Global Health Complex, high pressure situations often foster the formation of new coalitions as diverse groups unite for a shared goal to produce an adaptive response. 21,60 These symbiotic coalitions across silos and with partner organizations should be sustained to provide a higher quality continuum of care and to increase system capacity.…”

“…5,21,43,59 JAMA Network Open | Global Health Complex, high pressure situations often foster the formation of new coalitions as diverse groups unite for a shared goal to produce an adaptive response. 21,60 These symbiotic coalitions across silos and with partner organizations should be sustained to provide a higher quality continuum of care and to increase system capacity. 53 Training of staff should focus on the process of clarifying roles and accountabilities, coherent decision-making in complex situations, productive resource allocation, crisis communication skills, and adaptability to tailor responses to fluctuating circumstances, imperfect information, and to the diverse needs and roles of staff.…”