Across the globe, COVID-19 has killed millions, affected billions and cost trillions. It has had an impact on healthcare services that will resonate for years. In this article, Dr David Barrett, Senior Lecturer in Nursing, University of Hull, examines the role of healthcare leaders in responding to recent challenges.
The COVID-19 pandemic is a ‘wicked’ problem (Schiefloe, 2021) – one that has wide-ranging implications for multiple parts of society, and in which one response may have unintended consequences elsewhere. We have seen the ‘wickedness’ of COVID-19 throughout the crisis: for example, societal lockdowns reduce spread of infection, but have catastrophic consequences for economies, for businesses, and for the mental health and wellbeing of many.
Wicked problems are complex and fast-moving, requiring a response which is coordinated, coherent and consistent. We have seen extraordinary efforts from all healthcare workers to deal with the ‘sub-crises’ that have punctuated the course of the pandemic, from shortages of personal protective equipment to the extreme pressure on critical care bed availability. The responses to these challenges have required planning and implementation at pace, which is where healthcare leadership has come to the fore.
Healthcare leaders have displayed incredible skills, innovation and resilience throughout the pandemic. They have had to demonstrate creativity and flexibility to “make faster decisions, with more information, and less clarity” (Lobdell et al, 2020). They have had to protect the health and wellbeing of their staff and patients, whilst adapting to the requirements of rapidly changing circumstances, policy and clinical evidence. Leaders have demonstrated proactivity, adapatabilty, clear communication, and an ability to instill a sense of optimism, even when challenges seem insurmountable (Stoller, 2020).
A cornerstone of leadership is the implementation of change. Crises such as COVID-19 act as powerful catalysts for change, with leaders more open to innovation and risk-taking, and their followers more accepting of new ideas, practices and systems. John Kotter – an authority on the process of implementing change – highlights that prerequisites of successful change are a sense of urgency and low levels of organizational and individual complacency (Kotter, 2008). Healthcare has never before been through a period where the sense of urgency was so high and feelings of complacency so low, and we have seen the impact of this in the pace with which changes in practice have been implemented successfully.
As we move out of the pandemic, leaders will have the opportunity to review changes that were made, identify those that will bring long-term benefit, and embed these in normal practice. Kalina (2020) highlighted how, post-pandemic, healthcare can continue to benefit from the enhancements in remote working, greater acceptance of technological solutions, reduced reliance on physical estate, and more effective utilization of resources.
In the coming years, healthcare leaders will need to focus on supporting colleagues, organizations and systems as they recover from an unprecedented period of pressure. However, they will also benefit from working with teams who are more accepting of change, more resilient, and more able to rise to whatever challenges they face in the future.
- Kalina P (2020) Resilient and inclusive healthcare leadership: Black Swans, COVID‐19, and beyond. The International Journal of Health Planning and Management. 2020; 35: 1611– 1613.
- Kotter JP (2008) A sense of urgency. Massachusetts, Harvard Business Press
- Lobdell KW et al (2020) Improving Health Care Leadership in the Covid-19 Era. NEJM Catalyst: Innovations in Care Delivery. June 4th 2020: doi: 10.1056/CAT.20-0225
- Schiefloe PM (2021) The Corona crisis: a wicked problem. Scandinavian Journal of Public Health. 49(1):5-8. doi:10.1177/1403494820970767
- Stoller J. K. (2020). Reflections on leadership in the time of COVID-19. BMJ Leader 4:77-79
Dr David Barrett is the Programme Director for the University of Hull’s part-time, online MSc in Healthcare Leadership.
If you would like to learn more about the course, please follow the link: www.hull.ac.uk