There is perhaps no greater need for, or measure of, leadership than during a crisis.
When the shadow of a crisis is looming and as it onsets, we immediately look to experts – those with advanced knowledge, capabilities, and training – to take charge. Military units, for example, have highly trained personnel for every aspect of mission success, all of whom are skilled extensively in adaptability under fire before they ever engage the enemy.
In the global war against COVID-19, most of the thoroughly competent frontline staff and senior health leaders have never received such formal preparation; and while their response has been overwhelmingly commendable, crises offer opportunities for reflection and improvement.
This pandemic has tested leaders around the world in a way that has no peacetime equivalent, and it has brought many characteristics of military leadership to the forefront.
The first characteristic is a recognition of the indisputable importance of leadership, which is paramount in the military. There is no question that during a crisis, leadership matters and that there are definite consequences for getting it wrong; there is no place for bravado or inadequacy.
The second characteristic is the pre-eminence of experts… and rare adherence to their advice. Overall, most infectious disease physicians (experts) have been delivering a consistent message over the past few months and, for the most part, people have listened and #stayedhome. The projected fatalities have to a large extent been lessened by each person’s contribution to flattening the curve (though this is not intended to take away from the tragedies that have occurred). The clearest example of the converse situation is climate change, in which case, most experts have been delivering a consistent message and, for the most part, there has been no remarkable widescale response.
Third, there has been an extremely helpful immersion in the capability and practice of adaptability, which involves creativity, innovation, resourcefulness, coalition-building, and a solution-centred mandate. In military operations and in day-to-day work for many people over the past few months, a conclusion that, “I tried and it didn’t work” is simply not acceptable. For this reason, the current crisis might have saved companies like Blockbuster Video that allowed themselves to become obsolete by forcing them to entertain a new, potentially salvific, modus operandi. Since national governmental lockdowns were enacted, in the words of Twelfth Night, most of us have had adaptability thrust upon us, which has inspired brilliant examples of alternative solutions despite incomplete information, imperfect or unusual resources, and the reliance on new allies. The focus on “mission success” has ignited a creativity within many of us that may not otherwise have been activated to the same extent or at least with the same urgency (sorry, Blockbuster).
Fourth, in many cases, there has been a greater tolerance for minor imperfections and a recalibration of key priorities. “The art of the possible” is a term used commonly in the military, which involves recognizing the need to devise an efficacious strategy and make decisions when they are needed, instead of preparing the perfect plan that is too late. 16 stipulations for a morning latté have given way to essentials (toilet paper); but, more seriously, sports stadiums converted to temporary hospitals, for example, may not be ideal, but if nearby hospitals suddenly become overwhelmed, we would all be grateful to have them.
Finally, during this pandemic, it has become abundantly clear that we need each other as local, national, and global communities. The approach that every government in the world has taken relies on all of us doing our part: following the recommendations and in many cases, pleas, of leaders and experts, being creative in how we strive to maintain personal relationships and professional commitments, and being patient with others and ourselves when things don’t go exactly as we would like. There has also been a heightened sense of care: instead of beginning remote meetings with fatuous questions about the weather or the football/cricket/whatever, there has been a genuine concern for the health of others and their families. At Sandhurst, the elite British Royal Military College, the acknowledgment of the essential interdependence of key contributors, as well as the duty of care for each other, are fundamental components of their pedagogy and understanding of leadership.
Despite the overlap of these five characteristics of military leadership with the experience of many during the coronavirus pandemic, there is one glaring and inexcusable difference: preparation.
In the military, leadership development is part of every officer’s career from selection to retirement – it undergirds everything they do – and yet, with the exception of the work of the Faculty of Medical Leadership and Management (FMLM), The Staff College: Leadership in Healthcare, the Executive Master’s in Medical Leadership at the Cass Business School, and others in the UK, most NHS physicians, even those in senior positions, have little or no formal leadership training. This appears to be an international trend. A recent nation-wide study by Canadian Health Leadership Network (CHLNet) indicated that funding in Canadian health organizations for leadership development has decreased in the past five years and that although 80% of the nearly 2,000 survey respondents reported being in positional leadership roles, half have never had any formal leadership development. Among other approaches, through combat simulations followed by expert and peer feedback, all military officers are highly trained in adaptive leadership; it becomes part of their DNA. There is a moral imperative to provide similar development opportunities related to crisis leadership for health leaders.
As soon as the World Health Organization (WHO) declared that the COVID-19 outbreak was a global pandemic, the CEO of the Canadian College of Health Leaders announced that our top priority is preparing and sharing resources to support health leaders across our country and beyond. In addition to an expert-informed guide for leadership in a crisis document (available in English & French), the College has devised a four-part model of the stages of a crisis, including the characteristics, leadership imperatives, and development needs of each stage. The first stage is preparation (before a crisis), the second is the peak, the third is the wake after the peak but before the end, and the fourth is following a crisis.
Although many health organizations are currently in Stage 3 (wake after the peak), it is highly possible that there will be at least one if not multiple waves of recurrences of the pandemic. This suggests that, to some extent, all health organizations should be ready at Stage 1 (preparation), which absolutely needs to be a better-informed Stage 1 than it was four months ago. Preparation includes providing the requisite training in adaptive and crisis leadership for senior and frontline leaders.
After this deadly pandemic, leadership will be focused on ensuring that the necessary healing can take place, along with addressing the logistical challenges of re-introducing non-essential operations and procedures. But there should be a third vital priority during Stage 4 and a second moral imperative: a collective re-imagining of how we can incorporate our wartime successes into the new and, as a result, improved, post-crisis world. A respect for trustworthy leadership and expertise, a genuine openness to innovation and a solution-centred mandate, a patience for the “art of the possible”, and an authentic care for each other are the hallmarks of effective leadership during and following a crisis.
Great artists borrow and the best artists steal, so I will conclude with the words of one of my heroes that summarize why I was inspired to contribute:
“In times of struggle, leaders must lift their inner and outer spirits and find HOPE.”
Elder Little Brown Bear
During the coronavirus pandemic, there has been a global army’s worth of examples of heroes who have demonstrated the vision, adaptability, compassion, humility, and courage needed to meet this foe head-on, while providing hope to us all. We have an obligation to ensure that these principles are carried forward into the post-crisis world.
Thank-you to health leaders and professionals for the valiant work that you are doing, particularly if you continue to be in harm’s way. We have devoted our careers to supporting you and to celebrating your triumphs, large and small.
Our hope is that by researching and sharing the wisdom of leaders during this unprecedented global war against an invisible enemy, and that by recognizing that we are indeed in this together, we will return, one day very soon, to peace at last and to a better, re-imagined world.
Thank-you to the senior editors at BMJ Leader for this opportunity.
Health and happiness!
Jaason Geerts, PhD
Leadership for professionals
The Canadian College of Health Leaders
Dr Jaason Geerts
Dr. Jaason Geerts completed his PhD at the University of Cambridge in leadership for doctors, military officers, and other professionals. He is currently working for the Canadian College of Health Leaders (CCHL) and LEADS Canada as a researcher, program designer, and senior consultant. As an academic, he is actively publishing and is a visiting lecturer at the Cass Business School (London). Jaason has applied his research as an expert advisor to programs at the Yale School of Medicine, the Yale School of Management, the University of Zurich Business School, the National Health Service (NHS), and the UK Defence Academy (Joint Services Command and Staff College (JSCSC)). Jaason is currently a faculty member at the Canadian Foundation for Healthcare Improvement (CFHI) and a leadership instructor and program director for the Schulich School of Business. He recently led two nation-wide Canadian Health Leadership Network (CHLNet) research projects on leadership in Canadian health organizations and on “wise practices” of leadership development. Jaason is also a qualified teacher and was nominated for the Toronto Star’s Teacher of the Year.