This post originally appeared on Forbes.
The pandemic has been a great teacher of organizational lessons—and nowhere has that been clearer than in the medical field. Michael J. Dowling, president and CEO of Northwell Health, New York’s largest health system and private employer, has been reviewing the teachings from Covid and assessing which of them will provide guidance to the organization over the next five to 10 years. Based on the Northwell Health experience, here are six lessons that any organization can adopt, not just to manage or prepare for emergencies, but also to ensure growth and strength.
Agility may be more valuable than analysis. A significant aspect of Northwell Health’s success, says Dowling, is the speed at which the organization adapted to new circumstances. “We demonstrated very clearly that we can be extraordinarily agile and flexible [and simultaneously] much more solid than we ever thought we could be,” he says. “In a crisis, you have to move very, very quickly [without time to] analyze it out of existence…. In the Covid crisis, the whole organization had to do this, and we demonstrated we could. That’s a source of pride and confidence.”
During a pandemic is no time for experimenting, yet it might also be the best time. Agility requires balancing risk with moving quickly. Even complex organizations can generate new, adaptive processes and norms if they give employees the leeway and support to experiment with new methods while maintaining a firm grounding in both the organization’s mission and the current conditions.
Integrate functions and solutions where you can. Northwell Health’s network is comprised of 23 hospitals and more than 830 outpatient facilities, including ambulatory, urgent care and post-acute units as well as research and educational organizations. All of these were involved in supporting the Covid agenda and employees could be moved around as needed to shore up various parts of the system at different times. “Without the ambulatory [units] and the urgent care, we would have been in real trouble,” says Dowling. “Our nursing leadership put together nursing programs for nurses that were never in the ICU but now had to be in the ICU. They were not going to replace an ICU nurse but [they] could be an assistant to an ICU nurse.… If we had a problem with one hospital, people from all the other hospitals [came] to help.”
Organizational silos and lack of interdepartmental or interdisciplinary bridges and understanding can slow new initiatives and dampen even the best intentions to support other groups. Practice in coordination and collaboration is crucial, as is collective support of the organization’s mission. Northwell’s ability to shift experience and skills across the organization proved to be a great boon during the crisis. It also creates flexibility in non-crisis times that can be tapped for innovation and to support change management. “The interdisciplinary nature of how we operated during Covid changed the perception of a lot of our caregivers,” says Dowling. “We had medical students working in various parts of the organization; we had orthopedic surgeons and ophthalmologists and dermatologists helping in the ICU. They begin to understand what the ICU does and they all have a much better appreciation for what the other disciplines are doing.… We have always made the case that you’re part of one team, whether you’re working in a hospital or a post-acute-ambulatory or resource center.”
Invest now in planning, people and resources to be more prepared and flexible in the future. Even if you haven’t done this kind of planning before, start now to be ready when the next emergency hits. Dowling was anticipating and preparing for crises more than 20 years ago. “We started developing a very coherent, comprehensive emergency management infrastructure with the right people who knew what they were doing. I’ve always believed, based upon where we exist in New York, next to three airports, and being in New York itself, that we eventually would have a crisis. We also developed our own supply chain company, we have our own transport company, we have the largest lab in the United States, and we have all the protocols of what it is you do when you have a crisis. We had it before 9/11, we had it for Hurricane Sandy and Hurricane Irene. We took out the templates that we had before, and we modified them for Covid.”
Skillful crisis management relies on a deep understanding of preventative measures and interrelated issues, both internal and external, that will have impact on the organization. All leaders can make efforts to understand future needs as well as the mishaps and disasters that are likely to occur. Dowling says he’s “always looking five to 10 years out. What are the skills we need in the future that we don’t have today? [For example,] technology is going to be a much bigger player in the future. What kind of data analysts will we need? Programmers? How will we deal with cybersecurity? We’ve got to reassess, based upon where we see the world going, the types of skills we’ll need, and then try to figure out how we train people for these roles…. I can have all the beautiful buildings and wonderful strategy, but if I don’t have the right skill and talent, you can’t get anything done.”
Reduce variation in service delivery. “We created a clinical care committee that met every day and developed standardized protocols based on the new learnings about how every part of the health system should take care of Covid,” says Dowling. “We standardized the care and treatment of Covid patients, we dramatically reduced variation, we eliminated it. We did it in a crisis, so the template is there and we can do it in a non-crisis for stroke, cardiac care, for various kinds of surgical care.” Once they’ve established successful methods or approaches, many organizations benefit from explicit standardization or calibration in repetitive processes and interactions. There will always be appropriate exceptions, but most activities can be trained, measured and implemented more easily once norms exist.
Keep communication upbeat and continuous. Particularly in the post-Covid environment of remote and hybrid work, it takes ongoing effort and energy to keep people together, on point and galvanized to support the same mission. “We have thousands of people working remotely. I was always able to walk down the halls in the main office and see hundreds upon hundreds of employees. I could have meetings at the coffee pot; I could have meetings in the hallway. So how do you make up for that?” asks Dowling. “[During Covid] the message I communicated everywhere was one of optimism, that we are smarter and stronger than the enemy, and at the end of the day, there’s only going to be one winner and it’s going to be us.”
It helps to maintain as direct a connection as possible between senior leadership and employees at all levels to ensure a coherent understanding of the mission, major initiatives, and performance expectations. Dowling meets with “all new employees that are hired. Since Covid it has been mostly through Zoom. I met with 270 people this morning. I talk about the history, where we are today, how we got here. The values, behaviors, expectations, what’s acceptable, what’s not acceptable. And for the next six months my senior people and I will be out meeting with the staff at every facility.”
Be intentional about fostering organizational culture at all levels. This starts with selecting the right people. “We spent an awful lot of time getting the right committed people with positive, collaborative attitudes to take on leadership positions,” says Dowling. “When you build that culture and you hire people that have that attitude, it makes life easy.” To ensure that the organization has the agility and flexibility necessary to rise to the occasion in the face of crisis, you need to create the connections and relationships that help percolate the culture throughout all groups. Dowling does this by moving “people around all the time, [not because they’re] bad in the job that they did. It’s moving them to get a different perspective on life from another angle…. I feel very privileged that we have a cavalry of young, dynamic people in the organization that, when you blow a horn, the cavalry comes.”
It’s the responsibility of the leadership to cultivate pride and morale so that employees can thrive, even under very tough conditions. That includes showing people a brighter future so they aren’t consumed by current challenges. “Leadership is about managing the present, selectively forgetting the past and creating the future,” Dowling says. “Get people excited in doing it.”
Every organization faces crises and disasters from time to time. By applying these six lessons from Northwell Health’s pandemic experience, you’ll better the odds of navigating a challenging period successfully and being ready for the next one.
Onward and upward —
LK