Wednesday, September 3, 2008

Hurricane Gustav: Another Valley

I have recently mentioned CHRISTUS’ experiences at the top of the mountain and the bottom of the valley in a period of two-and-a-half months. On one hand, we successfully separated conjoined twins at CHRISTUS Santa Rosa Children’s Hospital, while on the other we experienced a heparin incident in our NICU at CHRISTUS Spohn South. We talked about the importance of an organization on a Journey to Excellence being able to successfully experience and address those issues in the valley, and through those learnings, gain the knowledge and expertise to move toward the top of the mountain once again.

We predicted that other valleys would present themselves to CHRISTUS Health as we continued our Journey to Excellence for the next 10 years of our history. Indeed, such was the case five days ago when Hurricane Gustav directly aimed itself to several of our hospitals in the Gulf Coast region.

Just as we experienced in Hurricane Rita several years ago, we had to evacuate four of our hospitals in the direct line of the storm: CHRISTUS Hospital - St. Elizabeth in Beaumont, Texas; CHRISTUS Hospital - St. Mary in Port Arthur, Texas; CHRISTUS Jasper Memorial Hospital in Jasper, Texas and CHRISTUS St. Patrick Hospital in Lake Charles, La. In addition, we had to determine the potential consequences of the after-effects of the storm on our hospitals in close proximity, including CHRISTUS St. Frances Cabrini Hospital in Alexandria, La.

Because we are an organization that debriefs after our valley experiences, we learned a great deal from the challenges which Rita presented. Therefore, this time we were much better prepared both at the system and regional level, because our Risk management department has since made efforts to improve our disaster preparedness throughout the U.S.

Consequently, all of our regions, including Mexico and our newest region in New Mexico, participated in system-wide conference calls and made themselves available to take evacuees from the affected regions and to also provide supplies and staff as requested.

The affected regions were able to evacuate their patients smoothly and in an orderly fashion, so when the storm reached its peak, we had few or no patients in the four campuses that were in the line of the storm. However, all of these four campuses agreed to keep their Emergency Departments open and operational so that they could continue to serve their communities.

What leadership skills are necessary and were demonstrated to help us successfully walk through this most recent valley? I believe that there are seven critical skills to highlight.

First, organizational skills. All hurricanes and most other crises in valleys naturally create chaos and disarray. Our leaders demonstrated the ability to minimize this chaos and create plans, next steps and to-do lists which resulted in hour-by-hour plans that accomplished the goals which had been outlined several days before the hurricane hit.

Second, analytical skills. It is clear that every problem or issue during such crises cannot be identified in advance, and our leaders demonstrated their ability to quickly analyze the problem, create a rapid solution and implement it promptly.

Third, team building. Because crises such as hurricanes play out over a prolonged period of time of (often four to six days), one small group of people cannot provide the leadership which is required to come through a crisis successfully. Therefore, the breadth and depth as well as strength of team is vital during this period of time, so that several sub-teams can be assigned to work and then rest, rotating with other teams that will do this in reverse. Great team-building during Gustav was demonstrated throughout the CHRISTUS system, both in the U.S. and internationally.

Fourth, innovation. Unfortunately, during crises, some routine solutions do not address the issue successfully, and therefore the ability of the leadership team to innovatively think of new and potential solutions rapidly is essential. There were many examples of innovation during our recent crisis, including cross-staffing and opening up a daycare center with the faculty from our school-based health centers as two examples.

Fifth, flexibility. Traditional roles and responsibilities often do not suffice and create success during a crisis; therefore, all members of the leadership team must be flexible to do whatever is necessary to address the urgent challenges they face. Clearly, during a crisis in a valley, the responsibility at the end of each of our job descriptions, “other duties as assigned” should probably become the lead responsibility during this period of time.

Sixth, optimism. Walking through valleys like living through hurricane Gustav is a devastating experience under the best circumstances. Often, whatever can go wrong does go wrong, and occasionally even the best thought-out plans to address the issues are not successful. However, if leadership becomes discouraged, they will then become ineffective, and all the best-laid plans will quickly deteriorate, adding to the general chaos mentioned above. Consequently, a leader must make sure at all times--particularly when seen publicly or making public announcements--that optimism is visible or embraced in the words used in both verbal and written communications. This is of course helped by rotating schedules so that excessive exhaustion is avoided, and is also aided by celebrating the incremental victories as these crises unfold. That is, making sure the successes are communicated as widely as the challenges. We have discussed celebrating incremental victories in the past as necessary to re-energize leadership to move to the top of the mountain, and this is never more important than when one is in the valley.

Seventh, resilience. After several days of in being in the midst of a crisis, the team will often find themselves “hitting a wall,” much like a runner experiences in the 21st mile of a marathon. Unfortunately, crises are often not over when the wall is in sight, and therefore leadership must find the resiliency they need to continue the journey with the strength and energy that is required. Resilience was seen continuously during our recent experience, as our system and regional leadership teams were fully present and enthusiastically participated in our regular conference calls.

As we have discussed in the past, leadership skills and competencies are essential if an organization is to reach excellence and sustain themselves at the top of the mountain. But in reality, these skills are even more important as one’s organization is experiencing a walk through the valley.

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