Leadership in a Time of Crisis

James G. Adams, MD Professor and Chair Dept of Emergency Medicine Northwestern University Feinberg School of Medicine g Northwestern Memorial Hospital Chicago, Illinois

What s a Crisis? Whats

Sudden Instability Change of the usual order of things Often dangerous Of d Requires a decision
What does it mean to Decide

Every Human Activity Has Variability...

Lower L Specification Mean Upper U Specification

p(defect)

Target

Systematic Elimination of Unwanted Variability

Crisis Leadership
Make sense of it Make a decision Make M k meaningful communication i f l i i Make it stop Make sure it does not happen again

What did Toyota do wrong?

Crisis communication:
50% expressing compassion 25% signaling technical competence, competence
understanding and controlling the issue

25% ensuring justice, fair resolution justice

"Crisis management". Kansas City Public Schools. 2007 http://www.kckps.org/crisis/. Crisis management Schools. 2007. http://www kckps org/crisis/. http://www.kckps.org/crisis/ "Resource guide for crisis management in Virginia schools" (PDF). Virginia Department of Education. Education. 2002. http://www.pen.k12.va.us/VDOE/Instruction/crisis-guide.pdf.. http://www.pen.k12.va.us/VDOE/Instruction/crisis-guide.pdf.. "Quick Reference Guide for the National Response Plan ( Q p (version 4.0)" (PDF). May 2006. ) ( ) y http://www.dhs.gov/xlibrary/assets/NRP_Quick_Reference_Guide_5-22-06.pdf. http://www.dhs.gov/xlibrary/assets/NRP_Quick_Reference_Guide_5-22-06.pdf. "Emergency Management Institute Home Page". http://www.training.fema.gov/. Page". http://www.training.fema.gov/. Boin, Boin, A.; P. Hart and E. Stern (2005). The politics of crisis management: Public leadership under pressure. pressure. New York: Cambridge University Press Press. Hellsloot, Hellsloot, I. (2007). "Review of "The politics of crisis management: Public leadership under pressure" by A. Boin, P. Hart, E. Stern and B. Sundelius". Journal of Contingencies and Crisis Boin, Sundelius". Management 15 (3): 168169. doi:10.1111/j.1468-5973.2007.00519.x. 168 doi:10.1111/j.1468-5973.2007.00519.x.

Barriers and Myths

We are rational We are insightful g

We are wired to sense threat When bad things to occur, we externalize the cause

The power of genuine listening

Suspending the voice in our own heads. heads Be quiet for 30 seconds.
Were you really quiet? W ll i ?

The mouse in the maze

If we put a mouse in a maze, tasked to find the maze cheese, what happens?
Put a doctor in the maze maze Put a leader in the maze during a crisis

Seems simple
Listen Figure out the best route

Genuine Listening
Control the voice voice.
Change what it says. This voice creates reality Can you suspend the voice? y p
This is required for genuine listening. If you can listen without reacting, the other will y g, not frustrate you. You will gain insight. g g

Plan before you begin to navigate the route to your destination

Planning for crisis
An d A understandable f d bl framework h l you make sense k helps k of a crisis. What i do Wh action d you take if a parent rushes i and k h in d hands you a floppy, ashen baby?

Medical vs Administrative Crisis

Make sense of it
Recognize the crisis

Make a decision
Built in habits, reflexes

Make meaningful communication g

With your team and those who are affected

Make it stop p
Treat the cause

Make sure it does not happen again

Preparing for Administrative Crises

A widely publicized medical mistake A fi financial crisis th t deeply disrupts our budget i l i i that d l di t b d t

Clinical Crisis, Personnel Crisis, Financial Crisis, other

Make sense of it
Recognize the crisis

Make a decision
Built in habits, reflexes

Make meaningful communication g

With your team and those who are affected

Make it stop p
Treat the cause

Make sure it does not happen again

Every Human Activity Has Variability...

Lower L Specification Mean Upper U Specification

p(defect)

Target

Systematic Elimination of Unwanted Variability = Increased Probability of Quality