Leadership in Medical Disaster Management
Leadership in Medical Disaster Management
Leadership, especially medical leadership, is a very crucial task with the incomparable potential to influence every aspect of a person’s professional career regarding the challenges that are evident during a medical emergency. During this era of emergency medicine, how one is prepared to respond to critical medical disaster emergencies could be the enormous difference needed in revolutionizing the nursing and medical faculty (WHO, 2021). In recent history, medical leadership has received lots of attention, especially concerning the actions and responses one takes in times of stress and emergency (Hershkovich et al., 2016). Being at the center of service delivery in the medical sphere, physicians are the ideal people to take up leadership responsibilities today. However, these physicians are often only trained on the diagnosis, administration, and therapeutic aspects of healthcare, ignoring both the practical and theoretical aspects of leadership, especially during disaster emergencies.
Leadership Skills of an Emergency Specialist
An excellent medical emergency leader should possess unique skills essential to the task at hand. They include,
Aligning Operations with Organizational Values While Maintaining a Clear Vision
The primary focus of all physicians has always been pivoted on their professionalism and practice; however, during emergency leadership, physicians need to modify this mindset and adjust their approach to other aligned viewpoints and visions. For instance, leaders must offer more strategic thinking, set new short-term goals and objectives, align these new goals with organizational practices and attain them (Hershkovich et al., 2016). The importance of this skill comes in handy, especially in terms of stress and emergency when leaders are required to make almost instantaneous and automatic responses while still keeping in mind the organization’s vision, mission, and values. During life-threatening situations, this skill helps physicians to act appropriately, sometimes against instincts, such as during earthquakes.
Unfortunately almost all of the young physicians who come out of medical schools are structured to operate as excellent individuals with a focus mainly on their daily one-on-one interactions with the patients disregarding the ability to implement strategic planning and implementing (Gamble et al., 2009). During emergency medical disasters, implementing strategic planning is crucial to the survival of many victims and patients. Especially in the early response phase, medical emergencies are often characterized by many constraints that require effectively limited resource allocation, which requires severe strategic planning (Hershkovich et al., 2016). A good leader in times of an emergency disaster should be able to create and implement short-term objectives adaptable and flexible in planning, such as role rotation among staff, flexibility in team structure, and resource allocation.
Communication, Collaboration, and Negotiation Skills
Leading is not all about the leader themselves; it also encompasses how the leader relates with their team members in communicating roles, collaborating with them, and negotiating to work effectively. Leaders are often the negotiators between their teams and the organizational management to maximize the level of understanding and agreement between the two factions and minimize instances of communication that could have adverse effects (Gamble et al., 2009). Even though these skills are often acquired and developed slowly over time, their use comes in handy in handling emergencies, especially when dealing with conflict resolution, team building, and building group resilience, especially in a heterogeneous team of group members. Collaboration is inevitable in an emergency disaster situation, and working alone is not an option for any leader. As a result, a good leader should know which tasks require a one-person performance while which ones require collaboration, and how many people depend on the job’s complexity. Furthermore, the leader should be responsible for coordinating cooperation between the different infrastructures put in places such as the receiving hospital, the neighboring assisting hospital, ambulance, police, and other rescue service providers, to ensure efficient and effective coordination of activities to save lives.
The Ability to Analyze and Process a Complex Environment with Order
During medical emergencies, the ability of a leader to process and analyze a complex scenario in an orderly manner is an element of efficient leadership. The disaster environment is often influenced by lots of uncertainties, limited decision-making time frames, limited resources, and safety considerations. However, the leader is still required to analyze and process incoming information in a clearly defined manner to weigh the available alternatives of action and choose the most suitable and effective option in the limited period (Hershkovich et al., 2016). Furthermore, emergency disasters may be influenced by a wide range of non-medical parameters which the leader needs to acknowledge by being trained to widen their perspective in handling such situations (Uhr, 2017). These non-medical parameters include legal. Social, cultural, and political considerations. Research shows that the ability to give simpler meaning to complex situations is a critical aspect of leadership every crisis leader requires.
The Ability to Make Quick Decisions Based on Knowledge, Experience, and Situational Analysis
The last important skill a medical emergency response leader requires is the ability to come up with informed decisions on short notice based on situational analysis as well as experience and knowledge. Study shows that a medical leader who is not well educated and with the least experience will most likely end up making lots of errors in their decisions as compared to their well-learned and experienced counterparts. Emergency disasters often tend to put one against the lines of public interest, personal beliefs, organizational values, and practices and hence end up creating complex ethical dilemmas which often require experience or high situational analysis to make informed decisions (Uhr, 2017). Medical leaders should be prepared to confront these ethical dilemmas to take relevant action.
Communication Skills and Team Dynamics in Disaster Management
One of the major roles of a disaster management leader is to continuously strengthen the endurance of the team before the mission, during, and after the mission through proper communication and management of the team. A good leader should be able to communicate the visions and missions of the organization to the team members (Johansson & Back, 2017). Furthermore, the leader needs to ensure the roles of each member are well articulated to them to minimize instances of confusion and errors. A leader should possess communication skills such as listening, use of gestures, facial expressions, and body movement to ensure efficient communication both to their team members, the victims, and the organization’s management. Team members must communicate with each other to promote bonding and the ability to understand each other. Also, when a leader is using their communication skills to contribute to the conversation, they not only efficiently receive their team’s deliverables but also help the team to learn how to get closer to the management.
Effective teamwork requires that team members communicate in ways that promote cohesion within the members. As a result, effective medical disaster management leaders must take steps to ensure that all team members develop these effective communication skills (Hershkovich et al., 2016). Effective communication builds trust amongst the medical team members, loyalty, and message clarity between the different levels of the response team. Ambiguous and poorly structured communication in the emergency disaster response operation may lead to preventable fatalities, eroding motivation and trust among members. A cohesive team that communicates well among itself creates an environment where members feel free to express new ideas and also present creative solutions which may end up saving the day. Furthermore, reflective listening develops the feeling of empathy within leaders, a critical aspect of leadership. Empathy plays a crucial role in leadership when a leader has the emotional capability to put themselves in the shoes of both the victims and those of the other team members (Paige, 2022). Empathy is the cornerstone for building healthy team relationships and communication.
Different individuals see the same thing from different perspectives. A leader should acknowledge the fact that a team member may respond to a certain situation differently from how they would respond. Leaders should also learn to motivate their members in terms of distress. When motivated, members feel appreciated to handle the disaster in a more orderly and clear manner. The leader should as well be ready to congratulate and show appreciation to his team during and after the disaster. Another important aspect of team dynamics is trust. Team members are expected to trust their leader and the organizational management regularly (Paige, 2022). For instance, when members disagree, they should still have a sense of trust that they are still safe in their disagreeing viewpoints. The leader should exercise trust leaning, a process where one person stands in the middle of the trust circle and leans towards the direction of different members ensuring all participants experience the trust lean from both perspectives.
A good leader should have the problem-solving ability to resolve disagreements amongst the members of their team. As a problem solver, the leader should be able to listen to both sides of the conflict and come up with a workable solution without any party feeling like they have been sidelined or discriminated against (Paige, 2022). A win-win situation is always the best way to solve a conflict where each party in the conflict has to give up something to gain something. The rest and debriefing effect also works to create good team dynamics when the leader sees that their team members are working tirelessly around the clock without rest which may affect their mental health. In such a scenario, the leader should work to reduce this tendency and direct their members to take rest and recharge (Gamble et al., 2009). Instances of mental debriefing help minimize the likelihood of stress and mental disorders ensuring the team carries out the mission as required hence increasing chances of success.
Communication Technology as a Leader During Disaster
According to Peter F Drucker, management is doing things right, however, leadership is doing the right things (Patel, 2022). Leadership entails doing the right things to ensure a common goal is achieved among the team members. That makes communication a very crucial aspect of leadership and the different technologies used in leadership are an important consideration (Johansson & Back, 2017). The constantly evolving technology is impacting all angles of life and the medical disaster management sphere has not been left behind. Technology has not only facilitated the freedom of team members to work from afar, but it has also equipped the leaders with the ability to lead from a distance. Leaders in disaster management can use technologies such as smartphones to view and assess the tasks carried out by other team members in real-time using platforms such as WhatsApp and Facebook. Such fast apps have helped leaders to make any necessary changes in the tasks and functions of team members.
Leaders are using emerging digital trends in the technological sector to thrive both personally and professionally. Platforms such as WhatsApp have made it easy for leaders to communicate and share information with their members through the WhatsApp groups formed and moderated by the leaders. That has helped the easy delivery of information sometimes in real time due to the video conferencing abilities such as Zoom and Google Meet. Managing in real time helps steer one’s leadership in the right direction (Patel, 2022). Holding meetings through various platforms such as Skype and Hangouts means one’s team doesn’t have to wait for their physical approval to carry out their roles in times of distress and when fast decision-making is required hence saving time and lives.
Communication technology has also been seen as a new way to circumnavigate the language barrier in disaster management. As various teams may be present during the disaster management practice, a leader may find themselves having to deal with the issue of the language barrier in having to communicate effectively. As a result, through technology, translation apps and software have come in handy to offset this problem (Patel, 2022). Today through advancements in technology in communication, an English-speaking leader can efficiently relay information to a Spanish-speaking subordinate and elicit quick reactions in emergency medical disasters such as accidents, earthquakes, and tsunamis.
The Disaster Management Process
A leader should be able to effectively handle a disaster, especially a medical disaster before, during, and after the crisis. Being a leader in a medical disaster management situation means being in a crisis is the norm, however, things may escalate to undesirable levels within a short period (Colvell, 2022). If disaster management was to be broken down, one would come up with five distinct steps of the disaster management process. These five steps include prevention, mitigation, preparedness, response, and recovery.
Step 1: Prevention
This is the initial step of managing a disaster and is a precautionary measure where actions are taken to avoid an incident from occurring and potentially turning out to be a disaster. That is achieved through deterrence practices and surveillance.
Step 2: Mitigation
Mitigation includes those efforts directed at reducing the probability of an emergency occurring and reducing the damages that are caused by unavoidable emergencies in disasters (Jones, 2022). These mitigating practices include building construction barriers such as levees and gabions to shield against damages of flooding and tsunamis.
Step 3: Preparedness
These activities are aimed at increasing the community’s potential to respond when medical disasters strike. Preparedness measures typically include developing mutual agreements and memos of understanding between various response teams at the community level and national level to come in handy and assist in managing a disaster if and when it occurs (Jones, 2022). Training both the response personnel and the citizens on how to handle emergencies is also a great way to ensure community preparedness (WHO, 2019).
Step 4: Response
The response includes the actions carried out immediately before, during, and after the medical emergency. Response actions are aimed at saving lives, reducing the physical destruction impact of disasters, alleviating suffering, and reducing economic costs (Jones, 2022). Actions relating to responding include making contacts with the emergency operations center, calling the police, ambulances, and rescue service providers, evacuating threatened civilians, offering medical care, and first aid, and carrying out search and rescue operations.
Step 5: Recovery
Recovery measures include actions taken to return the affected community to normal or at least almost-normal conditions. The restoration of basic operations, financial assistance, reconstruction of broken infrastructure, cleaning of debris, and repair of social and mental damages include aspects of recovery (Jones, 2022).
Effective Approach During Emergency Phases
Disasters consist of four major phases which include the signal detection phase, acute phase, chronic phase, and the learning phase. Different approaches are required depending on the phase of the disaster (Colvell, 2022). Measures which are effective in the acute phase may not necessarily be effective in the chronic phase.
Effective Approach During Signal Detection Phase
The signal detection stage is regarded as the pre-disaster phase and the main objective of this phase is to avert the disaster by acknowledging the signs and getting a head start. At this phase, a good leader should focus on minimizing the probability of a disaster happening. As a result, leaders should focus on coming up with a disaster management plan at this stage. It is crucial to remember that flexibility in the emergency plan is key. Not all factors can be considered while preparing this plan and hence it should provide room for any contingencies and flexibilities which may occur later (King et al., 2016). It is also important to note that not all disasters have warning signs, but most of them do, as such, a leader can get a great head start and be ahead of the problem by acknowledging that something is indeed wrong and needs attention.
Effective Approach During Acute Phase
At this phase, the disaster is in full swing and is the most demanding phase of the disaster. At this phase, depending on the type of personnel at hand, they may respond thoughtfully or frantically. At this stage, if some signs were spotted earlier, the leader shall have the required time to minimize the full-swing impact of the disaster (Caro, 2016). The leader is tasked with stabilizing the disaster. The aim is to clear the health catastrophe at hand. this is the time of change and making impromptu decisions, and it is important the leader is fluid and avoids carrying out ill-fated procedures that may worsen the situation (King et al., 2016). In this stage, great medical emergency leaders should over time develop long-term fixes while looking into the future. Though it might be hard, a good leader should embrace and re-evaluate the situation to gain momentum for policy changes in the acute phase.
Effective Approach During Chronic Phase
At this phase, the disaster is still active, however, various procedures have already been put in place to minimize the effects of the disaster. At this stage, the causes of the disaster have already been determined, and it’s up to the leader to determine whether their actions will be preventive of future occurrences or will be to embrace the current situation and learn how to thrive under the new circumstances (Colvell, 2022). At this phase, the leader should put focus and time into the development of good disaster communication channels to ensure information is well communicated among all related stakeholders. Because of the unorganized nature of disasters and crises, how information is communicated and propagated differs from one point and disseminator to the other. The leader should strive to manage the different perceptions that people, especially the public and the media have of the crisis.
Effective Approach During Learning Phase
At this phase, the organization needs to ask itself some questions such as how and what have they learned from the catastrophe they have just been through. The main objective of this phase is to ensure that future instances of such a disaster are minimized or completely removed (Caro, 2016). During this phase, the leader should critically look at the procedures which worked and work on making them better. For instance, practices such as timely responses to emergency calls can be lauded and included in future disaster management plans (Colvell, 2022). Also, the practices which did not work should be re-evaluated for replacement and changed into more applicable and acceptable practices and procedures. Through learning for and from the crisis, a leader can determine why a disaster occurred and prevent its reoccurrence in the future.
Leading during a disaster is a fundamental aspect of leadership that not every leader is capable of carrying out. Especially when it comes to medical emergency disasters, poor leadership could result in devastating effects on the lives and populations of citizens. Physicians should not only concentrate on the diagnostic and therapeutic aspects of nursing and caregiving and ignore the crucial practical and theoretical aspects of leadership, especially in disasters. Through good communication and practices, disasters can be easily avoided and managed through good leadership.
Caro, D. H. (2016). Towards transformational leadership: The nexus of emergency management systems in Canada.
Colvell, K. (2022). Leading During a Crisis. Ohiostate.pressbooks.pub. Retrieved 26 July 2022, from https://ohiostate.pressbooks.pub/pubhhmp6615/chapter/leading-during-a-crisis/.
Gamble, M., Hanners, R., Lackey, C., & Beaudin, C. (2009). Leadership and Hospital Preparedness: Disaster Management and Emergency Services in Pediatrics. Journal Of Trauma: Injury, Infection &Amp; Critical Care, 67(2), S79-S83. https://doi.org/10.1097/ta.0b013e3181af069f
Hershkovich, O., Gilad, D., Zimlichman, E., & Kreiss, Y. (2016). Effective medical leadership in times of emergency: a perspective. Disaster And Military Medicine, 2(1). https://doi.org/10.1186/s40696-016-0013-8
Johansson, C., & Bäck, E. (2017). Strategic leadership communication for crisis network coordination. International Journal of Strategic Communication, 11(4), 324-343.
Jones, M. (2022). Steps of Emergency Management. stlouis-mo.gov. Retrieved 26 July 2022, from https://www.stlouis-mo.gov/government/departments/public-safety/emergency-management/about/Steps-of-Emergency-Management.cfm.
King, R. V., Larkin, G. L., Fowler, R. L., Downs, D. L., & North, C. S. (2016). Characteristics of effective disaster responders and leaders: a survey of disaster medical practitioners. Disaster medicine and public health preparedness, 10(5), 720-723.
Paige, A. (2022). Team-Building Empathy Exercises. Small Business – Chron.com. Retrieved 26 July 2022, from https://smallbusiness.chron.com/teambuilding-empathy-exercises-22622.html.
Patel, A. (2022). How Technology Can Be Used to Empower Leadership. About Leaders. Retrieved 26 July 2022, from https://aboutleaders.com/technology-empower-leadership/.
Uhr, C. (2017). Leadership ideals as barriers for efficient collaboration during emergencies and disasters. Journal of Contingencies and Crisis Management, 25(4), 301-312.
WHO. (2019). Strengthening Leadership for Health Emergency Response. ReliefWeb. Retrieved 26 July 2022, from https://reliefweb.int/report/world/strengthening-leadership-health-emergency-response.
WHO. (2021). Leadership in Emergencies: Building competencies for effective leadership in all-hazards emergency response. World Health Organization.int. Retrieved 26 July 2022, from https://www.who.int/news/item/16-11-2021-leadership-in-emergencies-building-competencies-for-effective-leadership-in-all-hazards-emergency-response.