Healthcare Leadership in the COVID-19 Pandemic: From Innovative Preparation to Evolutionary Transformation

Abstract

Matthew A Crain,1 Amy L Bush,2 Heather Hayanga,3 Annelee Boyle,4 Merv Unger,3 Matthew Ellison,3 Pavithra Ellison3 1West Virginia University School of Medicine, Morgantown, WV, USA; 2West Virginia University Medicine Children’s Hospital, Morgantown, WV, USA; 3Department of Anesthesiology, West Virginia University Medicine, Morgantown, WV, USA; 4Department of Obstetrics & Gynecology, West Virginia University Medicine, Morgantown, WV, USACorrespondence: Pavithra EllisonDepartment of Anesthesiology, West Virginia University Medicine, 1 Medical Center Drive, Morgantown, WV, 26506, USATel [phone]Fax [phone]Email [email protected]: In pandemics, centralized healthcare leadership is a critical requirement. The objective of this study was to analyze the early development, operation, and effectiveness of a COVID-19 organizational leadership team and transformation of healthcare services at West Virginia University Hospitals and Health System (WVUHS). The analysis focused on how Kotter’s Leading Change eight-stage paradigm could contribute to an understanding of the determinants of successful organizational change in response to the COVID-19 pandemic.Methods: The fifteen core leaders of WVUHS COVID-19 strategic system were interviewed. A qualitative thematic analysis of the interviews was used to evaluate key aspects of leadership dynamics and system-wide changes in healthcare policies and protocols to contain the pandemic. Outcome measures included the degree to which WVUHS could handle and contain COVID-19 cases as well as COVID-19 death and vaccination rates in West Virginia compared with other states.Results: The leadership team radically and rapidly revamped nearly all healthcare policies, procedures, and protocols for WVUHS hospitals and clinics, and launched a Hospital Incident Command System. As a result of this effective leadership team and strategic plan, WVUHS surge capacity was adequate for COVID-19 cases. In addition, West Virginia was an early frontrunner in COVID-19 vaccination rates as well as lower death rates.Conclusion: WVUHS’s leadership response to the COVID-19 pandemic followed Kotter’s eight-stage paradigm for Leading Change in organizations, including the establishment of a sense of urgency, formation of a powerful guiding coalition, creation of a vision, communication of the vision, empowerment of others to act on the vision, plan for and creation of short-term wins, consolidation of improvements and production of more changes, and institutionalization of new approaches. This approach was effective in limiting the spread and impact of COVID-19 within the hospital network and across the state, with many lessons learned along the way.Keywords: hospital incident command system, organizational change, hospital management, leading change, COVID-19

Keywords

• hospital incident command system
• organizational change
• hospital management
• leading change
• covid-19