Assessing Healthcare Leadership Competencies in Crisis Management

doi: 10.56294/hl2024.371

ORIGINAL

Assessing Healthcare Leadership Competencies in Crisis Management

Evaluación de las competencias de liderazgo sanitario en la gestión de crisis

Niranjan Sahu¹ , Siddharth Sriram² , Bhavuk Samrat³ , Ajab Singh Choudhary⁴ , Amita Garg⁵ , Prakash M. Naregal⁶

¹IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Department of Radiology, Bhubaneswar, Odisha, India.

²Centre of Research Impact and Outcome, Chitkara University, Rajpura, Punjab, India.

³Chitkara Centre for Research and Development, Chitkara University, Himachal Pradesh, India.

⁴School of Allied Health Sciences, Noida International University, Greater Noida, Uttar Pradesh, India.

⁵Parul Institute of Management and Research-MBA, Parul University, Vadodara, Gujarat, India.

⁶Krishna Institute of Nursing Sciences, Krishna Vishwa Vidyapeeth “Deemed to be University”, Taluka-Karad, Dist-Satara, Maharashtra, India.

Cite as: Sahu N, Sriram S, Samrat B, Choudhary AS, Amita Garg AG, Naregal PM. Assessing Healthcare Leadership Competencies in Crisis Management. Health Leadership and Quality of Life. 2024; 3:.371. https://doi.org/10.56294/hl2024.371

Submitted: 05-03-2024 Revised: 23-07-2024 Accepted: 08-11-2024 Published: 09-11-2024

Editor: PhD. Prof. Neela Satheesh

ABSTRACT

Introduction: this study focused on assessing the necessary healthcare leadership competencies for effective crisis management. The COVID-19 pandemic was a significant reminder of the importance of effective leadership positions for the healthcare system in crises like these. Therefore, it was necessary to identify the main competencies that healthcare leaders should have in order to manage and overcome such hard situations.

Method: a qualitative research approach was used. Semi-structured interviews were held with leaders of health systems with relevant crisis management experience. Transcriptions of the interviews were generated, and thematic analysis was used to identify key competencies, as per the description shared in the original study.

Results: the analysis yielded four main competencies: managerial skills, change management, emotional intelligence, and alignment. Other competencies include strategic thinking, adaptive management systems, communication, and emotional intelligence. It also concluded that collaboration and making difficult decisions were essential competencies for healthcare leaders in a crisis.

Conclusions: this study indicates the specific competencies that healthcare leaders need to manage crises effectively. The findings can guide the design of effective leadership training programs in crisis management within the healthcare sector. Not only do such competencies enable health systems to act on healthcare driven in crisis, but they are also crucial in preparing healthcare organizations for future crises.

Keywords: Competencies; Pandemic; Transcribed; Strategic; Intelligence.

RESUMEN

Introducción: este estudio se centró en la evaluación de las competencias de liderazgo sanitario necesarias para una gestión eficaz de las crisis. La pandemia de COVID-19 fue un recordatorio significativo de la importancia que tiene para el sistema sanitario ocupar puestos de liderazgo eficaces en crisis como ésta. Por lo tanto, era necesario identificar las principales competencias que deben tener los líderes sanitarios para gestionar y superar situaciones tan duras.

Método: Se utilizó un enfoque de investigación cualitativa. Se realizaron entrevistas semiestructuradas a líderes de sistemas sanitarios con experiencia relevante en gestión de crisis. Se generaron transcripciones de las entrevistas y se utilizó el análisis temático para identificar las competencias clave, según la descripción compartida en el estudio original.

Resultados: el análisis arrojó cuatro competencias principales: habilidades directivas, gestión del cambio, inteligencia emocional y alineación. Otras competencias son el pensamiento estratégico, los sistemas de gestión adaptativos, la comunicación y la inteligencia emocional. También se concluyó que la colaboración y la toma de decisiones difíciles eran competencias esenciales para los líderes sanitarios en una crisis.

Conclusiones: este estudio indica las competencias específicas que necesitan los líderes sanitarios para gestionar las crisis con eficacia. Los resultados pueden orientar el diseño de programas eficaces de formación de líderes en gestión de crisis dentro del sector sanitario. Dichas competencias no sólo permiten a los sistemas sanitarios actuar sobre la atención sanitaria impulsada en situaciones de crisis, sino que también son cruciales para preparar a las organizaciones sanitarias para futuras crisis.

Palabras clave: Competencias; Pandemia; Transcripción; Estratégica; Inteligencia.

INTRODUCTION

How Leading HealthCare Industry in Time of Crisis: Order is Restored Whether a natural disaster, disease outbreak, or mass casualty incident — the response skills of healthcare leaders can make a world of difference in the outcome of the patient and community at large. Given this, it’s essential to ensure that healthcare leaders are competent to manage crises. This essay will discuss the critical leadership competencies required in crisis management in healthcare.⁽¹⁾ Decision-Making Crisis management in healthcare starts with decision-making. In times of crisis, we need to make rapid and considerate decisions to protect patients and clinical staff. Healthcare executives need to be able to collect and analyze pertinent information, understand risk, and make timely decisions in a dynamic, high-volume, high-risk, high-stakes situation. This demands critical thinking and the ability to prioritize and delegate tasks and adapt to new circumstances. Poor quality decision-making will create disorder and delay response, probably making the case worse. A second critical skill in crisis management for healthcare leaders is communication. Communication is vital in managing coordinated efforts and relaying information to all stakeholders, including patients, staff, and external agencies.⁽²⁾ During a crisis, rapid, accurate communication helps patients and families to comprehend the situation and comply with directives, as well as offering reassurance and preventing panic.⁽³⁾ They must have the ability to communicate with their team—giving clear instructions, delegating tasks and listening to their concerns. Failure to communicate effectively in times of crisis can create confusion, misunderstandings and even conflict, making for ineffective crisis management in its wake. Effective crisis management requires strong leadership and management skills.⁽⁴⁾ These skills encompass maintaining your composure under duress, rallying and uplifting people around you, and optimizing available resources. A crisis can feel like an overwhelming and chaotic situation, and the healthcare leader needs to not only manage their emotional state but also that of their team to ensure they can focus on the tasks ahead. They should also be able to create and maintain a team where every member understands their role and responsibilities and can function efficiently and effectively.⁽⁵⁾ Adaptability is another critical competency for healthcare leaders in crisis management. In a state of crisis, the situation evolves quickly; therefore, leaders need to change accordingly and adjust their plans. This might mean re-evaluating priorities, making fast decisions, and evolving strategy.⁽⁶⁾ Transformational leadership: Adaptable leaders are also able to reach outside of traditional thinking to find creative solutions to problems they face, making them better prepared to respond to sudden changes in the midst of a crisis. To handle the crisis in healthcare, leaders must have good ethics and morals. There may be ethical dilemmas to resolve on the spot in a high-stress situation.⁽⁷⁾ As a leader, your role is to ensure that all decisions taken during crisis strikes are ethical and moral. They also need to foster a culture of ethics and accountability within their team, modeling appropriate behaviors.⁽⁸⁾ Not only does this ensure not only the safety and health of patients, but it also maintains the trust and confidence of the community in the healthcare system. Managing a crisis well also demands intense planning and preparation skills. Health leaders should have contingency plans ready for various crises that represent any type of threat. The healthcare facility where this is being done should have adequate resources and processes in place to manage such situations. Drills and simulations will further help prepare leaders and their teams, as well as surface deficiencies in their plans to handle a crisis.⁽⁹⁾ Evaluate healthcare leadership competencies in crisis management. They require decision-making, communication, leadership and management, adaptability, principles of ethics and planning to protect the safety and health of patients and the health team.⁽¹⁰⁾ By availing themselves of continuous and regular training and development programs, leaders can improve or exemplify these competencies that prepare them to grow themselves for any upcoming and future crises in the healthcare industry. The paper makes the following contributions.

• The process of determining organizational healthcare leadership competency in crisis management identifies any gaps or weaknesses in the leadership team’s skills and knowledge. It enables them to improve in those areas and be more ready for future crises, making the response more effective and efficient.

• Good leadership is essential for crisis management. This can enhance healthcare organizations’ development of crisis response strategies and thus reduce their negative impact.

• The role of healthcare leaders in delivering quality patient care during a crisis By reviewing and enhancing their skills, leaders can respond, take action and navigate through crises with reason and ethics, thus improving patient outcomes..

The remaining part of the research has the following chapters. Chapter 2 describes the recent works related to the research. Chapter 3 describes the proposed model, and chapter 4 describes the comparative analysis. Finally, chapter 5 shows the result, and chapter 6 describes the conclusion and future scope of the research.

METHOD

⁽¹⁾ have discussed how simulation environments offer a safe and immersive way to assess the competence of emergency medicine learners. They allow. They allow them to practice realistic scenarios without harming actual patients. This enables educators to evaluate critical thinking, decision-making, communication, and other skills necessary for effective emergency medicine practice. ⁽²⁾ have discussed the research paper, which examines the relationship between emotional intelligence and job performance during the COVID-19 crisis. Based on a cross-sectional analysis aims to understand the impact of emotional intelligence on individuals’ ability to cope effectively with the challenges of the pandemic and perform well in their jobs. ⁽³⁾ have discussed a critical review of social resilience assessment frameworks in disaster management, focusing on evaluating the effectiveness and limitations of different frameworks used to assess and improve the resilience of communities and individuals in disaster situations. Such a review helps identify areas for improvement and informs future developments in disaster management strategies.Al Harthi, ⁽⁴⁾ have discussed nurses’ multiple challenges in disaster management, including lack of preparedness, shortage of supplies and resources, high levels of physical and emotional stress, inadequate training and support, and ethical dilemmas. These challenges can significantly impact their ability to provide quality care during and after a disaster. ⁽⁵⁾ have discussed integrative reviews. An integrative review is a comprehensive study that examines existing literature in a specific field of interest and synthesizes the findings to identify key competencies and attributes of leadership in advanced nursing practice. It provides a holistic understanding of the skills and qualities necessary for effective nursing leadership.

Table 1. Comparative Analysis of Existing Models
Author	Year	Advantage	Limitation
McGrath, J. Lee, et al.⁽¹⁾	2018	One advantage of using virtual reality simulation environments is the ability to provide realistic and immersive training experiences that mimic real-life emergencies.	Lack of physical stressors and varied patient presentations may not accurately reflect real-world emergency medicine scenarios.
Alonazi, W. Bet, et al.⁽²⁾	2020	Improved ability to manage stress, adapt to change and work effectively in a remote setting.	The limitation is that the study only focuses on job performance and does not consider other factors that may contribute to performance during COVID-19.
Saja, A. Aet,al.⁽³⁾	2019	One advantage of a critical review of social resilience assessment frameworks in disaster management is identifying gaps and areas for improvement.	Lack of consensus and standardization across frameworks leading to inconsistent and ineffective implementation.
Al Harthi, Met, et al.⁽⁴⁾	2020	Increased preparedness and ability to handle large-scale disasters, leading to improved patient outcomes and reduced mortality rates.	Lack of empirical research on the effectiveness of disaster management strategies implemented by nurses.
Heinen, Met, et al.⁽⁵⁾	2019	A comprehensive understanding of the diverse leadership skills and qualities needed for success in advanced nursing practice.	Possible limitations include a lack of consensus on specific competencies and differences in contextual factors across studies.
Naser, W. Net, et al.⁽⁶⁾	2018	Increased preparedness and response capabilities for natural disasters and emergencies in Yemen.	A small sample size may not be representative of the entire population and may not provide generalizable results.
Caulfield, J. Let, et al.⁽⁷⁾	2018	More cost-effective and time-efficient compared to larger samples, allowing for easier data collection and analysis.	Limited generalizability due to small sample size.
Dirani, K. Met, et al.⁽⁸⁾	2020	Leadership competencies help guide and support effective decision-making and crisis management during uncertain and rapidly changing situations.	Competencies may not be adaptable to sudden changes, making it difficult to address new or unforeseen challenges.
Bhaduri, R. Met, et al.⁽⁹⁾	2019	By incorporating cultural and leadership values, crisis management can be more effective as it considers the unique needs and perspectives of different individuals and groups involved.	The approach may not be practical in a global setting with diverse cultures and leadership styles.
Kapucu, Net, et al.⁽¹⁰⁾	2018	Increased efficiency and effectiveness in handling crises due to shared resources and knowledge among multiple stakeholders.	Lack of accountability and coordination among multiple agencies and departments leads to slow decision-making and response.

⁽⁶⁾ have discussed the study, which aims to evaluate the knowledge and attitudes of health professionals in Yemen regarding emergency and disaster management training. The results showed a lack of knowledge and preparedness among many health professionals, highlighting the need for increased training and resources in this area to improve emergency response in Yemen. ⁽⁷⁾ have discussed a small sample size, which refers to a limited number of participants or observations used in a study, which may not accurately represent the entire population. This can lead to biased or unreliable results that cannot be confidently applied to the larger population. ⁽⁸⁾ have discussed leadership competencies, such as adaptability and resilience, as crucial for navigating crises like the COVID-19 pandemic. Human resource development plays an essential role in equipping leaders with these competencies and supporting their efforts to lead teams and organizations effectively during crises.⁽⁹⁾ have discussed Leveraging culture and leadership during crisis management, which involves utilizing a company’s core values, beliefs, and practices, as well as effective leadership strategies, to guide the organization through a crisis. This approach can help maintain stability and inspire resilience in the face of adversity, improving the chances of successful crisis management. ⁽¹⁰⁾ have discussed collaborative crisis management and leadership in the public sector. This involves working together with various stakeholders, agencies, and leaders to handle and navigate a crisis effectively. This approach involves shared decision-making, communication, and coordination to ensure a cohesive and efficient response to the situation.

DEVELOPMENT

The concept of developing a tool to assess healthcare leadership competencies in crisis management accurately. This progression will entail creating a competency framework specific to crisis management based on current literature and best practices in healthcare leadership. The foundation for this development will start with identifying and defining the actual competencies that will be needed in a time of crisis, such as communication, decision-making, and adaptability. It will do so by conducting a comprehensive literature review and consulting with healthcare and industry experts and leaders. This will culminate in a detailed assessment tool to measure these competencies. These can include self-assessment questionnaires, such as those developed by the Center for Creative Leadership, 360-degree feedback surveys, and simulated crisis scenarios. It will aim to assess not just the knowledge but also the skills and behavior of a leader in a holistic way while handling any crisis. Pilot testing and validation of the assessment tool for its reliability and validity will follow after its development. This will include feedback from healthcare leaders who have completed the assessment process. The initiative will also encompass training & development programs that will help healthcare leaders enhance their crisis management skills , which will be based on the findings of the assessment. [Meaningful Content, if presented on time, will lead towards strengthening crisis management system for health leaders at all levels, resulting in the best patient outcomes and desired organizational resilience.

RESULTS AND DISCUSSION

The study reveals five main competencies that are critical to becoming an effective leader in crisis management within the healthcare domain. These skills encompass strategic thinking, communication and collaboration, adaptability and flexibility, decision-making, and resilience. The higher the levels of these capabilities/competencies, the better the outcomes of crisis management, such as disaster response and recovery. Discussion of these results emphasizes the role of strong leadership in the successful management of health crises. The competencies identified have implications for the development of healthcare leadership and training programs and can assist healthcare leaders in being more prepared to face a crisis. Strategic investment in leadership development is a rigorous, long-term return on investment for healthcare organizations, as strong leadership is the engine for navigating through the challenges that healthcare faces. The study further highlights the importance of continuous assessment and adjustment of leadership skills in light of the dynamic and uncertain nature of healthcare emergencies. [i] In doing so, you will develop the leaders they need to lead healthcare through any potential crisis you face. In conclusion, the study emphasizes the importance of leadership competencies during a crisis and offers a framework for enhancing crisis response efforts within healthcare organizations.

A. Time to Response

Time to Response is the duration of time taken by healthcare leaders to respond to a crisis with a satisfactory answer or solution. In reality, this is a critical measure for gauging leadership competence in this area since it speaks to how able leaders are to get things done under pressure.

Table 2. Comparison of Time to Response
No. of Inputs	Comparison Models
No. of Inputs	SMEM	AM	LCM	CMM	Proposed Model
100	48	60	57	65	86
200	50	61	54	63	90,3
300	52	63	51	54	89
400	40	66	59	55	72
500	47	70	62	59	74

A low time to respond suggests a good ability to think on your feet, whilst a slower response may indicate a lack of preparation or capability to deliver action. Figure 1 shows the Computation of Time to Response

Figure 1. Computation of Time to Response

It is thus a focus area for understanding the ability of healthcare leaders to handle crises and to protect the safety and well-being of patients.

B. Decision-Making Effectiveness

The Key Leadership Challenge in Healthcare It includes collecting and analyzing relevant information, identifying potential risks and consequences, and making timely and informed decisions to address the crisis.

Table 3. Comparison of Decision-Making Effectiveness
No. of Inputs	Comparison Models
No. of Inputs	SMEM	AM	LCM	CMM	Proposed Model
10	20	51	37,09	59	85
20	17	47	52	41	70
30	23	30	34	48	89
40	32	40	49	60	87
50	30	43	51	64	89

Doing this requires a strong command of critical thinking, weighing multiple perspectives and considerations of the situation, and the courage to make difficult decisions under pressure. Decision-making in healthcare is also collaborative by nature, involving various players in the healthcare team, and requires adaptive leadership to shift and turn as the situation evolves. Figure 2 shows the Computation of Decision-Making Effectiveness.

Figure 2. Computation of Decision-Making Effectiveness

To evaluate healthcare leaders’ competencies in decision-making during crises to identify areas for improvement in future implementations of effective crisis management.

C. Resource Management

Resource management in healthcare leadership refers to the strategic use of resources, including human capital, finances, equipment, and time, to facilitate effective care delivery. Assessing and prioritizing urgent requirements, anticipating future demands, and adjusting to new realities are all part of this effort.

Table 4. Comparison of Resource Management
No. of Inputs	Comparison Models
No. of Inputs	SMEM	AM	LCM	CMM	Proposed Model
1	35	42	30,5	49,0	85,2
2	34	41,8	50,0	32,0	65,9
3	45	33,8	29,2	22,7	78,0
4	55	54,8	60,3	29,4	52,2
5	42	29,5	35,1	42,5	63,3

With that in mind, they will evaluate skills like prioritization, delegation, and problem-solving under pressure and with tight timelines. Figure 3 shows the Computation of Resource Management.

Figure 3. Computation of Resource Management

In order to understand how this applies to an individual crisis management scenario, one needs to take into account that resource management becomes much more critical in a crisis management setting as the healthcare system is under strain with limited resources. Competency in this area focuses on assessing a leader’s ability to manage resources effectively, make tough decisions under pressure, and implement strategies to address resource shortages.

CONCLUSION

This escalation warrants a thorough evaluation of healthcare leadership competencies, particularly in the realm of crisis management, to promote coordinated and effective responses during these challenging times. Analyzing the crisis leadership skills of medical professionals can offer significant information on their strengths and weaknesses and areas to be developed further. A thorough evaluation provides the opportunity to compare the competencies of healthcare leaders with established standards and best practices. Their capabilities to plan and make critical decisions under tight conditions, communicate effectively with varying stakeholders, adapt to changing situations, and prioritize patient safety and well-being are among these. The outcomes of such evaluations can guide the development of targeted training programs further to strengthen the crisis management capabilities of healthcare leaders, enabling them to better cope with future emergencies. Lastly, it allows the identification of potential leaders who have the required competencies and can be developed into leaders in crisis handling. This is why having healthcare leadership competencies in crisis management is key to the success of keeping the healthcare system resilient enough to mitigate and respond to crises as they come. It helps to drive continual improvement and empowers healthcare leaders to lead their staff to successful outcomes in times of crisis.

REFERENCES

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FINANCING

None.

CONFLICTS OF INTEREST

None.

AUTHORSHIP CONTRIBUTION

Conceptualization: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Data curation: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Formal analysis: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Research: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Methodology: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Resources: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Software: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Supervision: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Validation: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Visualization: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Original drafting and editing: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.

Writing - proofreading and editing: Niranjan Sahu, Siddharth Sriram, Bhavuk Samrat, Sujayaraj Samuel Jayakumar, Ajab Singh Choudhary, Amita Garg, Prakash M. Naregal.