By Jong Eun Jung
The coronavirus pandemic has highlighted how the healthcare system and organizations across the nation work to respond to a crisis. Rangaraj Ramanujam, Professor of Management and Health Policy at Vanderbilt Business School, looks at America’s response to the pandemic from an operational and leadership theory standpoint. “(The pandemic) is going to require leaders and organizations to operate differently because (it differs from) what it takes to function when things seem relatively stable,” he explained. “In this new environment, you’re going to engage in a lot of sense-making, trying to understand where things are going. And that’s going to require a different kind of leadership. It’s going to require a different level of communication within organizations to be more honest.”
Ramanujam, whose research interests include the role of leadership, communication, and learning processes in enhancing the quality and safety of healthcare, shared four insights into the state of the healthcare system and organizations during the worldwide pandemic.
Reliability of the Healthcare System
During this crisis, people wonder about the reliability of the healthcare system. Ramanujam says that it’s hard to say because of the variation across hospitals. It’s not enough for each hospital to be individually reliable because the pandemic needs to be addressed at a systematic level. “I think (the healthcare system) is probably not anywhere as close to being as effective as we want it to be, simply because healthcare hasn’t operated as a system — it’s operated and continues to operate as a set of hospitals which have interdependencies with other hospitals,” he said. “So I think the challenge of reliability… is a challenge of managing hyper interdependence.”
Safety of Healthcare Workers and Patients
In the case of a pandemic, Ramanujam says that it is vital that hospital leaders view their employees’ physical and psychological safety as a priority. In addition, leadership has to communicate this message to healthcare workers so that the workers perceive the hospital climate to be safe. In turn, workers will respond to cases in the hospital more effectively and efficiently, which improves patient safety. “(When) people pay attention to safety procedures, compliance is much higher, and responding to errors and correcting errors (are) more likely to happen. And that, therefore, improves patient safety,” he said.
Ramanujam states that one salient operational failure during the pandemic is the lack of preparedness for a crisis. For example, the number of ventilators were supplied based on normal demand, and the suppliers did not expect a surge in demand. This led to a shortage of ventilators in hospitals. In addition, he says that the nation failed to distribute accurate and reliable test kits for the virus during the early stages of the pandemic. “We need to come up with testing kits, we (have) to pretest the kits and make sure they’re okay. And make sure that we have enough kits and send them out to people. That basic operational process failed in its entirety. And we’re still paying the cost,” he said.
According to Ramanujam, the United States needs to respond to the crisis in a more coordinated manner. He suggests that America needs to prepare better by performing a lot of training exercises that bring various organizations together to ensure that coordination happens faster. He cites an example from 15 years ago, when people from the federal and local governments teamed up to respond to a simulation of a potential pandemic. This training helped them learn to respond quickly to a challenging situation together. “The pandemic… requires coordinated response from multiple organizations at multiple levels — federal, state and local. The overall effectiveness of our response to COVID-19 hinges not on any one organization — it depends really on a system-level coordinated response across organizations,” Ramanujam said. “And so I think that’s going to be the challenge going forward.”