Posted: 16 Oct. 2020 05 min. read

Reimagining Healthcare Models of the Future

Leading in times of change

This blog explores a conversation about leadership in the crisis with Deloitte’s Global Healthcare Leader, Dr Stephanie Allen (SA) joined by special guests Lt Gen David Morrison AO (DM) Former Chief of Army, Dr Jillann Farmer (JF) Deputy Director-General of Clinical Excellence at QLD Health and Dr Bruce Green (BG) Chief Medical Officer and Managing Director, Deloitte US to talk through the aspects of leadership and decision making in times of extreme uncertainty, ambiguity, and pressure.

Stephanie Allen (SA)
: The COVID-19 pandemic has been an epic test of character for millions of people around the world, especially front-line workers. Our leaders have had to adopt a dual ambition to develop coherent, long term strategies while acting immediately in the short term. Yet, for all their expertise, they understandably don’t have all the answers. David let’s start with you, how have you experienced this feeling as a leader?

David Morrison (DM)
: Like everybody, I’ve watched healthcare workers with deep admiration through the pandemic as they struggle with the unknown. They are dealing with enormous ambiguity and trying to find the right path for everyone. When I’ve made leadership decisions in tough situations, I’ve always come back to a framework that helped me to determine the best course of action – it’s called the OODA loop (Observe, Orient, Decide, Act). Using this gave me confidence in my choices, even when I didn’t have all the answers, and it made me realise that leaders are the custodians of culture – not it’s captive. 

I agree, one of the most important things I’ve learned is that leaders must be inclusive in order to enable action. How do you feel about this Jilliann?

Jillann Farmer (JF):
One of the things I miss most about my experience at the United Nations is having diversity at my fingertips. When you’re in an environment that doesn’t have this built in, you have to seek it out and create it for yourself. That time was so formative, as I had to become comfortable with not having all of the information.  What I learned though, is that when you’re making such rapid decisions, you can’t afford the paralysis of seeking certainty.

We’re living in a time where some of the biggest leadership challenges we will ever face need to be managed at speed. Bruce – do you think your experience in the military has positioned you well for an environment like this?

Bruce Green (BG):
Thirty-four years as the Surgeon General, you’d think so! I was in charge of air evacuation after 9/11 and at the same time, preparing to go to war with Afghanistan, so I had to rapidly consider my actions. The OODA loop helped me to develop effective solutions. During that time, we made a lot of choices about care delivery and how we could place the patient at the centre. From there, we integrated the virtual tools needed to help one another in a changing environment. 

It’s fantastic to hear how virtual care delivery can be adopted both in and out of crisis, particularly as our cultures continue to evolve. David – how do you keep your culture alive and vibrant as a leader, particularly when we become fatigued?

: I had moments in my professional life, where everything seems to close in on you – I don’t mind saying that. As a leader, you try to convey calmness, decisiveness and empathy but, you can also go to some pretty dark places. My advice would be to harness what you can control and let go of what you can’t.

That perspective of ‘what can I influence?’ is something we can all use. Jillann, I know QLD Health is working on is refining their transformation agenda, as well as managing the immediacy of the COVID-19 situation. How do you manage competing pressures on your time?

At my time at the UN, I was pursuing a really ambitious reform agenda, so I had to develop a way of working that made crisis response ‘business as usual.’ Whilst at first, a crisis would be phenomenally disruptive for us, the second time it happened, the disruption has less impact and we pulled from our experiences to re-establish our priorities. My experience in adapting my team to those dual ways of working was challenging, but effective, as it taught them how to manage crises with confidence.

It might be a hybrid model, where we learn more from our mistakes than actually getting things right. What do you think Bruce?

I think the main difference between leadership in a crisis and non-crisis is the rapid pace at which you have to make decisions. Normally you would establish executive intent and act with transparency, then build trust. The same is true in crisis, but you don’t always have enough time to consult.

Do you think we will be better leaders because of the crisis?

I don’t think the crisis will automatically turn us into better leaders. My martial arts instructor of many years used to say, “forget practice makes perfect, perfect practice makes perfect.” And I agree, you can’t expect to transmogrify into a great leader just because you have survived something difficult. It requires reflection, learning, and an act of intention.

You’re right, it’s not something we just acquire, it’s something to reflect on and build on, like any other skillset.

Yes, and we need to remember that we have teams because, as leaders, we don’t have all the answers. That’s why seeking input is critical to becoming a better leader. To establish environments of trust, cooperation and collaboration is to be human with those that we work with and lead.

More about the author

Dr. Stephanie Allen

Dr. Stephanie Allen

Global Healthcare Leader

Dr Stephanie Allen is the Deloitte Global Healthcare Leader. Deloitte has the largest professional services health care practice in the world. Deloitte has been independently recognised for its global and holistic approach to health care analytics to deliver new insights, for the way in which it is integrating exponential technologies to drive sustainable quality and cost improvements, and for its extensive clinical expertise working on contemporary models of care. Stephanie also leads the Health & Human Services Practice for Australia and is a consulting partner with over 25 years’ extensive experience in health care in both the UK and Australia. Stephanie has worked closely with eminent health and research institutions on complex planning, clinical, financial and operational transformation programs and on large scale technology implementations. She has served on a number of Health Care Boards and is passionate about the role of health care as an economic driver of prosperity, as a magnet for research and talent, and in supporting people to lead the lives they value.