By: Brooks Jackson, MD, MBA
It’s been said that the value of an organization’s leadership is overlooked during times of prosperity or stability and often amplified during times of turbulence or uncertainty.
While there is no single blueprint to navigating a crisis, the ability to make quick (not perfect) decisions and adapt to changing circumstances are desired leadership qualities. Gathering and using reliable information to guide decision-making, and having trusted teams and processes in place also are important considerations.
The key ingredient that binds all of these factors is effective communication.
Health care systems, like any business or organization, abhor a vacuum when it comes to communication, especially during times of crisis. When its leaders do not communicate clearly and consistently, the information vacuum is filled with speculation and rumor—by employees and stakeholders, by patients and families, and by the general public. And speculation and rumor can often be worse than reality itself.
I’ve been reminded of the value of communication as the COVID-19 crisis brought never-before-encountered challenges to the University of Iowa Health Care mission of medical education, research, and patient care, as well as our planning and response to this pandemic. Getting the word out has been central to our efforts to understanding and adapting to conditions that have changed on a weekly, and sometimes daily, basis.
We are not alone, of course. The coronavirus has impacted health systems and medical practices across the nation. And the coming weeks and months will be just as challenging as we work to define and establish a “new normal” for our providers, students and trainees, and patients.
Although the first COVID-19 cases in Iowa were reported in early March, our preparation began in late January as we communicated across our health system and with county and state public health officials, university leaders and the Board of Regents, and colleagues and at institutions around the country and world. Raising awareness about the emerging pandemic—and letting our employees know that we were already addressing the issue—helped set the stage for changes implemented in the weeks that followed.
For example, we issued an enterprise-wide email to all our employees the day we activated our emergency response system on March 10, with instructions on properly using and conserving PPE, and preparing for a potential surge of COVID-19 patients. Subsequent broadcasts over the following days and weeks shared other updates, like the admission of our first COVID-19 inpatient, social distancing and other safety measures, child care resources for our staff, and the implementation of protective face shields for employees, just to highlight a few. We also publicly shared our successful initiatives in setting up an influenza-like illness clinic, remdesivir clinical trials, in-house COVID-19 virus and antibody testing, and our COVID-19 convalescent plasma treatment program.
We revamped our organization’s internal news website to categorize coronavirus-related information for easy scanning and viewing. As we closed entrances, modified visitation policies, and established requirements for face coverings and social distancing, we shared our guidelines—and the rationale behind these decisions—internally and externally.
Our experts in hospital epidemiology, transfusion medicine, infectious diseases, virology, internal medicine, and other specialties have fielded requests from multiple news media outlets, including national news organizations. Our chief medical officer has cleared time on her schedule to participate in weekly news briefings with county emergency management officials and answer COVID-19 questions from the public via Facebook Live. Similarly, two of our Spanish-speaking faculty have participated in Facebook Q&A sessions developed specifically for the Latinx population.
Internally, we’ve distributed weekly video messages to thank our employees for their commitment and service. We also have livestreamed two Q&A forums on COVID-19 each week—one related to patient care, and one focused on our research enterprise and medical education efforts. I’ve had the opportunity to lead the Carver College of Medicine forum, and it’s been gratifying to see the level of interest from our employees, based on the questions and comments submitted before and during the sessions. For the collegiate forums, we’ve included guest panelists who cover topics such as pediatric care and COVID-19 and the impact of our hospitalist-led Home Treatment Team, which monitors COVID-19 patients who are recovering at home.
While we don’t always have immediate answers, our employees seem to appreciate the opportunity to hear from and engage with leadership on a more regular basis. This was especially clear when we held a series of town hall sessions in late May to outline the financial implications of COVID-19 on UI Health Care. Sharing “bad” news is never easy, but admitting that we are working through problems—and promising to share more details as they become available—is better than waiting for all the answers before saying anything.
In times like these, when difficult questions and mounting challenges are a matter of course, ongoing communication is not just prudent. It’s necessary as we continue to care for COVID-19 patients while reassuring non-COVID patients that we can continue to provide a safe environment for their routine and emergent medical care, including those treatments and procedures that were postponed.
Two things I have learned over the past several months: First, collaboration truly is a hallmark of this university and our academic health system. I continue to be impressed by our people, who remain willing and eager to find solutions and get things done.
Second, strategic communication will guide many of our initiatives moving forward. This is not to say that we failed to communicate with our staff and the public before COVID-19, but the pandemic has underscored the importance of clarity and consistency. The first message people hear tends to be the message most believed, so slowing the rumor mill often means countering first perceptions. There’s room for improvement in any health care organization, but those that embrace traditional and non-traditional channels to reach employees, patients, and families will fare better in maintaining the public’s trust in a post-COVID-19 world.Brooks Jackson, MD, MBA, is University of Iowa Vice President for Medical Affairs and the Tyrone D. Artz Dean of the Roy J. and Lucille A. Carver College of Medicine.