The coronavirus has put health care organizations under a microscope and if it’s taught us anything, is that it pays to have the team, training and action plan for a crisis situation established long before it occurs. We spoke with Mary Ann Hart DNP, RN, and program director of the Regis online Master of Health Administration program, to understand what the role and responsibilities of health care administrators and managers are during a public health emergency.
Question: There seems to be a lot of speculation and buzz around “leadership” during the Covid-19 pandemic. Where do you think it stems from?
Well, when you think about it, when is leadership more critical than at a time when billions of lives and the world economy is at stake? We have never experienced something like this before, at least in modern history. And we are looking to leaders to navigate it in the short-term and to lead us out of it in the long-term.
Q: Who are the leaders we are talking about? Who should the public look to for direction and accurate information?
For starters – heads of governments like presidents and prime ministers, congress, governors and mayors, and officials in state, county, and local governments. Isn’t the main purpose of government to protect its people? Both strong and weak leaders have emerged from some governments to take charge (or not) in the pandemic, which means using their authority to keep the populace informed, inspire cooperation and confidence, as well as to produce and distribute scarce resources such as tests, personal protective equipment, ventilators. In addition to tracking the disease and directing the development of treatment and a vaccine.
Q: But what if you are a health care administrator or manager in a health care organization – not a government leader – aren’t you also in the center of the storm?
You certainly are. The COVID -19 pandemic is also testing the leadership skills of health administrators and managers, and not just now during the height of the crisis, but their ability to be effective will be tested for months and years to come.
I recommend everyone read the article in the New York Times Magazine article on April 19, 2020 Epicenter/Inside New York City’s hospitals as they face the pandemic, to get a strong sense of the challenge, not just for front-line providers such as doctors, nurses, and other staff, but for the administrators/managers of health care organizations. It will make you gulp, and educators like me are asking, how can we best prepare our health administration students for these challenges?
Q: Can you give some examples of what administrators/managers of health care organizations need to be prepared for?
It’s about administering, managing AND leading.
Health care administrators and managers must be prepared to address the urgent needs of their organizations in the present – its employees and the people it serves. They must take decisive and immediate action to make choices and allocate resources. There are many examples of this skill being demonstrated by managers and administrators in our health organizations; ensuring the workforce has personal protective equipment, converting whole units into Covid-19 only units overnight, ensuring there are an adequate number of tests and ventilators for the expected flood of patients, and re-deploying clinicians and staff. Communication within the organization and to the public is key to effective management.
Leadership requires a long-term approach. Many health administrators/managers are also leaders in their organizations, officially and unofficially. It’s about anticipating what comes next and having trust in the senior executives on your team ready to manage crises, not getting trapped by the details of managing. The health care leader must articulate and operationalize the mission and purpose of the organization while building a team that can manage in times of crisis. The health care leader looks beyond the immediate crisis to anticipate and plan for the future challenges of the organization.
Q: Beyond the challenges of responding to an influx of COVID-19 patients, what are the longer-term challenges of administrators/ managers and leaders of health care organizations?
The financial fallout from the COVID-19 pandemic for health care organizations is very significant, mainly from the cancellation of elective procedures and other health care that was deemed non-emergent. No one is quite certain yet what the final impact will be because so much depends on to what extent the federal or state governments will provide financial relief to hospitals and other health care organizations.
In addition, millions of people have lost their jobs – and their employer-sponsored health insurance – and this has implications not only for the people affected, but for health care organizations dependent on the revenue from insured patients. Fortunately, the Affordable Care Act and the expansion of Medicaid by some states, will help some of these people obtain insurance coverage.
The pandemic has also highlighted the critical need to address health care disparities in the United States, as it has become clear that communities of color have been disproportionately impacted by COVID-19. We must turn our attention to population-health, not just medical care.
In addition, the pandemic has shined a light on the safety and quality of our long-term care settings. The number of COVID-19 cases and deaths in our nation’s nursing homes and assisted living centers is shocking. And it is believed to be only the tip of the iceberg.
Q: What can we expect for the career prospects of health administrators/managers in this uncertain environment?
There will certainly be a pent-up demand for non-COVID-19 related health care that was delayed during the height of the pandemic once our society opens up again. I think that telemedicine and telehealth will have gained a stronger foothold as an important part of our health care delivery system. There may be an initial contraction of the health care sector, until the system is up and running normally again. Once it does, there will be an increased demand for not only clinicians and other health care workers, but for skilled health care administrators, managers, and leaders who can help us meet the pandemics – and other challenges of the future. The COVID-19 pandemic has showed the world how important it is to have a robust, responsive and equitable health care system with effective administrators and managers to lead it.