Revised 7/13/21
It’s a new year, but for providers and clinical leaders who continue to be stretched and stressed on all fronts by the pandemic, it may not feel that way. Their resilience has been severely tested physically, mentally, and emotionally.
Yet, the need for resilience is always paramount, crisis or no. And it falls to hospital executives—medical directors and administrative staff—to develop resilient clinical leaders and build a culture that supports strength and growth, even in tough times.
What Does Resilience in a Clinical Setting Look Like?
Before learning how to build resilience, it’s incumbent on us to understand the term’s meaning from a clinical perspective.
Resilience is emotional toughness and a “predictor of success for individuals in stressful situations,” says the Harvard T.H. Chan School of Public Health. It has several predictive factors that indicate who will have the quality, including heightened confidence in one’s abilities, disciplined routines, and support from social and family environments.
Dr. David Schillinger, Chief Medical Officer, SCP Health, defines resilience much more succinctly: Being able to come back again the next day.
“In the pandemic, that’s a reality,” he said. “You have to be able to get up and do it again despite the pressure.”
For hospital executives, his advice is more replete.
“Those in medical leadership have to be able to hear the [frontline] stories and encourage their people to be strong,” he said. “It’s difficult to tell them the fire won’t be that hot when they get there, knowing it will be just that hot when they get there.”
Building resilience typically requires time for recovery from the physical, mental, and emotional strain, as continued pressure without recovery time wears people down. However, during the crisis, there was little time for such rest to take place.
“When someone in room four dies because they were unable to breathe despite your best efforts to save them and you have to go into room seven to treat another patient, you don’t have processing time,” said Dr. Stephen Nichols, Chief Clinical Innovation Officer and Chief Medical Officer for the Virtual Clinical Medical Group, SCP Health. “The key to resilience, to me, is the ability to adjust. By that I mean, you need a wall between yourself and the situation, but you also need a door in that wall that you open at the right time. The challenge comes in knowing how to balance the two.”
Resilience Lessons Learned from the Crisis
Indeed, 2020 was a test of clinical resilience for all concerned, those on the frontlines and medical leadership alike. The need to adjust to quickly changing treatment recommendations, lack of a standard of care, and limited knowledge about how to treat the virus presented pressures that began to pile one on top of another.
Despite the pressures, lessons were learned that could improve clinical resilience when the next trauma occurs.
“We learned to utilize techniques, advice, and education via support groups to discuss the emotional and physical pressures that were wearing people down,” Dr. Schillinger said. “To be resilient, you have to get that off your chest, share it, and realize that these problems are not just unique to you. The lesson here is to help people understand there are resources available and that they are not going through this alone.”
According to Dr. Nichols, another lesson is for physicians and clinical staff to give themselves some grace and not walk around feeling guilt-ridden.
“We did the best we could with the information we had at the time,” he said. “But what we did helped to discover better treatment options.”
Another resilience lesson learned for operational and executive leadership was the need for flexibility.
“It was a matter of making decisions, meeting again to reconsider decisions and the results of making new decisions, and then varying the cadence in response to the circumstances,” Dr. Nichols said. “We did that as a company, going from weekly calls, for example, to bi-weekly to monthly as the situation demanded—and back to weekly when the situation warranted it.”
Leadership also includes support and encouragement of staff to take rest and recovery time.
“That’s very hard when everything is on fire, so to speak,” Dr. Nichols remarked. In an analogy reminiscent of how flight attendants advise passengers, to put their mask on first before helping others, he said, “A firefighter friend once told me, save some water for yourself; you can’t put it all on the fire.”
Creating a Culture of Resilience
Building resilience among clinical leaders requires more than putting out fires during a crisis, however. It also involves creating a culture that enables leaders to do their jobs well. While we expect providers to be resilient, we do a disservice if we also fail to build resilience into the organization.
At SCP Health, we put concerted emphasis on how we can support clinicians and frontline caregivers through adherence to our four core values of agility, respect, collaboration, and courage. They serve as a north star during challenging circumstances.
“It’s funny how little things in the environment can improve situations for people,” Dr. Nichols said. “A culture of support, coupled with recognition and a show of appreciation, can lead to resilience.”
How SCP Health Develops Resilient Clinical Leaders
We understand that clinicians deserve a work environment where practicing medicine is both rewarding and satisfying, even in the most challenging times. One reason we created the Provider Concierge Program was to give providers individualized attention from a designated concierge coordinator who supports physicians from onboarding through employment.
During our annual Medical Leadership Conference we offer medical leadership training through didactic sessions, group interactions, discussions, and active problem-solving, in addition to continuing medical education, and ongoing support to enable providers to keep up to date with the latest evidence-based care.
Conclusion
An adage says, “Tough times don’t last, but tough people do.” Even with vaccines now being distributed, we can’t know when the coronavirus pandemic will end. We can say with confidence, however, that those in medical leadership positions are committed to building resilience into our clinical leaders to give them the strength necessary to get through this crisis and any other that comes their way.
