As the incident commander during the 2013 Boston Marathon bombing, Chief Daniel Linskey experienced incredible challenges. His work involved overseeing the response to the bombings and coordinating with the investigation conducted by the FBI, Boston police, and state police.
During the manhunt for the bombers, he:
- Managed the unprecedented lockdown of the city of Boston
- Was the first commander on scene during the Watertown shootout
- Witnessed the emotional toll suffered by first responders and their families, including his own
Crisis Management in Healthcare
Health leaders have also found their organizations in the middle of other challenging, often unthought-of events, such as terrorist attacks, active shooter events, chemical incidents and cyberattacks, resulting in crippling information systems shutdowns.
In an ever-changing environment, healthcare organization leaders need to be prepared to handle myriad challenges. How do you start? What can you put in your leadership ‘file cabinet’ to access during a crisis?
How well institutions respond directly relates to the ability of their leadership teams to think, plan, respond, adapt, and lead their teams through the challenges ahead. Chief Linskey shared the following lessons in crisis management that healthcare leaders can apply to their own work.
Lesson 1: Get Comfortable with Being Uncomfortable
A good crisis plan starts with the entire team and other teams across the board.
For Chief Linskey, developing a crisis plan started with his own team, and then, incorporated teams across the board. With Linskey, it involved first responders, local hospital staff, and other key stakeholders.
According to the Chief, “Get your team involved with your planning. Your plan is important, but the planning process is the most important. You and your team need to understand the plan, nuances, and various scenarios to react properly and efficiently to the crisis. The more prepared you are with your planning, the more you can be prepared when a crisis comes to your front door step.”
Lesson 2: Become a Meta-Leader
A meta-leader is one who is capable of surrounding themselves with stronger leaders. A meta-leader leads up to those they are accountable too, across to the leaders of other disciplines while at the same time leading down to their team members tasked with carrying out the mission. A meta-leader needs to keep their team confident in the team’s and leader’s ability manage the crisis.
According to Linskey, every meta-leader “surrounds themselves with a resilient staff. Resiliency is built by a strong plan and a lot of practice on executing the plan. Robust systems and procedures will help staff remain strong during a crisis.”
Lesson 3: Plan and Test Your Crisis Plan
Within 22 minutes, the triage began, and all victims from Marathon Day in Boston were in surgery or receiving care in hospitals. Why did that happen – because the crisis plan had been tested, picked apart, tested again, and then, tried again.
What Makes a Strong Leader?
"A strong leader is someone who can evaluate their skills, recognize her strengths, gaps, and specialties, and surround themselves with stronger leaders. A strong leader can have his team take things to the next level. Strong leaders have team members who stronger in many areas than leaders themselves."
Linkskey's Personal Experience
Linskey’s personal crisis was Marathon Day, when he saw the mangled bodies, people dying in front him and potential explosive devices. He was overwhelmed and not carrying out the role of the leader. He observed a woman with a leg injury, grabbed a towel and bent down to apply pressure to her wound – even though there were medics that were more than capable to assist her.
A Lieutenant from another agency grabbed him by his coat collar and stated, “Chief, they got this – we need you in the middle of the street.” Linskey was furious. He was not furious with the Lieutenant telling him to think strategically and lead, instead of treating patients. He was furious with himself for having to be reminded to be the leader. He took three deep cleansing breaths, then his leadership ‘file cabinet’ opened, allowing him to become the leader he had trained his whole life to be.
“I pulled out all of the training, the planning, the crisis and leadership experiences of my life and began to address the challenges in front of me.”
Linskey advises organizations to “give your team in crisis five things to do during a crisis – 10 is too many; one is too few. Identify exactly what the team needs to do. The leader needs to deliver the mission while being the calmest, most confident they have ever been.
"As the leader, you need to refer back to the plan, apply the plan, and follow the plan and be prepared to throw it away and adapt a new plan as the challenges inevitability will require a different response. It’s important to have a plan, but not as important as it is to be able to plan.”
Originally published November 2, 2018, updated July 10, 2018.
Watch Stephen Curren, director of the division of resilience in the Office of Emergency Management within the Office of the Assistant Secretary for Preparedness and Response, talk with HIMSSTV about how healthcare has woken up to security risks.