Leading for Resilience by Michelle A. Barton, Marlys Christianson, Christopher Myers and Kathleen Sutcliffe

Given the ongoing COVID- 19 crisis, the need for resilience in the healthcare system—and everywhere else—has never been greater. Resilience can be defined as ‘the ability to absorb strain and preserve (or improve) functioning despite the presence of adversity.’ However, in the midst of chaos, fear, uncertainty and often completely insufficient resources, the call to ‘be resilient’ may feel like an impossible demand, especially if you view resilience as something one either has or does not have — a character trait like ‘grit’ or ‘fortitude’.

Our own work, however, suggests something different. As we have looked at resilience in emergency rooms, firefighting teams, military units and sports teams, we have come to see it not as something you have, but instead as something you do. Nor is it limited to recovery and picking up the pieces after a crisis has occurred. Rather, resilience is an approach to leading and organizing that helps teams manage well during adverse conditions. Recognizing this is especially important during a drawn-out and constantly changing crisis like the one we currently face. It means that there are steps you can take right now to help your organization and your teams keep functioning in the midst of adversity.

Enacting resilience is more complicated than just ‘digging deep’ or ‘buckling down’, and requires actions that can sometimes seem counterintuitive. Following are three important action steps leaders can take to build the resilience-in-action of their employees, teams and organizations:

Create productive disruptions. With chaos unfolding around you, it is tempting to meet urgency with speed, to jump in at the beginning of a shift and not look up until it is over. Our research suggests, however, that this kind of head-down action can lead to dysfunctional momentum. This is the tendency to keep engaging in a set of behaviours without pausing to recalibrate or to re-examine the processes or the changing context. When situations are volatile, unpredictable and complex, we can get so engrossed in the action that we do not notice small indicators that new problems are emerging or that the situation has changed so that our assumptions no longer hold.

For instance, wildland firefighters can get into trouble if they focus entirely on fighting fires—getting the right people and equipment to the right location, coordinating within and between teams and working to put the fire out—and miss cues that the

wind or weather is shifting, which can radically worsen the situation they face.

The solution for dysfunctional momentum is to actually create interruptions. Especially when situations are evolving quickly, it is critical to disrupt the momentum and to create opportunities to check in with one another about what is actually happening as opposed to what we assume is happening. One of the best ways to do this is through huddles, which are short debriefings that provide opportunities for front-line staff and caregivers to stay informed about current events. However, huddles are more than an information exchange. They also help staff make sense of work as it is unfolding as people can report concerns and anomalies as they look back on unexpected events and surprises.

Moreover, caregivers can also look forward and report leemers, a term used by naval aviators to describe a gut feeling that something is wrong even though there is no definitive proof. Huddles might be enacted differently during this crisis (i.e., they may be virtual instead of face to face), but they still can improve collective awareness, thereby potentially increasing response time and reducing the potential for failures.

Reconfigure, redeploy and repurpose resources. When turmoil replaces our normal daily routine, a tension arises between fighting to maintain normalcy and throwing the rulebook out the window. The most resilient teams, however, do neither. Rather, they take stock of what they have to work with—their routines, roles and resources — and then reconfigure, redeploy and repurpose. The goal is still to create order from chaos, but to do so by leveraging what you — or others around you — already know and do. We have already seen this on an organizational level as distilleries use their resources and manufacturing capabilities to produce hand sanitizer, athletic apparel companies make medical masks and gowns, and hospitals turn emergency rooms and other spaces into COVID- 19 intensive care units.

Yet this approach is not limited to physical resources; the daily routines and patterns of interaction among people are also critical resources that can be reconfigured in the face of unprecedented demands. Our routines and operating procedures are not static rulebooks, but in fact are living habits and patterns of interdependent action that can be recreated and revised. This means we do not have to throw out the old routines when facing a new challenge, because it is still valuable to have some plan