Lessons in Leadership: Advice for Guiding Scientific Organizations During Times of Change.

Health and medical research have enjoyed decades of steady growth and impact, often the envy of the world. Throughout my tenure as a physician-scientist, early career physicians from abroad, looking to advance their knowledge and career, would seek to work in my laboratory and others like mine across the country. This success has been due, in large part, to the investment we have made in medical research which has saved millions of lives across the globe. 

But change has come to our doorstep. Federal funding, the powerhouse of the medical research engine, is scarcer and trust in science is diminishing.

During times of dramatic change, the future of medicine will be determined by how we, as leaders in healthcare and as individuals involved in research, adapt to and rise above this new reality. While all change is hard, rapid change can feel unbearable or destabilizing. The more dramatic the change is, the harder the challenge. At the same time, times like this bring even greater opportunities for leaders to make an impact. 

Lower funding, less confidence, more leadership.

When times get challenging, turn to your true north. MedStar Health Research Institute remains committed to our mission of advancing the health and wellbeing of all people through transformational, interdisciplinary, and inclusive research. Staying true to your mission reinforces the organizations identify and demonstrates to their associates what they are working toward. It is also equally important to help others within the organization see its positive attributes and work to maximize those attributes throughout the change. As a research institution within a successful healthcare system with a diverse portfolio of research sponsors, we are well positioned to weather this storm. In fact, I believe we’re likely to emerge stronger and more innovative than we began.

Why am I so confident?  Because of the organizational structure we have built, the talented people committed to its mission, the experience we gained during other challenges (such as COVID) and because of our core strengths as a high reliability organization.. 

Staying informed and grounded – An Important tool for leaders facing change.

For leaders facing challenging circumstances, core concepts of active listening and collecting current information can help you stay close to the work, make agile change, build trust, and report back results:

• Active listening: I stay in active contact with our associates, investigators, and other key stakeholders to understand their experiences and needs. Difficult times affect people in different ways, so assuming you know how people feel is risky. Ask open-ended questions instead. Helping people navigate their own circumstances and concerns helps your organization rise above collective challenges, one person at a time.

• Collecting information locally and nationally: By connecting with team leaders and institute directors, I can keep my finger on the pulse of MHRI. Collecting information across multiple sources is critical when changes that once took weeks or months are happening in days. Hosting listening sessions, creating opportunities for people to ask confidential or anonymous questions, and crafting communications with transparency in mind will help you better understand how your teams are really feeling and build trust among your organization. 

• Tap into outside expertise: While local information is essential, learning from others across the nation is very helpful. Through a national network of chief scientific officers, we were are able to share information in near-real time through shared listservs and emails.  Learning how your national colleagues are addressing some of these changes can be particularly helpful.

• Keep an eye on national trends: Monitoring the news and how other leading organizations in your industry are responding to current events can be a helpful learning exercise. What occurs at one federal agency may not reflect the current status at another. What happened yesterday may no longer be relevant today. Keeping up with the latest helps ensure we can take the right steps at the right time.

Taking a highly inquisitive approach can help you gather and synthesize the latest information. Reaching out to others within and (crucially) outside your organization to activate your networks. Once a plan is developed and put into action, close the loop with your teams and associates so they know their leaders are on the case. Associates are looking toward leadership to navigate the changes, and it is the leaders’ responsibility to keep them informed and aligned as the organization makes necessary shifts.

Related reading: Health Systems and Researchers Can, and Must, Work to Advance Community Health and Equitable Access.

Bring forth innovation from challenges.

Very often, we find that the collective work to overcome and adapt leads to innovative solutions we might not otherwise have been able to imagine. To best take advantage of this opportunity, it’s important to build a culture that thrives when challenged.

As a High Reliability Organization (HRO), MedStar Health employs principles that make our system flexible and innovative. HROs operate under challenging conditions all the time, reducing errors and maintaining safety despite these circumstances. These principles include:

• Preoccupation with failure: We’re always on the lookout for potential risks

• Reluctance to simplify: We ask questions about complexities and seek out different perspectives

• Sensitivity to operations: We remain aware of the realities of the frontline, actively seeking feedback to improve processes

• Deference to expertise: We seek out experts, encouraging input from associates with knowledge and encouraging a wide variety of viewpoints

• Commitment to resilience: We bounce back, knowing that failure could occur and having procedures in place for when things don’t go according to plan

Our response to the COVID-19 pandemic is an important example of how HRO principles help us develop solutions during trying times. To help patients continue to receive care while maintaining social distancing, we quickly developed and implemented leading telehealth applications. Since then, we have embraced decentralized clinical trials and found more ways to increase access to care using telehealth and bringing clinical trials to patients through our partnership with Home Health.

To meet today’s challenges, we’re further diversifying our funding sources. This includes engaging with new funders, exploring innovative partnerships, and looking to nontraditional opportunities to advance health through research. We’re working to improve care for all, including those in rural areas. And we’re digging into research in new fields, such as chronic conditions, that can have a major impact on patients.

Related reading: MedStar Researchers Use Visualization Dashboards to Enhance Situation Awareness of COVID-19 Telehealth Initiatives.

A crucial time for thoughtful leadership.

There is no more critical time for leadership than during tumultuous periods of change. When we are faced with the unexpected or unfortunate, we look to those with experience to guide us through difficulty to more stable and predictable times.

I feel privileged to serve MedStar Health in a leadership capacity. I am proud of the deep and broad team of thoughtful, dedicated researchers we’ve assembled. It is an honor to serve as their coach and champion.

I often recommend “Team of Teams,” one of my favorite books on leadership. General Stanley McChrystal and his co-authors assembled a powerful framework for building agile, adaptable networks that can thrive in complexity and uncertainty. 

As our Institute’s leadership works closely with teams and individual researchers to adapt to our ever-changing landscape, I’m reminded that our collective work as a team of teams is as important as it have ever been, perhaps more.

We have a diverse portfolio of patient-centered research. We are connected to our community, building trust as we do research that benefits our neighbors every day. We are doing good work. We are benefiting society. We are improving the future of medicine. 

There is no doubt, change has come to healthcare research. The ultimate impact of that change will be determined in large part by how we respond, as leaders, as researchers, and as humans.

I encourage my colleagues leading scientific organizations to stay steady. Look to your mission for guidance. Here at MedStar Health, we believe deeply in our mission and the importance of our work. This mission remains our north star, reminding us of our charge, no matter how chaotic the environment may become.

No matter the challenges we face today, remaining steadfast in our commitment to science and medicine will allow us to embrace steadier times as stronger and more agile researchers, and organizations.