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Original research
Supporting the pursuit of professionalism during a crisis
  1. William O Cooper1,
  2. Nancy M Lorenzi2,
  3. Heather A Davidson1,
  4. Cynthia A Baldwin1,
  5. Daniel M Feinberg3,
  6. Joseph Hopkins4,
  7. Nathan O Spell5,
  8. Craig J Uthe6,
  9. Gerald B Hickson7
  1. 1 Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  3. 3 Clinical Neurology, Pennsylvania Hospital, Philadelphia, Pennsylvania, USA
  4. 4 Medicine, Stanford University School of Medicine, Stanford, California, USA
  5. 5 Education and Professional Development, Emory University School of Medicine, Atlanta, Georgia, USA
  6. 6 Family Medicine, Sanford Health, Sioux Falls, South Dakota, USA
  7. 7 Medical Education and Administration, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr William O Cooper, Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA; william.cooper{at}vumc.org

Abstract

Background Crisis plans for healthcare organisations most often focus on operational needs including staffing, supplies and physical plant needs. Less attention is focused on how leaders can support and encourage individual clinical team members to conduct themselves as professionals during a crisis.

Methods This qualitative study analysed observations from 79 leaders at 160 hospitals that participate in two national professionalism programmes who shared their observations in focus group discussions about what they believed were the essential elements of leading and addressing professional accountability during a crisis.

Results Analysis of focus group responses identified six leadership practices adopted by healthcare organisations, which were felt to be essential for organisations to navigate the crisis successfully. Unique aspects of maintaining professionalism during each phase of the pandemic were identified and described.

Conclusions Leaders need a plan to support an organiation’s pursuit of professionalism during a crisis. Leaders participating in this study identified practices that should be carefully woven into efforts to support the ongoing safety and quality of the care delivered by healthcare organisations before, during and after a crisis. The lessons learnt from the COVID-19 pandemic may be useful during subsequent crises and challenges that a healthcare organisation might experience.

  • communication
  • continuous improvement
  • behaviour
  • COVID-19
  • professionalism

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/leader-2021-000458

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Twitter @VUMC_CPPA

  • Contributors WOC participated in the planning, conducting and reporting of the work and serves as the guarantor responsible for the content of the manuscript. NML, HAD, CAB and GBH participated in the planning, conducting and reporting of the work. DF, JH, NS and CU participated in the conducting and reporting of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement statement Because of the nature of the work described, which involves leaders in health systems and multispecialty groups, there was no patient or public involvement in the design or implementation of this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.