• medical leadership
• healthcare planning
• analysis

The COVID-19 pandemic, even as we are in its early phase, invites reflection on best leadership practices. As hospitals and providers pivot to respond, the pandemic spotlights leadership in healthcare. What is working as we all collectively combat this global viral scourge? The impetus to analyse leadership practices especially now comes from the adage that ‘a crisis is a terrible thing to waste’.1 The danger of COVID-19 is self-evident and is already all too apparent around the world. At this writing today (1 April 2020), 873 008 individuals have been infected worldwide and 43 275 have died.2 In addition to the scientific opportunities to better understand the virus, its epidemiology, and strategies to prevent and cure COVID-19 disease, there is a clear opportunity to reflect on how to lead in healthcare through a crisis, to catalogue best practices, and to cascade these leadership practices broadly.

Even as we are in approaching the surge of the pandemic—in my community, on day 10 of a modelled course that predicts a surge approximately 40 days from now, there are already many lessons on leadership—extraordinary actions from ‘big L’ leaders—those with titled organisational responsibility as well as from ‘little l’ leaders—individuals without formal leadership titles whose leadership emerges organically. Indeed, a crisis such as this tests available models and hypotheses about leadership.

In cataloguing some best practices that I have witnessed at my institution—the Cleveland Clinic, I will try to articulate these practices and frame them through the lens of extant leadership models. The model by Kouzes and Posner3 of five leadership commitments—challenging the process, inspiring a shared vision, enabling others to act, modelling the way and encouraging the heart—provides an especially opportune taxonomy. What follows, then, is a catalogue of leadership practices, an annotation of each with specific examples, and a reflection …