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Crisis Leadership in an Acute Clinical Setting: Christchurch Hospital, New Zealand ICU Experience Following the February 2011 Earthquake

Published online by Cambridge University Press:  30 January 2015

Lev Zhuravsky*
Affiliation:
Christchurch Hospital, Christchurch, New Zealand
*
Correspondence: Lev Zhuravsky Christchurch Hospital Riccarton Avenue Christchurch New Zealand E-mail [email protected]

Abstract

Introduction

On Tuesday, February 22, 2011, a 6.3 magnitude earthquake struck Christchurch, New Zealand. This qualitative study explored the intensive care units (ICUs) staff experiences and adopted leadership approaches to manage a large-scale crisis resulting from the city-wide disaster.

Problem

To date, there have been a very small number of research publications to provide a comprehensive overview of crisis leadership from the perspective of multi-level interactions among staff members in the acute clinical environment during the process of the crisis management.

Methods

The research was qualitative in nature. Participants were recruited into the study through purposive sampling. A semi-structured, audio-taped, personal interview method was chosen as a single data collection method for this study. This study employed thematic analysis.

Results

Formal team leadership refers to the actions undertaken by a team leader to ensure the needs and goals of the team are met. Three core, formal, crisis-leadership themes were identified: decision making, ability to remain calm, and effective communication. Informal leaders are those individuals who exert significant influence over other members in the group to which they belong, although no formal authority has been assigned to them. Four core, informal, crisis-leadership themes were identified: motivation to lead, autonomy, emotional leadership, and crisis as opportunity.

Shared leadership is a dynamic process among individuals in groups for which the objective is to lead one another to the achievement of group or organizational goals. Two core, shared-leadership themes were identified: shared leadership within formal medical and nursing leadership groups, and shared leadership between formal and informal leaders in the ICU.

Conclusion

The capabilities of formal leaders all contributed to the overall management of a crisis. Informal leaders are a very cohesive group of motivated people who can make a substantial contribution and improve overall team performance in a crisis. While in many ways the research on shared leadership in a crisis is still in its early stages of development, there are some clear benefits from adopting this leadership approach in the management of complex crises. This study may be useful to the development of competency-based training programs for formal leaders, process improvements in fostering and supporting informal leaders, and it makes important contributions to a growing body of research of shared and collective leadership in crisis.

ZhuravskyL . Crisis Leadership in an Acute Clinical Setting: Christchurch Hospital, New Zealand ICU Experience Following the February 2011 Earthquake. Prehosp Disaster Med. 2015;30(2):1-6.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2015 

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References

1. Reyners, M. Lessons from the destructive Mw 6.3, Christchurch, New Zealand Earthquake. Seismological Research Letters. 2011;82(3):371-372.CrossRefGoogle Scholar
2. Ardagh, M, Richardson, S, Robinson, V, et al. The initial health-system response to the earthquake in Christchurch, New Zealand, in February 2011. Lancet. 2012;379(9831):2109-2115.Google Scholar
3. Rosengren, K, Bondas, T, Nordholm, L. Nurses’ view of shared leadership in ICU: a case study. Intensive Crit Care Nurs. 2010;26(4):226-233.Google Scholar
4. Pielstick, C. Formal vs. informal leading. A comparative analysis. Journal of Leadership and Organizational Studies. 2000;(7):99-114.Google Scholar
5. Center for Creative Leadership. Stepping into the Void. http://www.ccl.org/leadership/pdf/research/SteppingIntoVoid.pdf. Published 2007. Accessed March 5, 2012.Google Scholar
6. Jones, J. The Challenge of Leadership in Times of Crisis: A Case Study of Hurricane Katrina. Charleston, South Carolina USA: Bibliobazaar; 2011.Google Scholar
7. Nates, J. Combined external and internal hospital disaster: impact and response in the Houston trauma center intensive care unit. Crit Care Med. 2004;32(3):686-690.Google Scholar
8. Bass, M, Bass, R. The Bass Handbook of Leadership: Theory, Research, and Managerial Applications. New York, New York USA: Free Press; 2008:6-13.Google Scholar
9. Ballou, K. A concept analysis of autonomy. J Prof Nurs. 2008;14(2):102-110.Google Scholar
10. Reader, TW, Flin, R, Cuthbertson, BH. Team leadership in the intensive care unit: the perspective of specialists. Crit Care Med. 2011;39(7):1683-1691.CrossRefGoogle ScholarPubMed
11. St. Pierre, HofingerG, Buerschaper, C, Simon, R. Crisis Management in Acute Care Settings: Human Factors, Team Psychology, and Patients Safety in a High Stakes Environment. London, UK: Springer; 2011:260-262.Google Scholar
12. Kocolowski, M. Shared leadership: is it time for a change? Emerging Leadership Journeys. 2010;3(1):22-32.Google Scholar
13. Wooten, L, James, E. Linking crisis management and leadership competencies: the role of human resources development. Advances in Developing Human Resources. 2008;10(3):352-379.Google Scholar