Public Health Preparedness & Leadership

1. Public Health Preparedness & Leadership Louis Rowitz, PhD Director Mid-America Regional Public Health Leadership Institute

2. We cannot live in a post-September 11, 2001 world with a pre-September 11, 2001 mind. --adapted from Angela Thirkell, 1933

3. TRADITIONAL AND CRISIS LEADERSHIP • WHAT ARE THE • DIFFERENCES?

4. DEFINITION OF CRISIS • A CRISIS IS CHARACTERIZED BY A HIGH DEGREE OF INSTABILITY AND CARRIES THE POTENTIAL FOR EXTREMELY NEGATIVE RESULTS THAT CAN ENDANGER THE LIVES OF PEOPLE IN A COMMUNITY. (ADAPTED FROM KLANN)

5. TYPES OF CRISES • NATURAL DISASTER • ACT OF WAR • TOXIC CHEMICAL RELEASE • HAZARDOUS MATERIAL SPILL • CRASH OR DERAILMENT • STRIKE OR BOYCOTT • TERRORIST ACT • FINANCIAL CATASTROPHE

6. BE PREPARED The New Public Health Marching Song

7. ANALYTIC CONCEPTUAL STRUCTURAL SOCIAL

8. SYSTEMS THINKING AND COMPLEXITY Do you understand your community?

9. Events Patterns Systemic Structure Mental Models Vision The Iceberg

10. System Crisis Complexity Issues Recovery

12. Community Assets Map

13. Exercise on Forces for Change

14. CRITICALISSUE: HOW DO I KEEP MY FAMILY SAFE?

15. TIPPING POINT AWARENESS

16. Public Health ComplexityIssues: Leadership Demands Strategic Challenges P.H. The Tipping Point Societal Trends Community Context

17. Local Public Health Response (Complexity) Public Health Response Societal Pressure Community Crisis and Priorities Strategic Challenges National Agenda

18. Societal Pressures

19. Dimensions of Culture (Hofstede, 1997) • Power Distance • Collectivism vs. Individualism • Femininity vs. Masculinity • Uncertainty Avoidance

20. Power distance is the extent to which the less powerful members of institutions and organizations within a country expect or accept that power is distributed unequally.

21. Individualism pertains to societies in which the ties between individuals are loose; everyone is expected to look after himself or herself and his or her immediate familyCollectivism as its opposite pertains to societies in which people from birth onwards are integrated into strong, cohesive in-groups, which throughout people’s lifetimes continue to protect them in exchange for unquestioning loyalty.

22. Masculinity-femininity as a dimension of societal culture

23. Uncertainty of avoidance is the extent to which the members of a culture feel threatened by uncertain or unknown situations

24. STRATEGIC CHALLENGES

25. NATIONAL AGENDA

26. Adaptation to Change The Resilience Factor

27. The Structure of ChangeConner Synergy Nature Culture Process Resilience Commitment Roles Resistance

28. Leadership Styles and Environment Match

30. No Yes No Yes No Yes No Yes No Yes No Yes The Value of Structured Flexibility Do you understand the procedure? Learn It! Is there a need to make and exception? Follow the Procedure Use your best Judgment, communicate your actions to the appropriate person as soon as possible, and be prepared to explain what was done and why. Is there time to get approval/input from others? Check with the appropriate person to get advice or approval to proceed. If permission is denied, follow the procedure as directed. If desired, advocate for changing the procedure in the future. Record your learnings so we don’t do it again the same way. Go Ahead! Did it work? Record your learnings so we know why it won’t apply elsewhere. Would it work in other situations? Record your learnings for possible incorporation in updated procedures.

31. PUBLIC HEALTH CERTIFICATIONS HEALTH ALERT NETWORK PUBLIC HEALTH LEADERSHIP ESSENTIAL PUBLIC HEALTH SERVICES WORKFORCE DEVELOPMENT PUBLIC HEALTH INFRASTRUCTURE NATIONAL PERFORMACE STANDARDS PUBLIC HEALTH INFORMATICS MAPP EVIDENCE-BASED PUBLIC HEALTH HOMELAND SECURITY NATIONAL AGENDA

32. Time The New Beginning The Neutral Zone Ending, Losing, Letting Go Transitions (Bridges)

33. Social Capital Theory Those resources including trust, norms and associational networks inherent to social relations which facilitate collective action.

34. Core Public Health Skills Discipline Specific Content Management Skills Core Leadership Skills Individual Leadership in Practice Team Leadership in Crisis Best Practices New Leadership Pyramid Performance Capacity Building

35. ECOLOGICAL LEADERSHIP • ECOLOGICAL LEADERS ARE COMMITTED TO THE DEVELOPMENT OF THEIR LEADERSHIP SKILLS AND COMPETENCIES THROUGHOUT THEIR PROFESSIONAL CAREERS WHILE AT THE SAME TIME BEING COMMITTED TO THE APPROPRIATE APPLICATION OF THESE SKILLS IN THEIR COMMUNITIES CHANGING HEALTH PRIORITIES.

36. THE DELICATE BALANCE • ECOLOGICAL LEADERS IS ABLE TO BALANCETHE NEEDS OF DAY-TO-DAY PRACTICE OF PUBLIC HEALTH IN HIS/HER ORGANIZATION AND COMMUNITY WITH THE SPECIAL SKILLS AND APPLICATIONS NECESSARY TO ADDRESS PUBLIC HEALTH EMERGENCIES

37. Leadership and Preparedness in Crisis Situations

38. BIOTERRORISM:Competencies for Leaders • DESCRIBEthe chain of command and management system • COMMUNICATE public health information/roles/capacities/legal authority accurately to all emergency response partners • MAINTAINregular communication with emergency response partners

39. Competencies for Leaders (Continued) • ASSUREthat the agency has a written updated plan • ASSUREthat the agency regularly practices all parts of emergency response • EVALUATEevery emergency response drill • ASSUREthat knowledge and skills are transmitted to others

40. INCIDENT COMMAND SYSTEM WHO’S IN CHARGE? BIOTERRORISM OR DISASTER EVENT COLLABORATION COLLABORATION NO COLLABORATION

41. NEW PARTNERSHIPS • Emergency Management System • Police Department • Fire Department • Emergency Medical System • Community Health Centers • FBI • Local Public Health Department • Homeland Security

42. NEW MODELS OF COLLABORATION • Shared Work • Maintain Organizational Identities • Synergy

43. CHANGING WAYS TO WORK • CORE • SPECIALISTS • GENERAL WORKERS • COMMUNITY RESIDENTS

44. MEASURES OF SUCCESS:IN COLLABORATIVE LEADERSHIP • COMMUNICATION • ASSESSMENT • CONFLICT MANAGEMENT • DEVELOPMENT OF TRUST • DECISION-MAKING • ADDRESSING SAFETY CONCERNS

45. DEFINITION OF EMOTIONAL INTELLIGENCE • THE ABILITY TO USE YOUR EMOTIONS IN A POSITIVE AND CONSTRUCTIVE WAY IN YOUR RELATIONSHIP WITH OTHERS

46. A Framework of Emotional Competenciesp. 28 Cherniss and Goleman

47. Leadership Style, EI and Organizational Effectiveness

48. PEOPLE SMART STRATEGIES • Flexibility in communication • Personal stress management • Help others who express pessimism about the future • Show respect for others • Manage work rage

49. Exercise on Emotional Intelligence

50. Relationship betweenRisk Communication and Crisis Communication