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Military Principles Can Help Hospital Incident Command Centers Prepare for a Second Wave


As the U.S. begins reopening, potentially sparking a “second wave” of COVID-19 cases, hospitals and health systems will need to continue operating in a state of high-stress readiness.

As the U.S. begins reopening, potentially sparking a “second wave” of COVID-19 cases, hospitals and health systems will need to continue operating in a state of high-stress readiness. In preparation, leaders must ensure their Hospital Incident Command Centers can contend with the anticipated challenges ahead.

Unfortunately, these Command Centers were not built for longstanding crises but only short bursts of activity. As it stands, the need for prolonged, hyper-focused Command Center operations will seriously tax hospitals. What’s more, if the second wave is as grave as some predict, some hospitals might struggle to keep pace with the ensuing uncertainty and chaos.

Looking to the one other institution that regularly operates in similarly high-stress, rapidly changing environments, our hospital system can learn much from the U.S. military, specifically the principles that allow elite levels of operational units to thrive in sped-up life-or-death situations. These principles can also help Hospital Incident Command Centers build the muscle required to contend with future COVID-19 outbreaks. 

They include:

  • Embrace a culture of candor and self-accountability, thus empowering teammates at all levels to share lessons learned and drive outcomes. This increases the likelihood of continued engagement and continuous improvement, and shifts focus from individual tasks to owning functions and outcomes.

  • Communicate intent and then “let go” to unharness teams’ full potential and allow top executives to lead at the appropriate altitude. This requires clear articulation of such details as: desired outcomes; decisions that can and can’t be delegated; and the specific information that will need to flow through leaders on an ongoing basis.

  • Engage in a rigorous after-action review (AAR) process. A cornerstone for military command operations, AARs help teams quickly and continuously recognize lessons learned in challenging situations, and capitalize on them. A commitment to uphold this process makes it possible to respond to extreme challenges and pivot as needed with minimal friction. Best practices to keep in mind for AARs include incorporating operational and administrative decision-makers to increase the likelihood of connectivity and learning; including well-maintained lines of communications to share lessons learned and implement resulting action items; and engaging outside experts to establish procedures and methods for ongoing assessment and refinement.

Already a few evangelists for military blueprints have emerged among Hospital Incident Command Center leaders. To illustrate, Dr. Jim Stein, Chief Medical Officer of Children’s Hospital Los Angeles (CHLA) has been actively using the highlighted principles to rapidly and effectively respond to COVID-19. Beginning in the earliest days of the crisis, he codified clear structures and decision-making protocols to best support and empower teammates to execute in their specific areas of expertise. He also used AARs to build vital institutional knowledge and share real-time information throughout CHLA. 

Some hospital leaders might find it challenging to slow their operational tempo in order to deeply engage in a new process during such turbulent times. Those who are able to think big-picture and focus on continuous improvement will empower their teams to operate more smoothly, effectively and at an exponentially faster pace, both now and during the next crisis.

Elite military service members often field questions about how they’re able to operate when stakes are impossibly high. The answer is quite simple: they’ve done the preparation. When teams prepare and overall systems are at the ready, crises don’t hinder operations. They reveal their strength.   


T.J. Topercer and Chris Haggerty are former Navy service members, a Surface War Officer and SEAL, respectively. They now serve as consultants at the healthcare-focused human capital advisory firm FMG Leading.

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