Main Body

Leading During a Crisis

Kara Colvell

In this chapter we will be going over how to handle a crisis as a leader before, during, and particularly after a disaster. In the Miriam Webster dictionary, a crisis is defined as “an unstable or crucial time or state of affairs in which a decisive change is impending; especially: one with the distinct possibility of a highly undesirable outcome” (Webster, 2018). When in a leadership position, being in crisis is the norm, though the scale can drastically change. The reassuring view that this current crisis is simply a phase that will pass is true, but it will continue into another high-stakes gambit for the continuance of the company or community. If we were to break a crisis apart, there would be a total of four stages: signal detection, acute stage crisis, chronic crisis, and learning (Rowitz, 2014).

1. Signal detection. This is a pre-crisis stage. There are usually warning signs before a disaster, and the objective at this stage, barring averting the disaster, is to acknowledge the signs and get a head start on disaster resolution.
2. Acute stage crisis. This can be the most demanding stage; the crisis is in full swing. As a group, individuals can either respond frantically or thoughtfully. If some warning signs were noted and heeded, the added time can ensure responding to the crisis a cumulative and deliberate effort. This phase can also be called the “emergency development phase.” During this time, the leaders job is to stabilize and plan out the crisis.
3. Chronic crisis. The crisis is still in effect but action has taken place to reduce the effect; this development is also known as the adaptive occurrence. Here is where the underlying cause of the crisis is unfolded and the direction the leader will take is determined, which is to either lead in such a way as to ensure the avoidance of a similar situation or embrace the new direction and determine how to thrive. (Heifetz, Grashow, & Linsky, 2011)
4. Crisis resolution. The goal in any crisis is that at the end things return to normalcy. This is generally the case but situations never revert back to exactly how they were before the crisis. A new sort of normal is the result of the catastrophe.

I am going to apply management and leadership practices and theories to the Flint Water Crisis in this chapter which will include an investigation and application of: crisis management, adaptive leadership, distributed leadership, reform, crisis communication, and the situational crisis communication theory (SCCT).

Background to the Flint Michigan Water Crisis
The water crisis in Flint could be called one of the most severe public health catastrophes in the last decade. What makes this tragedy so devastating is that if regulations had been followed the entire situation would have been avoided. Events leading up to the disaster can be traced back to 1897 when the city instituted a policy that all pipes connected to the main water supply were to be made with lead. The understanding at the time was that lead was easy to work with and less expensive than using iron. Concerns for lead poisoning began in 1859, but it was not until 1920 that efforts were ubiquitously taken to restrict their use (Rabin, 2008).

Until 1967, Flint was treating and using their own water from the Flint River; at this time the city decided to begin purchasing their drinking water from the Detroit Water and Sewage Department due to a growing population and the burden it was to bring their water to standard due to manufacturing plants contaminating the river. Local water was kept as a backup and was treated but neither with consistency nor the frequency necessary to be considered ingestible. This went on for forty-five years; meanwhile, the city was no longer as profitable or populated as it used to be. In an effort to save money, the City of Flint decided to join the “Karegnondi Water Authority,” which would enable them to build their own pipeline to Lake Huron instead of buying that same water from Detroit.

At this point in time the city had clean water and no major problems; the upcoming decisions would be the turning point for Flint. The options were as follows: continue their contract with Detroit, which did not have a short-term option for when their pipe was completed, or treat the Flint River water at their own treatment facility. Because they were unable to receive a shortened contract, the city leaders of Flint made the executive decision to use their local water source until the pipeline work was completed in-spite of community outcry. Almost immediately there were concerns over the water’s taste, color, and odor along with an increased number of rashes particularly seen in children. Along with the physical manifestations, there were reportedly large numbers of water main breaks, and companies complained of the corrosive nature of the water damaging their equipment.

In the summer of 2014, there were also numerous alerts for the citizens to boil their water due to elevated rates of E. coli. Due to these problems, an evaluation was requested in September, 2014, and the leaders of Flint were notified that they were in violation of the Safe Drinking Water Act.

In 2015, one sample of water was taken from a residency and found to by high in lead; later that year more than 100 samples had been analyzed, and 20% of them were above the action level for lead. In September of 2015, a team of pediatricians published their data, proving that blood lead levels in the children of the community had increased exponentially after switching water sources in excess of 2.5 times. This data forced the city to conduct sampling for lead and copper which proved high and prompted the city to switch back to the original water supply of Lake Huron only 1.5 years after the original switch.

The treatment of water has a variety of applications and does not have a universal standard. The treatment needs for different bodies of water are different and can fluctuate in different seasons. This was the case with the Flint River; the treatment needs were complex and fluctuated based on rainfall. Testing is recommended for corrosivity and corrosion control when switching water sources. It will come as no shock to anyone that this testing was not conducted and because their water treatment facility had not been used in half a century, the plant was understaffed and undertrained. The reason is unknown, but during treatment of the Flint River the use of an anti-corrosion agent was not used. At baseline, this water was found to be highly corrosive, which in turn deteriorated the pipes and caused the iron and lead levels in the water to reach toxic levels along with causing the reddish color of the water. Moving forward, the objective is to replace all the lead pipes in Flint. Even with this course of action, Flint still has a long journey ahead to overcome this disaster (Masten, Davies, & Moelmurry, 2016).

Leading in Flint, what went wrong?
In many ways, the leadership traits displayed during the Flint water crisis can be used as a guide of what not to do. Reputations were ruined, charges of involuntary manslaughter have been made, and the governor of Michigan, Rick Snyder, called this disaster “a failure of government at all levels” (Carravallah & Woolford, 2017). The first instance that can be attributed to poor leadership was the initial change from Lake Huron water to the Flint River; this was done despite community outrage by the emergency manager after the city was pushed to bankruptcy. After the switch, in an effort to dispel fears over the drinking water, a press release came out stating that testing had been done and met drinking water standards; even the mayor made a statement touting the normalcy and purity of the water (Kennedy, 206). The Press Release was meant to assuage the fears of the community, and at the time it could have, but in hindsight the spirit of this statement was proven untrue, and instead instilled a deeper distrust of government leaders in the community.

One of the definitions of a good leader is bringing individuals together towards a common goal, in this situation there was discord and the goal of either party were not shared by the other. The leaders only thought, so it seems, was to cut costs, and the most impactful way to do that was ending the water agreement with Detroit. The whole disaster would have been averted if the city accepted the longer water contract, or if Detroit would have compromised on a shorter commitment. The citizens on the other hand had a top priority of safe drinking water for themselves and their families. The leaders did not take the communities priorities into account and instead relied on their own objective which ultimately caused the public health crisis. If the city had either been able to negotiate a shorter contract with Detroit to provide water to Flint, or accepted the longer contract, the whole crisis would have been avoided completely.

There was continuous evidence of the defects in the water, one of which was the elevated instances of bacteria which prompted the multiple times citizens were advised to boil their water before consumption. There was also the instance when General Motors would no longer use the water on their machine parts for fear of corrosion. Eventually the city was found to be in violation of the Safe Drinking Water Act, and in light of that information, the state chose to buy bottled water for their employees. Each occasion was an opportunity to prompt further investigation into the water, which would have decreased the extent of the catastrophe. As previously discussed, the first step to managing a crisis is the attempt to predict a crisis. If you can see it coming then you are one step ahead for finding a solution; in this case the warning signs went unheeded.

Eventually concern for lead was brought into play due to a memo leak, which is one of the worst ways that information can be divulged to the public from a leadership point of view. Concern for elevated lead levels were denied, even after a team from Virginia Tech sampled hundreds of home water lead levels and their preliminary data found disturbing results (Kennedy, 206). A team of pediatricians eventually shared the data with the press? that the instances of elevated lead levels in children had doubled since the water switch. These findings were still dismissed by authorities, but at this point in the narrative the knowledge of contamination gained traction, and the City of Flint finally released a lead advisory warning to the community. Very quickly afterwards, the community was provided with water filters and the water supply was switched back to Lake Huron.

During this time elections for city mayor were in process and the current mayor’s opponent ran on the platform of fixing the water crisis. She eventually won and declared a state of emergency over the elevated lead levels. Below is an abbreviated list of points that led to the crisis:

• Regulating lead pipe use for main water
• Failing to negotiate a contract and switching to Flint water
• Inadequate water treatment, inadequate training
• Ignored community concerns
• Inadequate testing
• Failure to accept other test results

Managing a Crisis
(1) Pre-Crisis Planning/Signal Detection
How can effective managers and leaders plan for or be prepared for a crisis? The objective of pre-crisis planning is instilling a course of action with the goal of circumventing or minimizing the effects of a crisis; allocating resources and responsibilities before encountering a disaster will free up time in the acute phase of a catastrophe. Due to the introduction of different factors in every situation, it is impossible to take every circumstance into account. Some examples of different factors include: Leadership style, proclivity to accept help, individuals involved and their temperament, among other unaccounted factors. There is evidence to suggest that planning for a crisis does hold an important role in crisis resolution by providing direction and a sense of familiarity in the individuals involved, it does not mean that the crisis will go remotely as planned or well (Eriksson & McConnell, 2017). It is important to remember that flexibility and improvisation is an important part of any disaster plan, as much as following the plan is reassuring, there is a place for creativity (Eriksson & McConnell, 2017). It is important to be observant and look for the tell-tale signs of a disaster waiting to happen. Obviously not every crisis has warning signs, but many of them do, and a leader can get ahead of the problem if they are willing to acknowledge that something is wrong.

There were several warning signs during the Flint water crisis: community dissatisfaction, disgruntled individuals, water color, General Motors changing their water source for their factory and citing corrosion, multiple water boiling warnings.

An important aspect of leadership is communication and listening to others, especially when a large group of individuals are worried about the same thing. In the Flint water crisis, there was a large community who was unsatisfied with the situation that was unfolding. Instead of taking their concerns seriously and doing their due diligence with regards to water safety, the community was plied with assurances without any substantive acts or behaviors of leaders.

(2) Acute Crisis
Clearing the health catastrophe is the primary and most important objective once the issue is known. It is important that a leader is fluid and does not double down on outdated or ill-fitting procedures during this time, as it is a time of change (Heifetz, Grashow, & Linsky, 2011). Effective leaders in this situation are ones who look towards the future and develop long term fixes in increments over time. It might be hard but embracing this time of crisis to reevaluate and gain momentum for policy change can help to get through the acute phase and after effects of the crisis (Heifetz, Grashow, & Linsky, 2011).

When test results were finally released and pollution levels of Flint drinking water were discovered, it was a turning point from pre to acute. Leaders initially gave out filters to the citizens, which rapidly progressed to bottled water as a means to revert back to normality. During this time, city appointed officials were up for re-election and the current mayor was not voted back into office. It is worth noting that his opponent ran on the basis of providing clean water to the city.

(3) Chronic Crisis
After the acute phase of a crisis is over, the initial concern for public wellbeing is at an end, and normalcy is tentatively reached, the next step is to provide damage control, specifically, the reputations of the leaders involved during the disaster. There are certain policies that can be put into place to make this endeavor much easier, and the most effective is crisis communication.

The reasoning behind putting time and effort into honing this particular protocol is that if good crisis communication occurs during the disaster, then it will be easier in the aftermath to come out with a more reputable character than if communication is not adequately used. This is due to crisis communication being the act of managing information and meaning; this includes the endeavor to manage perceptions of the disaster and the act of disseminating information to the public. Due to the unorganized nature of a crisis, the means by which communication is propagated differs per instance. There are different variables that can be applied to the eminent crisis which will better aid efforts in determining how to communicate effectively while keeping reputations intact (Coombs, 2008). This is the most damaging error in leadership that Flint leaders made during this crisis; there was no crisis communication. The leaders’ simply spouted assurances that fell on disbelieving ears. Due to the “doubling down” that was done in proclaiming that the water was okay, once the testing came out, that there were high lead levels the leaders were publicly shown as having been dishonest to their constituents.

(4) Learning
Within the leadership organization, once a crisis is over and before it is forgotten, some questions need to be asked and the answers thoughtfully considered. The primary inquiry to be made is “How can we use what happened?” or “What can we learn from this catastrophe?” The objective is to either prevent or minimize a future disaster with the information that can be gleaned from preceding events, such as instilling into practice new procedures. It is also important at this time to take into account the practices that worked well, for instance the timely response to a crisis or managing it in such a way that reputations were not ruined (Crandall, Parnell, & Spillan, 2013). There is usually resistance in learning from a crisis. This is typically due to different narratives as to why the crisis occurred and the culpability that is taken with the introduction of process change. Different types of learning can present. These approaches are called; learning as crisis, learning for crisis, and learning from crisis. Learning as crisis is the concept of a crisis happening which shakes your belief and makes you question other aspects. The example is given of Dr. Shipman in the UK who killed his patients. This was unheard of and individuals started seeing rogue doctors where there were none. It provided the momentum necessary to look at different sectors and inadequacies in thinking. The same with a hurricane, which due to the evacuation order, left thousands stranded on highways due to gas shortages. Learning for crisis is the act of taking cautionary steps to prepare for an eventual crisis, preparing the necessary individuals on what to do when crisis occurs. Some criticisms to this approach are the lack of urgency that is adopted from not being in a crisis, and which translates to less of the pre-emergency steps having secure foundations in an individual and the industry at large. Learning from crisis is the point where more crisis plans are implemented, which is after a crisis. The major role during this implementation is to investigate and get to the bottom of why the catastrophe occurred; too often analysis is superficial and only small aspects are recognized as at fault. Criticisms of learning from crisis is that individuals are too busy, tossing blame that no one is ready nor willing to accept that their processes need to change.

During this time of crisis, city appointed officials of Flint were up for reelection and the current mayor was not voted back into office. It is worth noting that his opponent ran on the basis of providing clean water to the city. The new leadership learned from their opponents’ mistakes and were resolved to fix the issue in Flint, or at the very least to provide clean water. The same problems occur in learning from a crisis that we previously discussed, scapegoats were chosen and blame kept getting pushed aside. In conclusion; scapegoating, failure to own responsibility, and root cause failure are three aspects that provide challenges to learning from a crisis (Smith & Elliott, 2007).

Reform after a crisis
After a crisis, either normality is reached or there is a new normal, and either way certain things will need to change. If things are reverting back to normal, then policies need to be put in place to prevent a similar disaster from occurring again, practices need to be looked into, and an investigation for the root cause of the crisis needs to be discovered so policies can be changed. Because a crisis can be the basis of reform, leaders need to be knowledgeable about the intricacies of long lasting reform and the balance between policy progress and crisis containment. Crisis and leadership go hand in hand, when times are uncertain leaders are looked to, to establish normalcy and safety.

The “crisis reform thesis” advocates that a crisis provides an opportunity for reform which leaders can exploit to gain approval for differing policies and practices. In the article “Public leadership in times of crisis, mission impossible?” the argument is made that “the requisites of crisis leadership are at odds with the requirements of effective reform” (Boin & Hart, 2003), stating that when a crisis is occurring there is pull for change but often the foundation is lacking to make the effects long term. This often causes the policy to flounder and produces criticism for the leader down the road, reform needs to be founded on a base of supporters without skipping steps; this provides the leader with more credibility and results in the reform being more likely to meet intentions (Boin & Hart, 2003).

Due to the leadership mistakes that were made, the key objective for the current leaders is to regain that trust lost after the overwhelming lapse in judgement for which the citizens of Flint Michigan paid the cost. The water crisis in Flint was and is a terrible public health failure, but through that unfortunate disaster, some good can be scavenged. The unique circumstances of this city provide researchers with a very good opportunity to study the effects of lead and other topics that are not generally problematic in our first world society; however, the citizens of Flint are unwilling to trust outsiders and individuals that they see are out there to gain from what happened to them. There is a chance to put this populace at ease in order to study the community researchers instilled community level ethical protections, and not only IRB processes, that helped the population feel more informed and pull the citizens together. Currently the City of Flint has a Community Ethics Review Board which is led by local residents. In addition, they have partnered with the Healthy Flint Research Coordinating Center which is in charge of vetting research studies for this community (Key, 2017). There are a variety of approaches that can be used in measuring “crisis management” including the Crisis Impact Scale which is discussed next.

Crisis Impact Scale
The crisis impact scale is a model which forecasts the level of a crisis, taking into account different variables and the weight that is put on them. This allows customizability in the scale to better suit the circumstances of each individual case. These factors include; intensity escalation, media and/or government scrutiny, effects on the operation of the organization, the image of the business/community, and financial effect. The scoring for each variable is from 0 (low risk) to 10 (high) and these numbers are then added together and divided by the number of factors applicable to the impending/present disaster. The closer the score is to 10, the worse the crisis. The ability to forecast a catastrophe does not mean we can predict a crisis or the outcome; most of this knowledge is used to “type” a disaster, be it Economic, informational, physical, human resource, reputational, psychopathic, or a natural disaster (Rowitz, 2014)

The crisis impact scale would have been a good start for leaders in Flint to have used when the warning signs of a crisis began to appear, with the design to ensure the continued service of their leadership to the citizens of Flint. Using the crisis impact scale along with a firm crisis communication protocol at the very least could have circumvented the more egregious leadership failures and diminished the scope of the crisis. In addition to measuring critical aspect of ‘crisis management’, there are leadership principles, practices, and theories that might help us understand what leaders in Flint could have done differently – we examine a few of these next.

Distributed Leadership
When talking about leadership the dialog used to focus on the actions of a single person and the outcomes of their action can be either negative or positive. Leadership theories, such as trait and charismatic theories, focus on the leader and their qualities with the assumption that when a leader acts, but resigns the followers to be ‘reactive’ (Northouse, 2015). In leadership research today, both actions of the “leader” and the “follower” are important to analyze, as the reaction shapes future actions that the leader will make (Chatwani, 2017). Distributed leadership tends to increase the impact of organizational development. When this type of leadership is in effect, cultural and social barriers tend to be diminished which enables the organization to be more fluid (Harris, 2009).

Complicated clinical situations that lead different specialists to merge their training in an unorganized and uncommon situation have different leadership needs. In predictable cases, specialists can almost work in solidarity without interference or help from other specialties; once the situation becomes unstructured, the need for distributed and coordinative leadership is in effect. Distributed leadership is the process of taking the responsibility of different roles. In the case of surgery, different physicians would be in charge of different organs. This still provides challenges, such as combining the differing functions into a united combined effort. Differing specialties proved useful in aligning roles easily based on usual functions outside of a crisis. This is unfortunately not the case when one or more of the individuals are not an attending but rather a resident. In this scenario, seniority does matter; it is understandably difficult for the resident to take charge of a situation even when their specialty correlates more directly with the skills needed over the other senior staff. “Transitions of leadership should occur after critical situations have subsided, never within it, or when one’s expertise is surpassed.” This reinstates that leadership is generally static but is adaptable to becoming fluid (Paquin, Bank, Young, Nguyen, Fisher, & Nugus, 2017). Distributed leadership is recognizing that different individuals have different strengths and weaknesses and choosing a leader for a task based on the skills most needed at the moment. Some criticisms for distributed leadership are that it muddies the responsibilities of individuals and there is no clear order, it can also enhance the problem of competing leadership styles (Harris, 2009)

What happened at Flint can be described as distributed leadership gone wrong. Due to the bankruptcy of the city, the power was placed in such a way that individuals who would help solve the monetary problem were placed in control. With too much emphasis being placed on cost savings, this allowed other areas to be silenced and resulted in a more lenient stance on regulations. If distributed leadership had been used effectively, it would have still put an emphasis on cost saving leadership, but it would not have been the most important aspect. Other individuals would have still used their leadership capabilities to search for warning signs, implement the crisis impact scale, and create a crisis communication chain. It would not necessarily avoid the crisis, but it would help with the cleanup.

Adaptive Leadership
Another leadership style that can be applied very directly to a crisis situation is adaptive leadership. This style helps leadership organizations flourish in changing times. Crisis can be termed an “adaptive challenge;” it demands improvisation and experimentation that have not been needed previously. This is partly due to the progress we are seeing both societally and technologically. Adaptive leadership has been defined as leaders promoting adaptability in their followers, the attention is placed on how the follower responds to problems (Northouse, 2015). This leadership tactic has the leader mobilizing individuals to solve problems on their own, giving them the resources necessary to succeed. There are four different viewpoints in the process of adaptive leadership: systems, biological, service orientation, and psychotherapy perspectives (Northouse, 2015). The systems perspective is the assumption that a problem has many different sides to it, and they also have the ability to change and connect to different things in unknown ways. Biological perspective is the recognition that individuals evolve based on the need for adaptation, both from internal stimuli and external. Adaptive leadership has a service orientation; the critical part of this leadership style is the ability to empower individuals to confront complex problems. Part of empowering individuals is being available and giving guidance and resources as needed. They psychotherapy perspective is the understanding of how individuals best overcome problems, by facing them directly and being able to distinguish between real and imaginary dilemmas and learning new ways to conduct themselves during problems, and to resolve conflict (Northouse, 2015).

The most important aspect of adaptive leadership is diagnosing a problem; usually individuals are so wrapped up in fixing the problem that examination of the root cause gets pushed aside. According to Heifetz et al., leaders need to separate themselves from the activity to be able to diagnose the challenge. The second step in this process is to determine if the issue is ready to be addressed. If a crisis is occurring, automatically assume that people are ready for change. Though in a pre-crisis phase not everyone will see the problem and it can be difficult to create the adjustment necessary to avoid a disaster. Third, leaders should understand what perspectives or biases they may bring to the crisis. People who have worked closely with someone or know them well can expect certain actions in different circumstances, changing things all at once can have unanticipated consequences. Fourth, determine how to dispel the information. Give clarity to why this adaption is important and how things will change, this gives shows that thought has been put into change on every level and enables followers to anticipate the impact this latest change will have one them. The last step is to give the initiative time to work; change is not easy for a lot of people, and it generally requires an interval to get ready and then make the adjustment (Heifetz, Grashow, & Linsky, 2009).

In conclusion, leading during a crisis is a fundamental aspect of leadership, and the consequences of poor leadership decisions can have devastating effects on populations. There are ways a leader can facilitate their organization to mitigate a crisis or avert it completely. The most important component in averting or mitigating a crisis is the ability to see a catastrophe coming, watching for signs and recognizing them as they appear is crucial. The crisis impact scale can provide a general idea of how to manage the incoming/ongoing crisis depending on which variables (organization image, public scrutiny, reputations, etc.) are most important to the organization. If a crisis occurs that cannot be avoided, implementing a crisis communication protocol will aid in all phases of the disaster, particularly in salvaging reputations. There are leadership styles that do work best during a crisis; distributed and adaptive leadership styles both have their roots in empowering individuals to play to their strengths.


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Leadership in Healthcare and Public Health Copyright © 2018 by Kara Colvell is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.