Leadership Through Organizational High Reliability During the COVID-19 Pandemic - Navy Medicine's Experience

ABSTRACT

Many of these required skills exist outside of what is traditionally taught in medical school.1 One leadership paradigm, the use of high-reliability organization (HRO) principles, is increasingly applied in several areas of medicine.2-5 The leadership of Navy Medicine found applying the principles and practices of an HRO to be of particular value in responding to the challenges of the current viral crisis. While many positive actions were taken in response to the outbreak and a great many medical personnel worked tirelessly to ensure the well-being of the crew and return the ship to sea, the ship did not leave Guam to continue on its mission until June 4, a little more than two months after the first case;nearly a quarter of the ship's personnel had contracted COVID-19. Deference to expertise was also demonstrated by bringing in public health professionals with the Navy and Marine Corps Public Health Center to work with the crew and the various Navy entities to determine which cleaning solutions worked best aboard the ship, how to reconfigure duty sections to reduce cross-contamination, and establish ways to reduce other disease vectors that could lead to reinfection of the crew based on available information at the time. Additionally, an outbreak investigation was conducted in coordination with the Centers for Disease Control and Prevention (CDC) to better understand transmission and characteristics of the disease.7 This study, published in the CDC Morbidity and Mortality Weekly Report, was one of the first scientific studies to identify the role that asymptomatic and pre-symptomatic cases played in disease transmission as well as the loss of taste and smell as additional symptoms not previously described.