SHIFTing the Mindset During COVID-19: Part 4 “Orchestrating Capacity”

Eileen Brown, co-author of Shift: A New Mindset for Sustainable Executioncontinues her blog series called “SHIFTing the Mindset During COVID-19.” In this week’s post she begins to outline the Shift-to-Execute framework, and looks at how we can build capacity in key areas to manage the current crisis.

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In the three previous installments of this blog I have provided some examples that illustrate the importance of structure, rhythm and awareness as key levers for execution. Now I will progress to our Shift-to-Execute framework that outlines an approach for orchestrating these levers in a series of four sequential adjustments or “shifts” to achieve desired outcomes: capacity, alignment, collaboration, and focus. This installment of this blog will focus on Shift 1: Capacity.

Before getting into the shifts, I need to highlight the need for orchestration of the levers within each shift. Inside the four shifts, structure, rhythm, and awareness will need to be uniquely balanced to appropriately address each situation, problem, and industry. Those immersed in the situation are best qualified to dial up or dial down each lever to find the right balance that allows them to execute the shift successfully. No two situations will require the same mix. In many cases, just being aware that there are three levers to adjust may help guide leaders in considering the complete range of appropriate actions to drive change.

Capacity

Capacity is about filling gaps. Everyone wants more capacity, especially during a pandemic – more healthcare providers, more ICU beds, more ventilators, higher unemployment benefits – but unfortunately there are limiting factors: skills, space, time, and funding to name a few. As such, these capacity-related decisions require trade-offs: do I have the space and the necessary staff to accommodate additional ventilators? How do we create the most capacity out of what we have? What adjustments can we make to processes and tools to realize efficiencies or involve more minds, without necessarily increasing the number of resources? This is what it means to orchestrate the levers to fill capacity gaps. Sometimes more of a good thing is not a good thing. For example, think of an orchestra: even when the brass and strings perform flawlessly, if the woodwinds are not up to par, you can’t get the best sound. It would be a waste of effort to ask more of the brass and strings until the woodwinds catch up in their performance, so that all sections can make balanced and incremental improvements together.

Structure: In building capacity, structure depends on getting the right resources at the right time to fill gaps. In dealing with the COVID-19 outbreak, hospitals have increased their ICU capacity in ways that are easiest and right for them – cancelling elective surgeries, relocating non-critical patients to alternate facilities, setting up tents in their parking lots, or re-purposing nearby conference centres and hotels into temporary hospitals. Squeezing more from the in-demand assets that you already have is critical to building capacity in the most efficient way.

As testing and contact tracing become more important in eradicating cases, provinces are creating job boards for workers experienced in this field to apply. Websites to solicit volunteer workers, foodbank donations and blood donor clinics have also proven effective. Just adding more resources may not fill the gaps effectively if they are not the right fit to the role. At the federal level, we see that the structure of the government’s emergency benefit program has already been modified several times to accommodate more Canadians’ needs. The website has also been modified to segregate applicants by their birth month in order to streamline their experience and reduce wait times.

The notion of capacity building is much easier to grasp when it applies to us as individuals. Many of us have had to modify our own support structure through the help of family or neighbours to get through the “go home and stay at home” order for non-essential activities. Essential stores have expanded their own capacity by moving to no-touch and curbside solutions and adding more time slots for pick-up to boost capacity, while balancing the number of available employees and their need to rest occasionally.

Rhythm: Healthy tension can serve to hone processes and fill gaps by eliminating waste without creating exhaustion or burn out. In a pandemic, this is a tall order when it comes to supplies and human resources due to the specialized nature of the healthcare skills involved. Andrew Cuomo, governor of NY used a rhythmic solution to fill a capacity gap by proactively establishing a new process for managing ventilator capacity, when it became clear there was a shortage and he could not get the numbers he might need. Rather than prolonging non-productive and contentious conversations among the governors to secure supply, his approach was to try and pinpoint the location of every potential extra ventilator in neighbouring states. First he got agreement from the other governors on which of their surplus ventilators he could earmark as his own and call for, if the need arose. He did not waste time and effort physically moving them ahead of his need. He saved space and costly transportation while building potential surge capacity. The process would also allow for the immediate release of his hold on these earmarked machines so they could be reallocated to future hot spots as the need arose. This approach made it much easier for all the governors to agree to participate as they did not have to give up immediate control over the machines. It was a dynamic method for pivoting to match ventilators to wherever the need became the greatest, rather than arguing about the greatest need in order to justify building their own physical stockpiles. Flexibility and responsiveness are characteristics of rhythmic solutions that allow organizations to build capacity by doing more with less.

Other examples of doing more with less are all around us: bank customers have taken on the role of the teller when they do on-line banking, and have a higher satisfaction rate in doing so. In the retail industry, customers are encouraged to place and pay for online orders and have them delivered or picked up at curbside. Self-ordering and check-out pushes some of the work to the customer and results in fewer ordering errors and greater convenience in many cases.

Awareness: Engagement is the third lever that can be pulled when building capacity. Though the daily news coverage on the pandemic is overwhelmingly negative, it is uplifting to see the engagement of over 5000 businesses rising to the challenge and becoming local sources of constrained medical supplies for Canada and the rest of the world. The local innovation and technology being applied to this global pandemic is staggering – every day brings new ideas, breakthroughs and unprecedented advancements. At the individual level, there are numerous volunteers stepping in on the front lines in nursing homes and care facilities where the staff has been infected with the virus.

The complexities that it takes to generate the necessary awareness and engagement to enable such radical changes on such a pressing timeline should not be underestimated. Goals must be socialized and valuated, and financial trade-offs must be assessed. Things are never quite as simple as they appear especially when it comes to processes and products that have tight specifications and stringent quality requirements.

In these worst of times, the best in people is rising to the surface in terms of their willingness to engage their minds, talents and actions. It will be this effort that enables us to be self-sufficient as a country in coping with the severity of this virus. Some may question the preparedness of our governments to deal with COVID-19, but if we look at what has been accomplished to build capacity – the engagement of our citizens, on a personal and professional dimension, and their ability to innovate and execute makes me prouder than ever to be a Canadian.

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Check in next week for Part 5 of the “SHIFTing the Mindset During COVID-19” blog series, where Eileen will be discussing drug trials and testing strategies.

Click here to find out more about Shift: A New Mindset for Sustainable Execution.