JMIR Publications

ABSTRACT

Adaptive Leadership has become an essential skill for leaders in the health system to respond to the COVID-19 pandemic as new knowledge emerges and case rates rise, fall and rise again. This leadership approach has been described as an iterative process of taking a wide view of the situation, interpreting the meaning of incoming data from multiple directions, and taking real-time action. This process is also common in start-ups that try to create a new product or service of uncertain value for a consumer market that may not yet exist. Startups manage uncertainty through “Pivots”, which can include changes in the target group, need, features, or intended benefit of a product or service. Pivots are large changes to account for the high likelihood of getting something wrong, and distinct from the “tweaks” or small tests of change that define quality improvement methodology. This case study describes three Pivots in the launch of a remote monitoring program for COVID-19. Adaptive Leadership helped inform strategic decisions, with Pivots providing a framework for internal and external stakeholders to make meaning of large program changes to address shifting needs. As healthcare always has a lot of uncertainty, these strategies are relevant at any time and for all healthcare leadership.