Leading through Uncertainty in Public Health | Xavier Crockett | TEDxGrandJunction

Key Concepts

• RISE Framework: A leadership framework developed by the speaker over 15 years, comprising Resilience, Integration, Strategy, and Sustainability.
• Resilience: The ability to adapt and bounce back under pressure.
• Integration: Bringing people and resources together from different sectors to address complex issues.
• Strategy: Having a well-defined plan for operations, including logistics like food, shelter, and transportation.
• Sustainability: Creating systems and processes that outlive the individual leader and can be built upon by future generations.
• Unprecedented Uncertainty: The current environment characterized by complex medical emergencies, political polarization, eroding trust in healthcare, and the resurgence of diseases.

The RISE Framework for Leadership

The speaker, Xavier, a healthcare professional with nearly 15 years of experience in disaster and emergency response, presents a leadership framework he calls "RISE." This framework is built upon his extensive experience, particularly during challenging events, and is designed to guide the next generation of leaders.

1. Resilience: Adapting and Bouncing Back

• Definition: Resilience is the fundamental ability to adapt and bounce back under pressure.
• Personal Experience (Snow Apocalypse, Atlanta, 2014): Xavier recounts his first leadership opportunity as a young emergency responder during a severe snowstorm in Atlanta. Despite having only 1.5 years of experience, he was tasked with leading a team to decompress a hospital's medical and surgical floor. The situation was chaotic, with conflicting directives from dispatch, hospital administration, and the ED director. He admits he had "no solution and no system" but "did stand."
• Key Takeaway: Leaders don't just endure storms; they rise to the occasion and ideally bring solutions and systems.
• Real-World Application (Measles Outbreak, Mesa County): Xavier recently worked for 40 consecutive days responding to a measles outbreak, the first in Mesa County in 20 years. He highlights that their initial response plan had to change completely within 48 hours, requiring a larger team (24-30 people instead of 8-10) and significant adaptation. This demonstrates the necessity of being adoptable, not just resilient.
• Argument: Resilience is not just about bouncing back but also about being adoptable to changing circumstances.

2. Integration: Uniting for Collective Action

• Definition: Integration is the process of bringing people and resources together from various sectors to address complex challenges.
• Personal Experience (Hepatitis Cases, Georgia Jails, 2019): Xavier describes a surge of Hepatitis cases in jails, requiring nurses, who typically don't work in such environments, to conduct testing and treatment. He learned the importance of integration a year later when he was able to secure community nurses and supplies from EMS and hospitals to address the issue.
• Argument: Resilience is collective, not siloed.
• Real-World Application (Hurricane Sandy, 2012): Xavier recalls working in a shelter during Hurricane Sandy and witnessing unprecedented collaboration between housing, transportation, human services, and nonprofits to care for individuals holistically. This experience solidified his belief in integrating across the spectrum.
• Key Takeaway: Leaders embody integration, working collaboratively with all stakeholders.

3. Strategy: Planning for the Unforeseen

• Definition: Strategy involves having a comprehensive plan that addresses all aspects of an operation, from logistics like food and shelter to operational execution.
• Personal Experience (Post-Snow Apocalypse, 2015): A year after the "Snow Apocalypse," Xavier attended a briefing where he was impressed by the detailed planning that covered everything from where people would eat and sleep to how they would access affected areas. This level of strategic thinking profoundly impacted him.
• Argument: A lack of strategy, as experienced during the "Snow Apocalypse," is evident and detrimental.
• Key Takeaway: Leaders need to understand and implement robust strategic planning.

4. Sustainability: Building a Lasting Legacy

• Definition: Sustainability is about creating systems, teachings, and processes that outlive the leader and can be built upon by future generations. It's about ensuring that the impact of one's work continues.
• Personal Experience (Tornadoes, Central Georgia, 2023): Xavier, now in a state executive position, responded to a severe tornado event in Spalding County. He found the local emergency manager, Glenn, overwhelmed and unsure of the immediate priorities. Xavier guided him through established priorities: 1. Save lives, 2. Property/utilities/water safety, 3. Control and command.
• Real-World Application (Post-Tornado Response): Despite being away from his local team for a year, Xavier discovered that the systems he had helped establish were functioning effectively. The specialist he left in charge had, with the team, proactively acquired 14 mass casualty and shelter trailers, enabling them to set up shelters within an hour. This demonstrated that his efforts in building sustainable systems had outlived his direct involvement.
• Argument: The goal of leadership is not just to be remembered but for one's work to outlive them.
• Connection to COVID-19: Xavier states that the sustainability piece truly solidified during COVID-19. Initial plans crashed, forcing a complete rebuild and highlighting the critical need for adaptable and enduring systems.

Conclusion and Key Takeaways

Xavier's RISE framework emphasizes that effective leadership in today's complex and uncertain world requires:

• Resilience and Adaptability: The capacity to withstand and adjust to unforeseen challenges.
• Integration: The ability to foster collaboration across diverse sectors and individuals.
• Strategy: The foresight to plan meticulously for all operational aspects.
• Sustainability: The commitment to building enduring systems that benefit future generations.

Xavier concludes by stating that leaders don't need to be perfect but must "rise to the occasion when the occasion is there." The commitment is not necessarily to have all the answers but to be willing to find them.