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5 Key Elements of Resilient Systems: Where Life Sciences and Homeland Security Intersect

“How an institution responds to a variety of crises…is one of the most challenging and consequential aspects of leadership.  Understanding what a crisis is, when you are in it, and what skills are needed to manage through it is an essential skill for government and private sector leaders.  To understand crisis response takes more than skills in communication, leadership or incident command; though necessary, it also takes an understanding of the complex political, regulatory, international, ethical, and legal regimes that govern the incident and the skills to manage these different and sometimes conflicting concerns… This course will provide to all students a deeper understanding not merely of the mechanics of crisis response but how the law, politics, and policy empower and hinder our capability to respond.”

This is the course description for “Mitigating and Managing a Crisis”, a class offered during my final semester of obtaining a Master of Public Health at the Harvard TH Chan School of Public Health.  I was looking for something different from my typical purview of hospital management, payment systems, and healthcare innovation – a foray into the world of crisis management seemed like a fun twist to add to my transcript.  Better yet, the instructor, Juliette Kayyem, was an author, mother, entrepreneur, CNN analyst, and former Secretary for Intergovernmental Affairs in the Department of Homeland Security for the Obama Administration.  Neat!  It was January of 2019 when I hit “enroll” on my registration portal – little did I know that 12 months later, humanity would be gripped by a global pandemic, and industries across the planet would be frantically reworking operations and activating incident command units to adapt to a profoundly challenging new environment.

Professor Kayyem’s class was fantastic, and the best academic diversion I’ve taken – her expertise was as humbling as her expectations were high.  When I turned in my final exam for Professor Kayyem’s class, I’d also just accepted a job as a management consultant in the life science industry with Halloran Consulting Group.  In that moment, I could have never predicted that one year later I’d be sifting through my notes from class in search of frameworks and guidance to help Halloran’s clients persist through the COVID-19 crisis that humanity is working to mitigate.  Turns out there’s much about how the Department of Homeland Security approaches managing attacks, hurricanes, oil spills, and cyber threats that can be applied to how clinical operations manages drug and device development both on an organization-level and on a trial-level; especially when it comes to building resilient systems.

Resilience is “the capacity of social, economic, and environmental systems to cope with a hazardous event or trend, disturbance, response, or re-organization”.  Systems are the processes, procedures, expectations, and norms that, when integrated effectively, keep an organization humming.  Based on her pivotal role managing the H1N1 pandemic and the BP Oil Spill, as well as her experience with the National Commission on Terrorism (among her many other formative career highlights), Professor Kayyem highlighted Five Key Elements to Building Resilient Systems, which I see as directly translatable into the life science industry.

  1. Redundancies: Identify your system’s “points of failure” and determine how you can protect them or back them up.
  2. Flexibility: Design flexibility into background systems to facilitate quick response and deep recovery.
  3. Fail-safe: Assume there will be another disaster and build processes with an eye toward minimizing the harm of the response and stopping cascading losses.
  4. Ability to rapidly rebound: Develop systems that can help you return to regular operations as quickly as possible after downtime or interruption.
  5. Commitment to learning: Assume there will be another disaster, learn in real time, and have the discipline to iterate on the rebuilding process to continue to improve response.

Infectious disease and epidemiological insights indicate the unfortunate reality that the novel coronavirus will continue to challenge the life science industry for the foreseeable future.  Thus, our call to action is to build resilience into our processes, systems, and infrastructure to enable our response to inevitable “spikes” in case load.  It’s only once we design this agility into the fabric of our organizations that we’ll be able to continue doing the work of developing life-saving therapies for patients in need.  The table below translates the 5 Elements of Resilient Systems from a Homeland Security context to a life science company context.

Elements of Resilient Systems
Life Science Organization-Level Applications vs. Clinical Trial-Level Applications

  1. RedundanciesLife Science Org:
  1. FlexibilityLife Science Org:
  1. Fail-safeLife Science Org:
  1. Ability to rapidly reboundLife Science Org:
  1. Commitment to learningLife Science Org:

Furthermore, what makes the life science industry unique is the monumental importance of empathy.  Our “customers” are patients managing illnesses or conditions that are, or could ultimately be life-threatening, which has brought patient-centric care to the forefront of clinical operations.  Industry has faced challenges incorporating the patient perspective into our decision-making process, but our environment during the pandemic has demanded an even more heightened sensitivity to patient needs and experiences.  I’m hopeful that an up-side to COVID-19 will be the ability to truly join the mechanics of business process with the humanity of empathic understanding.  For that reason, I’ve added empathy as a 6th pillar to Professor Kayyem’s Elements of Resilient Systems.

  1. EmpathyLife Science Org:

One of the most valuable lessons that’s come out of the COVID-19 era is the importance of recognizing that seemingly unrelated disciplines can be united by crisis.  We can choose to see this as a sad reality, or we can choose to be inspired by the innovation and collaboration that the pandemic environment has fostered.  Translating the Key Elements of Resilient Systems from a Homeland Security context to the life sciences highlights the importance of identifying opportunities to look outside our own industry for innovative solutions to challenges we sometimes mistakenly view as uniquely ours.  Let’s just say I’m glad I paid attention in class.