Public Health Leadership in a VUCA World Environment: Lessons Learned during the Regional Emergency Rollout of SARS-CoV-2 Vaccinations in Heidelberg, Germany, during the COVID-19 Pandemic

Abstract

The purpose of this work is to share methods used and lessons learned during a comprehensive inter-institutional pandemic disaster response in Heidelberg, Germany, conveying experiences of the regional SARS-CoV-2 vaccination rollout campaign for up to 1,000,000 vaccines in the year 2020. In this volatile, uncertain, complex, and ambiguous (VUCA) environment, the following five strategic elements were pertinent for institutional arrangements so that specific contributions of the various project partners would be available fast without the necessity of extensive negotiations or information exchange: (1) robust mandate, (2) use of established networks, (3) fast onboarding and securing of commitment of project partners, (4) informed planning of supply capacity, and (5) securing the availability of critical items. Planning tools included analyses through a VUCA lens, analyses of stakeholders and their management, possible failures, and management of main risks including mitigation strategies. The method of the present analysis (VUCA factors combined with analyses of possible failures, and management of stakeholders and risks) can theoretically be adjusted to any public health care emergency anywhere across the globe. Lessons learned include ten tactical leadership priorities and ten major pitfalls.

Keywords: COVID-19; SARS-CoV-2; VUCA world; disaster; disaster management; disaster response; leadership; learning organization; organizational psychology; pandemic; public health; resilience; vaccination; vulnerable populations.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

SARS-CoV-2 vaccination disaster response actors’ diagram. There were four groups of players: (1) the political key stakeholders on different layers (yellow), (2) medical services and organizations (green), (3) public or non-commercial organizations (blue), and (4) private or for-profit organizations (orange). Centralized vaccinations were carried out in Heidelberg, Germany, and the surrounding region, i.e., the Rhine-Neckar district, and parts of the Neckar-Odenwald district and Karlsruhe districts covering a population of 750,000 to 1,000,000 potential vaccine recipients. Vaccine centers were supported by mobile teams in order to better reach vulnerable populations. CIMIC = civil–military cooperation.

Figure 2

(A) (above). Key stakeholder analysis and management. This analysis was conducted on two axes that correspond to power and commitment: “Impact on success” refers to the power of a particular player for the given project, while “supporting change” refers to the institutional will to contribute. The analysis at the beginning of the project was compared to the current situation, with the direction of change in key player management illustrated with arrows. Each player’s position prior to the project was mapped; the arrows show the degree of empowerment and motivation developed over time, mainly through leadership by influence. The vaccine task force set strategic goals; the district coordination team consisted of personnel from a number of offices within the district administration office. The team was made responsible for operational aspects, such as the orders of material and vaccines, as well as the general construction of the vaccination centers and the communication among the different actors. (B) (below). Risk management analysis.