5 Lessons From the ER That Could Help Save Your Company During a Crisis

Aug 14

This doctor's tips could help restore order to your business -- and maybe even give it new life.

The virtues of the humble "routine" may seem antithetical to the risk-taking nature many entrepreneurs pride themselves on. But our tendency toward the predictable may not just be comfort food for the brain — it's a foundation that could save us in crisis moments.

Without a doubt, humans are creatures of habit. We're hard-wired to opt for safety and tend to create an established, daily routine at every life stage. This is what Dr. Iscovich, my co-author of The Art & Science of Routine, calls a "time bubble" — a mental barrier between the world and the individual made up of our daily activities.

Iscovich contends that routine is a pathway to high performance. Whether it's hitting the treadmill every day at 6:20 a.m. or clearing our desk once per quarter, he says humans perform best when our lives possess consistency and structure. Likewise, repetition, the sister of routine, allows us to do everything from perfecting our elevator speech to keeping our cool in high-pressure situations.

And Iscovich's knowledge of maintaining balance in the face of upheaval comes partly from his own experience. The former emergency physician served as CEO of EmCare West, a multimillion-dollar emergency medical care organizations. In his view, in some ways the business world isn't so different from the ER. A certain level of structure and commitment can also keep companies from the brink — whether it's hemorrhaging money when stocks plunge or facing down bankruptcy. As smart business professionals, we can prepare for the chaotic and unexpected.

Here are five insights from Iscovich to help ensure your company thrives in times of uncertainty and crisis.

1. Insist on decorum and mutual respect.

According to a study published by Clear Review, 40 percent of employees say they don't feel appreciated. Civility, not to mention kindness, may be cultural norms threatened in the social media era, yet according to Iscovich, such etiquette observances are critical in times of crisis. "We must focus on the mission and respect every one of the team members' input at all times," he says. "Yes, we may encounter momentary catastrophes, but our shared values and our mission are not momentary."

Makes sense, right? When everyone is working toward the same goal, there's a cohesive team mentality instead of one of rogue individualism. It's interesting to note that when the brain is in the grips of fight or flight, we slip into survival mode and become super egocentric, incapable of compassion or empathy. Yet according to Iscovich, you can calm everyone in the room and increase team spirit by speaking to the group instead of singling out individuals, keeping the bigger picture in mind instead of getting lost in the details.

Just look at Starbucks CEO Kevin Johnson's reaction to the 2018 incident that unleashed a viral media storm. At the time, two African American men were arrested at a Philadelphia Starbucks because the manager said they didn't purchase beverages. When news of this event broke, it unleashed a torrent of public anger about the subjects' mistreatment. Acting quickly, Johnson employed Starbucks' shared values of responsibility and accountability. Recognizing the need for mutual respect, he issued a public apology and created seminars to standardize practices for equitable treatment. He even gave thousands of employees the day off to complete special training. And as of this writing, Starbucks' stock has soared in the last three months and reached an all-time high close on July 26, 2019.

2. Enforce a distinct and recognized chain of command.

"One voice must rise above the chatter to quickly deliver a targeted message in times of insanity," says Iscovich. According to him, order is not democracy in times of crisis. Having one uncontested leader is imperative, he says — and if that leader is you, you must own it.

"One of the greatest errors is just to delegate to other executives," he adds. "Problems exacerbate when leaders don't say, "Hey, I'm in charge here. The buck stops with me.'" Iscovich acknowledges such authoritarianism may be unwelcome in less challenging times, but it can help instill stability when an individual — or organization — is under attack. A team may create more chaos with loud, impassioned opinions when only one measured voice could suffice. Keep your team focused on what needs to be done and predesignate a speaking hierarchy. This preemptive routine can help ensure tasks are executed quickly and efficiently.

3. Remain calm and mindful.

"We can prevent hysteria by focusing on the breath," says Iscovich. "Stress increases blood pressure, leading to shorter breath lengths. These send panic signals to the body. It's a vicious cycle that can spiral out quickly, putting us in survival mode and cutting off the prefrontal cortex, making good decisions impossible." Similar to the way cardiovascular exercise can improve ability to handle physiological stress, organizations can strengthen their "calm" muscles to keep the hive mind centered when danger threatens. Just as mindful, diaphragmatic (belly) breathing can be our best ally in crises, so too can a self-prescribed response yank us back from flying off the handle.

Focusing on regular responsibilities and developing a crisis time bubble can also be beneficial to getting groups to the point where following coping mechanisms feels second-nature. Why does this matter so much? When things get hectic, Iscovich says people tend to abandon what they're doing and focus on the fire. But in times of crisis, it's often best to stick with what you know. Following protocol allows the collective "brain" in the room to relax into familiarity, lowering blood pressure and reducing tension. To further mitigate stress's deleterious impact, it can be helpful to identify stress points. It's also helpful to pay attention when stress begins mounting in order to take a moment away. "Excuse yourself," advises Iscovich. "Gain some objectivity so you can address your colleagues in a calm fashion. This is particularly needed if you're a leader, as it allows you to lead in a nonoverly emotional manner."

Related: 50 Rules for Being a Great Leader

4. Don't sweat the small stuff in times of crisis.

Iscovich recommends getting clear on the essence of an emergency. His high-stress trauma unit dealt with emergencies and kept calm by way of committing to the concept of triage: Handle the most urgent concerns — the core problem — first.

Another example: When leading one of his own companies, Iscovich says he experienced a bleeding of profits that led to a poor third quarter. Not too long after, it became evident his organization was heading to the danger zone. "To fight the crisis, we developed an operating procedure — a new routine. We established a war room and went to the heart of the situation, which in this case, was collections. You really have to focus on the core, the vital signs of a company, to keep it healthy when the inevitable calamity strikes." Along these lines, Iscovich recommends not wasting time considering down-the-road possibilities when your company is plummeting. Focus on taking care of what's right in front of you rather than allowing yourself to be distracted by future possibilities.

5. Develop standard-ordering procedure (SOP) to keep the wolf from the door.

Fear often stems from uncertainty. But entrepreneurs are used to experiencing fear and taking action anyway. Still, there are ways to mitigate the unknown, including making a cultural choice to learn from and incorporate each crisis into an ongoing, company-wide standard operating procedure (SOP). "When we draw from precedent, we have a context to work from," says Iscovich. "By establishing routine, future events don't feel so overwhelming."

For example, Marriott's 2018 data breach, the second-largest in history, is a teachable moment. Generating a set of best practices for facing a crisis, and hosting debriefs after the worst is over, can better arm an organization with coping strategies for uncertainty. "Marriott was proactive," says Iscovich. "They created a website providing credit monitoring and a call center to address consumer concerns. This digital trail is essentially a living SOP — a precedent that can be culled from in times of future crises."

Routine in times of crisis

Clearly, Iscovich recommends practicing routines and building time bubbles to stave off the exigencies of uncertainty. Even so, he allows for a degree of spontaneity to face the unknown. "Routine is important. However, even the best models don't always work well and don't fit all situations. If you're trying to apply the same analysis, statistical or otherwise, to every danger, you are bound to find cracks in your paradigm. It's best to have a solid game plan but also to prepare for multiple solutions and outcomes."

Undoubtedly, structure is necessary when the world seems to fall apart. It helps us stay grounded and in control. Yet every crisis is different. The best we can do is to prepare now in order to give ourselves a protocol for responding to life's curveballs.