May 1, 2020

HEADS UP! During Crisis: A Decision-making Checklist

Clinician Leadership | Leadership Development

Reading Time: 4 minutes

In the course of our coaching practice, one of the principles we discuss most frequently with our clients is the notion of the importance of “heads up” time. It is typical and natural for busy executives to spend much of their day in “heads down” time, attending to the important priorities and tasks at hand.  The danger, though, is that leaders spend too much time in that mode and fail to take important time to step back, assess the big picture, re-evaluate focus, and attend to the non-urgent but important long term initiatives critical to sustained success.

The metaphor we often reference in discussing this principle is a nature hike.  Out of necessity when hiking in unfamiliar and rugged terrain, it is important to stay “heads down” to avoid stumbling over roots, boulders or other obstacles.  But if one never pauses for “heads up” time to observe the big picture and take in the majestic beauty of nature, the focus, purpose and direction of the journey may be lost.

It seems particularly important, but difficult, to engage in this practice during the current crisis. With circumstances shifting so rapidly, so many issues to attend to, and extraordinarily long and stressful hours at work, it may seem counterintuitive to suggest carving out time and space step back. But that is precisely when it may be most critical.  It is imperative that leaders assimilate the fast moving information, avoid getting lost among the details, reassess focus and optimize resource allocation, and, most importantly, make thoughtful decisions.

In times like this, it is important to act with urgency, but not frantically.  As a colleague of mine put it, the goal is to move “thoughtfully fast.” Or in the word of the legendary UCLA basketball coach, John Wooden, “be quick but don’t hurry.”  The question is how to do that when things are so turbulent and time pressures so acute?

In those brief moments of “heads up” time it may be helpful to use a decision-making checklist, a concept akin to the pilot’s checklist used to promote aviation safety.  Here are a few suggestions on the items you may find helpful in constructing an effective tool:

Is this the right time to make a decision? 

We find that often leaders feel compelled to move to action on an issue if it happens to land on their desk but that compulsion may not always be a good one.  Consider whether it may be best to postpone a decision. Are there other, more critical priorities that should take precedence? Is more information needed?  Is time needed for emotions to cool down?

Have the key stakeholders been identified and engaged appropriately? Have their relevant requirements been addressed?

One of the quickest ways to derail a key decision is to fail to address key stakeholders impacted by the decision.  While it is true that in crisis it is not always possible to deeply engage those stakeholders in a decision, it is nevertheless important to be intentional about that choice and make every effort to anticipate and address the impact of the decision on those whose support for the decision is essential.

Has the relevant, “knowable,” data been gathered?  Is the decision is supported by the data?   

While it is important to not fall victim to overanalyzing urgent decisions, it is equally important to avoid relying exclusively on intuition when critical data can be gathered and taken into account in the decision-making process.


What assumptions have been made about things that are not “knowable” at this time? Have those assumptions been shared and has there been opportunity for others to challenge them? 

It is important and necessary to make assumptions about key factors for which there is little to no data or certainty. It can be helpful to explicitly capture and share those assumptions to provide opportunity for others to discuss and challenge them.  While the leader may have a solid grasp of the issues at stake, someone looking at the situation through another lens might offer critical insight that would otherwise be missed.

Has an effective implementation plan been put in place outlining the roles and responsibilities and providing necessary direction and support?

When things are moving fast, it is easy to overlook details necessary for effective implementation.  And with disruptive change, those affected often need a greater level of direction and support as they adjust to new roles and implement new processes. A brief pause to consider important implementation details can help to avoid derailment and rework that might otherwise occur.

Has the range of risk been identified?  How does that range align with the organization’s risk tolerance/capacity? 

Making decisions in crisis is certainly not for the faint of heart.  Risk is unavoidable, and the risk of not acting may be far greater than taking affirmative action.  It can be helpful, though, to develop an understanding of the magnitude of risk under different assumptions around key factors.  This sensitivity analysis can help enable the leader to be fully aligned with her/his stakeholders as the decision moves forward.

Have contingency plans been defined for alternative scenarios? 

 With unavoidable uncertainty surrounding key decisions, contingency plans that provide in advance for the organization’s response under different scenarios can be of great value. Should adverse developments occur, it can help to mitigate the damage that might otherwise occur.

Have relevant metrics been defined to track outcomes and prompt corrective action as needed? 

Closely related to contingency planning, it is helpful to identify the metrics by which the impact of a decision will be assessed. When actions are taken on the basis of important assumptions, it is critical to be vigilant should one or more of those assumptions turn out to be incomplete or incorrect so that corrective action can be taken promptly.  This is also a useful tool to help reassure those who held a different set of assumptions that should their point of view turn out to be what transpires, the decision will be adjusted accordingly.

With this simple set of questions, you may find that your “heads up” time is both more efficient and more effective as you move expeditiously through key considerations for moving forward.

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About the author

Robert "Bob" Porter, JD, MBA, PCC

Robert "Bob" Porter, JD, MBA, PCC is an accomplished organizational leader with over 30 years’ experience in health system leadership. Bob has extensive experience in working with senior leadership executives in complex organizational settings, with a proven track record for engaging diverse stakeholders in the redesign of organizational systems and processes to achieve breakthrough improvement in performance.

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