Running Head: CASE STUDY

Leadership and System Thinking

Case Study Analysis

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Group Case Study Analysis

Influenza pandemic is a public health issue of global concern dating back to several
centuries (Osterholm, 2005). One of the worst pandemic, the pandemic of 1918, came in four
different waves; the second wave being the most turbulent, causing tens of millions of death
worldwide (Wever & Bergen, 2014). The re-emergence and spread of human cases of H5NI in
2003 drew attention to the capacity of countries to detect and contain novel virus infections
(Muen, Kennedy, Chung, & MacDonald, 2013). An important factor in this ability is the
preparedness of public health leaders, as well as leaders of a host of other sectors, for a potential
pandemic that affects countries on a global scale (Osterholm, 2005).
Case Study: The Influenza Pandemic
Osterholm (2005) highlighted the possibility of a global influenza pandemic. This
pandemic, which could originate somewhere in Asia, will rapidly spread via international travel
to other countries and regions of the world, eliciting several chain reactions. Due to the
increasing number of people infected, countries will protect their vaccines and public panic will
ensure. Governments will place travel restrictions to control the spread of the infection, leading
to global shortages in needed supplies. Protective equipment will be in short supply in addition
to essential medicines for treating diseases. Health workers will be affected and some will die,
further worsening the pandemic (Osterholm, 2005).
The burden of influenza disease and related deaths globally will be a result of limited
production of influenza vaccine, lack of a national commitment to universal annual influenza
vaccination, and lack of adequate preparedness in preventing and controlling influenza
pandemics (Osterholm, 2005). For example, there is no plan for addressing staffing issues in the
event of an epidemic, and little or no plan to train health care workers during epidemics. Thus,

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there is little planning in health care delivery systems for the pandemic (Osterholm, 2005). In
addition, there is no ethical plan to identify who would receive the limited antiviral agents during
influenza pandemics as well as preventing shortage of production of critical items such as
antiviral drugs, masks for respiratory protection, or antibiotics for the treatment of secondary
bacterial infections (Osterholm, 2005). Furthermore, production and distribution of influenza
vaccine is inadequate both technically and financially (Osterholm, 2005).
To ameliorate these problems, there should be coordination among sectors, using the
systems approach, and the application of leadership theory that encourages allocation of
resources to followers for risk management and preparedness (Nahavandi, 2014).
Effect of Challenges on Crisis Response by the System and Individual Leaders
Various leaders within the system experience a myriad of challenges that affect crisis
response as individuals and systematically. Some of these challenges include communication
and interpersonal skills, prioritization, and motivating of followers (Nahavandi, 2014).
Individual Leaders
As individual leaders, these challenges potentially affect crisis response. For instance, a
Governor of a pandemic inflicted state, who has poor leadership skills, may find it difficult to
generate support from the multiple stakeholders needed to respond quickly to the pandemic
(Davey, 2007). As predicated by the Leader-Member Exchange Theory, in the absence of good
quality relationships with followers, followers will not be sufficiently motivated to take on
riskier tasks and heavier workloads to combat the pandemic (Nahavandi, 2014). The result is
that the Governor will be less effective in combating the pandemic, leading to costly loss of lives
and resources.
System

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As a system, leadership challenges also affect crisis response. Where leadership

challenges exist, the system will not function as a whole (Nahavandi, 2014; Osterholm, 2005).
For instance, local public health leaders in an affected state may not properly channel
communication relating to shortage of resources to responsible authorities at national level. This
poor channeling will worsen the shortages and demoralize health workers at the disease frontiers
(Osterholm, 2005). Also, disease control measures, if not well communicated by the Director of
the Centers for Disease Control and Prevention (CDC), will not be instituted on a timely basis at
local levels, leading to avoidable loss of life (Davey, 2007; Osterholm, 2005).
How transformational and Transactional Leaders Might Influence Outcomes
According to the National Governors Association (NGA; 2006), the fundamental
components of an effective pandemic plan are to: stress communication, intergovernmental
coordination, public education, health resources, curbing economic impacts, maintaining
essential services, using appropriate legal authority to stop disease spread, and training (p 6).
Transactional and transformational leaders perform these functions differently.
Transactional Leaders
In the case of health resources in preparation of a future pandemic outbreak, a
transactional Governor might seek to upgrade the manufacturing process of the influenza
vaccine, as the current method of vaccination production is outdated (Osterholm, 2005). A
transactional Governor, using a contingent reward approach, may implement a program with
manufacturing companies and supplement new production technologies with government
funding. According to Herper (2012), the cost to bring a new drug to market is approximately
$1.3 billion. Supplementing the development of new production technology with government

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funds could potentially reduce manufacturers research and development costs, which in turn
may keep the final cost of the vaccine at a manageable level.
Transformational Leaders
Similarly, preparation for a future influenza pandemic will need a transformational
Governor to address the issue of coordinating a strategy among multiple sectors using the
systemic approach (intergovernmental coordination; Davey, 2007). As indicated by the NGA
(2006), leaders must clearly define roles and responsibilities so that each participant in the
system is fully aware and empowered to act in a timely manner. A transformational leader
focuses on building relationships with followers by creating emotional bonds (charisma and
inspiration); challenging innovation and creativity (intellectual stimulation) and; developing a
relationship with each individual follower (individual consideration) (Nahavandi, 2015).
Considering this, instead of merely giving directives to the followers for implementation, a
transformational Governor would ensure that sufficient time is taken to meet with participating
sectors as a group, as well as individually, to assess the needs of each sector and formulate a
cooperative plan to supply the necessary resources (both tangible and intangible). A primary
objective of a transformational leader is to empower the follower by assuring them that they have
the capability to seek out new solutions (Nahavandi, 2015).
How Poor Leadership Might Affect the Outcome of the Influenza Pandemic
Poor leadership will adversely affect the outcome of a potential influenza pandemic
(Osterholm, 2005). In the first instance, planning and preparation will be inadequate and the
devastation from the pandemic, in human and economic terms, will be massive (Osterholm,
2005). The hallmark of ineffective leaders as outlined by Nahavandi (2014) include intimidating
style, coldness and arrogance, untrustworthiness, self-centeredness and overly political actions,

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poor communication, poor performance, and inability to delegate. Leaders who exhibit these
characteristics will find it difficult to motivate stakeholders to galvanize action to address the
pandemic. Response to the pandemic, therefore, will be slow and costly in human and financial
losses (Osterholm, 2005).
Conclusion
There is no doubt that an influenza pandemic will happen again (Danforth, Doying,
Merceron and Kennedy, 2010). However, it remains unclear when it will happen and what
would be its origin (Danforth et al., 2010. The roles of a Governor are limitless when the safety
of the people is concerned. With the governor`s authority proactive vaccination can be
emphasized because it is cost effective both in human lives and in resources (Snacken, Kendal,
Haaheim and Wood, 1999). To meet the overwhelming demand for care during any occurrence,
our current policies and procedures need to be re-visited so as to ascertain their sustaining ability
in handling any infectious outbreak (Osterholm, 2005). There should be a detailed operational
plan to manage, control and sustain the people for a very long period in the event of a sudden and
protracted outbreak (Osterholm, 2005). Vaccines production should be increased and more
antigen-sparing formulas should be developed to help boost human immunity (Danforth, 2010;
Osterholm, 2005). A proactive contingency plan, such as communication system, availability of
vaccines, first responders, and well-equipped health facilities to support other preventive
measures should be in existence. Good leadership at all levels that utilize both transactional and
transformational styles is required to bring this to reality.

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References
Danforth, Doying, Merceron & Kennedy (2010). Applying social science and public health
methods to community-based pandemic planning. Retrieved from
http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=57268830&S=R&D=b
th&EbscoContent=dGJyMNXb4kSeqLY4zdnyOLCmr02ep7dSs6m4SLWWxWXS&Con
tentCustomer=dGJyMPGss0q1qK5IuePfgeyx44Dt6fIA
Davey, V. J. (2007). Questions and answers on pandemic influenza. AJN The American Journal
of Nursing, 107(7), 50-56.
Herper, M. (2012). The truly staggering cost of inventing new drugs. Retrieved from
http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-ofinventing-new-drugs/
Nahavandi, A. (2015). The Art and Science of Leadership. (7th ed.). Upper Saddle River, NJ:
Pearson Education.
Moen, A., Kennedy, P.J., Cherry, P.Y., & MacDonald, G. (2013). National inventory of core
capabilities for pandemic influenza preparedness and responses. Results from 36
countries with reviews in 2008 & 2010. Influenza and other respiratory viruses 8(2),
201-208
National Governors Association [NGA]. (2006). Preparing for a pandemic influenza. A primer
for Governors and Senior State Officials. Retrieved from
http://www.nga.org/files/live/sites/NGA/files/pdf/0607PANDEMICPRIMER.PDF.

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Osterholm, (2005) Preparing for the Next Pandemic. The New England Journal of Medicine
352.18 1839-42 Retrieved from
http://search.proquest.com.ezp.waldenulibrary.org/docview/223936027?accountid=14
872
Snacken, Kendal, Haaheim and Wood (1999). Emerging infectious disease. The next influenza
pandemic: Lessons from Hong Kong. Vol. 5, No.2, Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640700/pdf/10221870.pdf.
Wever, P. C., & Bergen, L. (2014). Death from 1918 pandemic influenza during the First World
War: a perspective from personal and anecdotal evidence. Influenza and other respiratory
viruses, 8(5), 538-546.

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