Leadership cusp marlies van dijk april 8 2014 final

Leadership in CUSP

Marlies van DijkBC Patient Safety and Quality Council

Complex adaptive systems are composed of many interdependent, heterogeneous parts

that self organize and co-evolve.

UNPREDICATABLE - RESILIENT – UNCERTAIN

(and difficult to manage)

(Camazine, 2001; Kauffman, 1995; Allen & Varga, 2006)

Self-Organization

Self-organization is a process whereby local interactions give rise to patterns of organizing.

H.J. Lanham et al., How complexity science can inform scale-up and spread in health care:Understanding the role of self-organization in variation across local contexts. Social Science & Medicine (2012)

InterdependenciesOverarching term for relationships, connections, and interactions among parts of a complex system.

Pre-Intervention Post-Intervention

Lindberg, C., & Clancy, T. R. (2010). Journal of Nursing Administration

Sense Making

TECHNICAL

CULTURE/ADAPTIVE

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“the most common cause of failure in leadership is produced by treating adaptive challenges as if they were technical problems.”

Ron Heifetz

Senior Lecturer in Public Leadership, co-founder of the Center for Public Leadership[1] at the John F. Kennedy School of Government

, Harvard University, and co-founder of Cambridge Leadership Associates

So now what? How do we lead in a complex system…

Acknowledge Unpredictability

Tailor to local context

Recognize Self-Organization

Develop “good enough”Facilitate sense-making

Facilitate Interdependencies

Foster new relationships

Encourage Experimentation

Ask questions, admit ignorance and deal with paradoxH.J. Lanham et al., How complexity science can inform scale-up and spread in health care:Understanding the role of self-organization in variation across local contexts. Social Science & Medicine (2012)

Not New!Adaptive Leadership

Lau Tzu's Tao Te Ching (c. 500BC) wrote of the best leader: "when the task is done, the people

will say we did it ourselves".

“I have a dream” “I have some

new clinical guidelines for you….”

Compliance Commitment

A minimum performance standard that everyone must achieve

A collective goal that everyone can aspire to

Uses hierarchy, systems and standard procedures for coordination and control

Based on shared goals, values, and sense of purpose for coordination and control

Threat of penalties, sanctions, shame creates momentum for delivery

Commitment to a common purpose creates energy for delivery

WHY?

HOW?

WHAT?

Where do you fit?

How can we shift all team members to distributed leaders?

Create EnergyBurning Platform Versus Burning Ambition

• Need to move from a burning platform to a burning ambition

• We need to articulate personal reasons for change as well as organizational reasons

• If the fire goes out, all other factors are redundant

@PeterFuda

At present, prevailing strategies [in healthcare] rely largely on outmoded theories of control and standardisation of work. More modern and much more effective, theories seek to harness the

imagination and participation of the workforce in reinventing the system

Don Berwick, Former CEO, Institute for Healthcare Improvement

Contact:

Marlies van Dijk

mvandijk@bcpsqc.ca@tweetvandijk