Healthcare fails when good people apply the wrong kind of solutions to the healthcare system.
This post highlights concepts that will improve your leadership using complexity theory. (see Edgeware: lessons from complexity science for health care leaders by B. Zimmerman, C. Lindberg, and P. Plsek)
Use a New Metaphor
Military and machine metaphors dominate healthcare thinking (e.g., cog, mesh, direct, follow, limit, leverage, tune, ramp up, etc.). These metaphors shape our solutions. Complexity offers something different:
Simple is like following a recipe to bake a cake: anyone can follow the instructions and get a good result.
Complicated is like sending a rocket into space: a team of smart people, improving process with each attempt, can figure out the best way to fly in space.
Complex is like being in a romantic relationship or raising a child: success with one is no guarantee of success with another.
Features of Complex adaptive systems:
- Non-linear
- Adaptive
- Distributed control (central control slows system’s ability to react)
- Size of input produces unpredictable effect (small input might create huge impact)
- Large numbers of connections between a wide variety of elements
Leadership Principles
1. Focus on Minimum specifications / Good Enough: Don’t even try planning all the details before you start; it’s impossible. Get a clear enough sense of the minimum needed and get started.
2. Find Attractors: Learn which patterns or areas draw the energy of the system. Imagine how to attract a bird to leave your room vs. How to roll a marble down a track.
“Complexity suggests that we create small , non-threatening changes that attract people, instead of implementing large scale change that excites resistance. We work with the attractors.” p. 11
3. Get Comfortable with Uncertainty: Solutions need to be rapidly adaptable. They must be comfortable with both data and intuition, planning and acting, safety and risk.
4. Use Paradox and Tension: lead by serving, keep authority without having control, give direction without directives
5. Tune to the Edge: Don’t be afraid to stray from the centre. Go to the fringes for multiple actions ; let a direction arise.
6. Be Aware of the Shadow system: Gossip, rumor, informal relationships, hallway conversations
7. Use Chunking: Grow complex systems by connecting simple systems that work well
8. Mix Cooperation and Competition: don’t think either/or
(photo credit: www.nytimes.com)