Leadership for organizational adaptability: A theoretical synthesis and integrative framework10/16/2018
Abstract:
One of the biggest challenges facing leaders today is the need to position and enable organizations and people for adaptability in the face of increasingly dynamic and demanding environments. Despite this we know surprisingly little about this topic. In this paper we provide a theoretical synthesis and integrative review of research from strategy, organization theory, innovation, networks, and complexity to provide a framework of leadership for organizational adaptability. Our review shows that leadership for organizational adaptability is different from traditional leadership or leading change. It involves enabling the adaptive process by creating space for ideas advanced by entrepreneurial leaders to engage in tension with the operational system and generate innovations that scale into the system to meet the adaptive needs of the organization and its environment. Leadership for organizational adaptability calls for scholars and practitioners to recognize organizational adaptability as an important organizational outcome, and enabling leadership (i.e., enabling the adaptive process through adaptive space) as a critical form of leadership for adaptive organizations. From: The Leadership Quarterly Volume 29, Issue 1, February 2018, Pages 89-104 Researchers recently examined the core components of a health systems science curriculum in undergraduate medical education. They found the following:
Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking. Gonzalo JD, Dekhtyar M, Starr SR, Borkan J, Brunett P, Fancher T, Green J, Grethlein SJ, Lai C, Lawson L, Monrad S, O'Sullivan P, Schwartz MD, Skochelak S. Health Systems Science Curricula in Undergraduate Medical Education: Identifying and Defining a Potential Curricular Framework. Acad Med. 2017 Jan;92(1):123-131. doi: 10.1097/ACM.0000000000001177. PubMed PMID: 27049541. In 2012, Case Western Reserve University (CWRU) launched its FLEX program when Dean Pamela B. Davis, Dean of the School of Medicine, endorsed a grass-roots concept of empowerment to potentially facilitate a culture change within the university faculty. Using focus groups to determine the barriers to achieve such a goal, members of the Steering Committee of Women Faculty School of Medicine (WFSOM) proposed a program to address the disparities in the number of women entering the field of health sciences as compared to the proportion of women in leadership positions in their field.
Mission FLEX: A Professional Development Program for Women Faculty of the School of Medicine is a customized program that provides training and skills development to help talented women faculty advance their careers and prepare for leadership opportunities. Through a series of workshops and coaching sessions, FLEX provides executive leadership training to build competencies in communication, leadership and executive presence. Goals
Learn more about FLEX here: http://case.edu/medicine/flex/ Last year, a team from the MIT Leadership Center published a whitepaper titled, "Problem-Led Leadership: An MIT Style of Leading." In that paper, Deborah Ancona and Hal Gregersen write how the MIT pattern of leadership often leads MIT people to want to avoid the formal label of a leader. There is an "anti-leadership" effect seen at MIT. Rather, students and graduates want to dive into complex problems, solve challenging cases, and identify opportunities that intrinsically inspire and motivate them to succeed. In essence, they are driven by a problem-led leadership style where they identify and articulate a compelling problem that will inspire people to contribute their best efforts in a spirit of interdependency and collaboration.
I'm reminded of my days at MIT where the first year was pass/fail. You weren't worried about your grades. You just needed to get through and pass the courses. We were working on complex problem sets from the beginning and most exams were open-book. MIT didn't train you to memorize facts. MIT trained you to use information at your fingertips to solve problems. The authors in the paper write, "Systems thinking is a perspective that, once it is learned, informs decisions in every part of life. Thus a hallmark of MIT-style leaders is that they approach organizations as self-organizing systems." Are you working on a complex problem? See if a problem-led leadership framework will help you reach a solution! During active implementation, a host of different drivers impact how programs and innovations are put into practice. Leadership drivers in the context of active implementation focuses on leadership approaches related to transforming systems and creating change. While there are many different leadership frameworks and models, we will look at two types of leadership strategies: technical leadership and adaptive leadership.  http://implementation.fpg.unc.edu Technical challenges can usually be managed by leaders because the issues can be clearly identified, defined, and assessed. From there, potential solutions can be explored that will best overcome the technical issues. Leadership is involved with choosing the right solutions and implementing them effectively.
Adaptive challenges require leaders to view the issues from different perspectives and navigate a multistakeholder approach to solutions. Dr. Ron Heifetz, author of The Practice of Adaptive Leadership: Tools and Tactics for Changing your Organization and the World, lists a series of ways to address adaptive challenges:
Before employing a leadership strategy to overcome challenges, it is critical to properly identify the type of challenge or barrier that is hindering active implementation. Different types of challenges call for different types of leadership strategies. What types of leadership models do we find in academic health centers? What types of leadership models are effective?
Here's an abstract from a recent commentary written by Patrick O. Smith: Leadership is a crucial component to the success of academic health science centers (AHCs) within the shifting U.S. healthcare environment. Leadership talent acquisition and development within AHCs is immature and approaches to leadership and its evolution will be inevitable to refine operations to accomplish the critical missions of clinical service delivery, the medical education continuum, and innovations toward discovery. To reach higher organizational outcomes in AHCs requires a reflection on what leadership approaches are in place and how they can better support these missions. Transactional leadership approaches are traditionally used in AHCs and this commentary suggests that movement toward a transformational approach is a performance improvement opportunity for AHC leaders. This commentary describes the transactional and transformational approaches, how they complement each other, and how to access the transformational approach. Drawing on behavioral sciences, suggestions are made on how a transactional leader can change her cognitions to align with the four dimensions of the transformational leadership approach. Smith PO. Leadership in Academic Health Centers: Transactional and Transformational Leadership. J Clin Psychol Med Settings. 2015 Dec;22(4):228-31. doi: 10.1007/s10880-015-9441-8. Review. PubMed PMID: 26604205. According to Egon Zehnder, the key leadership competencies that are crucial for most executive positions at large organizations include the following:
When assessing managers who are advancing into leadership positions, consider their curiosity, insight, engagement, and determination. These traits are likely to predict how far managers will progress.  As organizations assess candidates for leadership roles, how are they evaluating current competencies along with potential for growth? How are organizations providing opportunities, coaching, and the support that may be needed to close the gap between their potential and their current competencies? In an ideal organization, individuals would have opportunities to be matched to rotations or assignments that will help them develop specific leadership competencies. Summary:
The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources. On-site interviews were conducted with the CEOs of the top-performing hospitals. Content analysis of the transcribed interviews revealed 10 clear imperatives that our sample of CEOs said were essential. Chatfield JS, Longenecker CO, Fink LS, Gold JP. Ten CEO Imperatives for Healthcare Transformation: Lessons From Top-Performing Academic Medical Centers. J Healthc Manag. 2017 Nov/Dec;62(6):371-383. doi: 10.1097/JHM-D-16-00003. PubMed PMID: 29135761. |
