NMAHP Leadership programme ehealth applications in healthcare Stepping

NMAHP Leadership programme: ehealth applications in healthcare ‘Stepping up Leadership’ Session 2 Quality Education for a healthier Scotland

Quality Education for a healthier Scotland

Our 2020 Vision…. …. . is that by 2020 everyone is able to live longer and healthier lives at home, or in a homely setting. We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission. Scottish Government, 2012 Quality Education for a healthier Scotland

Everyone Matters: 2020 Workforce vision “We will respond to the needs of the people we care for, adapt to new, improved ways of working, and work seamlessly with colleagues and partner organisations. We will continue to modernise the way we work and embrace technology. We will do this in a way that lives up to our core values. Together we will create a great place to work and deliver a high quality healthcare service which is among the best in the world” Scottish Government 2012 Quality Education for a healthier Scotland

Outline 1. The context of change – the shifting carpet 2. What does this mean for how we think about leadership? – new steps, new dances 3. What does this mean for how we develop as leaders? – learning to dance on the shifting carpet Quality Education for a healthier Scotland

1. The shifting carpet Quality Education for a healthier Scotland

Your shifting carpet…. . So how has the carpet shifted for you? What does that feel like for you as a leader? Quality Education for a healthier Scotland

We are moving … From “Old World” … • Lower complexity, slower change …To “New World” • High complexity, fast change • Learning has a short shelf-life • Learning has a long shelf- life • Knowledge is scattered • The ‘senior ones’ know most • Somewhere ‘someone’ knows • No individual can pretend to ‘know’ • ‘More of the same’ is the rule • Innovation is the ‘rule’ Source: Obeng, E and Gillet, C (2008) The Complete Leader. London Business Press, Buckingham, p 3 Quality Education for a healthier Scotland

Meaning shifting roles… From “I manage”… To “I lead…” • My team reports to me • I have a hierarchical role • I understand what is happening • I have fixed objectives • I manage by fixing things myself • I manage from knowledge and experience • • • We are part of a virtual network Influencing is the way forward I cope with ambiguity I manage projects I lead teams to fix things I lead without knowledge and experience Source: Obeng, E and Gillet, C (2008) The Complete Leader. London Business Press, Buckingham, p 3 Quality Education for a healthier Scotland

Leadership across networks “There is a transition occurring from the old paradigm in which leadership resided in a person or a role, to a new one in which leadership is a collective process that is spread throughout networks of people”. Nick Petrie, Center for Creative Leadership, 2011, p. 6 Quality Education for a healthier Scotland

Quality Education for a healthier Scotland

http: //www. gov. scot/Resource/Doc/289816/0088790. pdf Quality Education for a healthier Scotland

Quality Education for a healthier Scotland

Adaptive leadership Where we are facing ‘adaptive’ challenges, i. e. , “systemic problems with no ready answers”, the solutions exist not in the single leader but rather… “… in the collective intelligence of employees at all levels, who need to use one another as resources, often across boundaries, and learn their way to those solutions”. Heifetz & Laurie, 1997 (p. 124 -134) Quality Education for a healthier Scotland

What is adaptive leadership? According to Heifetz: Leadership is an activity Leadership is what individuals do in mobilising other people, in organisations or communities, to do “adaptive work” When you have a problem or challenge for which there is no technical remedy, a problem for which it won’t help to look to an authority for answers – the answers aren’t there – that problem is an adaptive challenge. Ronald Heifetz & D L Laurie, The Work of Leadership, Harvard Business Review, Jan-Feb 1997 Quality Education for a healthier Scotland

Why “adaptive leadership”? Technical Problems versus Adaptive Challenges Leadership from those in authority is too often technical and this enhances the need for adaptive leadership from those without authority They go beyond their job descriptions and formal authorisation Does the organisation recognise or undermine them because they are a challenge to the formal leadership? Quality Education for a healthier Scotland

Three things are required for adaptive change 1. A felt imperative to change - our source of motivation to try new behaviour 2. Insight into how our own thoughts and feelings are part of the problem 3. Taking action – trying new behaviour in order to learn Quality Education for a healthier Scotland

Keith Grint: 3 kinds of problems Type of challenge: Response required: Tame Management Wicked Leadership Critical Command Reference: Keith Grint & Clare Holt, “Followership in the NHS”, The King’s Fund, 2011 Quality Education for a healthier Scotland

A typology of problems & decision styles* Increasing uncertainty about solution to problem LEADERSHIP: Wicked Ask questions MANAGEMENT: Tame Organise process Increasing requirement for collaborative compliance / resolution COMMAND: Critical Provide answer Coercion / Physical *Reference: Grint & Holt, 2011, p. 13 (Hard Power) Calculative / Rational Normative / Emotional (Soft Power) Quality Education for a healthier Scotland

What does this mean for “followers”? * Increasing uncertainty about solution to problem Responsible followers Wicked Technical followers Tame Critical Compliant followers Coercion / Physical *Reference: Grint & Holt, 2011, p. 14 Increasing requirement for collaborative compliance / resolution (Hard Power) Calculative / Rational Normative / Emotional (Soft Power) Quality Education for a healthier Scotland

Complex environments need leaders who will tackle wicked problems… Getting beyond our assumptions in: What we pay attention to What insight we have into ourselves How we interpret events How we relate to others What we do to build shared purpose How we take initiatives Quality Education for a healthier Scotland

The skills challenge Guarding against assuming causality, halo effects, stereotyping …. (our “defensive routines”) Striving to understand our self-limiting thoughts and feelings Being aware of our own feelings, attitudes and beliefs Being open minded Quality Education for a healthier Scotland

Pausing to reflect… • What are you noticing? • What is making sense? • What questions is this raising for you? Quality Education for a healthier Scotland

Any of us who might feel disheartened by the size of our challenges can take heart from the fact that…we don’t have the solutions because there are no solutions (yet). The answers will not be found in a report…. but along the messy path of innovation. . . the most important skill needed is to take another step forward. Source Petrie, N (2011) Future Trends in Leadership Development. A White Paper. Centre for Creative Leadership. P. 28. Quality Education for a healthier Scotland

Adaptive leadership with Ron Heifetz and Marty Linsky on the practice of adaptive leadership on the weekly leader podcasts http: //weeklyleader. net/2010/ronheifetz-on-adaptive-leadership-video/ Quality Education for a healthier Scotland

Quality Education for a healthier Scotland

Thank you for listening Quality Education for a healthier Scotland

References Kim Turnbull-James (May 2011), Leadership in context: lessons from new leadership theory and current leadership development practice, The King’s Fund http: //www. kingsfund. org. uk/sites/files/kf/leadership-in-context-theory-current-leadership-development-practice-kim-turnbull-james-kings-fund-may-2011. pdf Michael West (May 2014), Developing collective leadership for healthcare, The King’s Fund / Center for Creative Leadership http: //www. kingsfund. org. uk/sites/files/kf/field_publication_file/developing-collective-leadership-kingsfund-may 14. pdf Nick Petrie (2014), Future trends in leadership development, Center for Creative Leadership http: //www. ccl. org/leadership/pdf/research/future. Trends. pdf Ronald A Heifetz & D L Laurie, “The Work of Leadership”, Harvard Business Review (Jan-Feb 1997), pp 124 -134. Accessible via Knowledge Network Keith Grint & Clare Holt (2011) Followership in the NHS, The King’s Fund http: //www. kingsfund. org. uk/sites/files/kf/followership-in-nhs-commississon-on-leadership-Management-keith-grint-claire-holt-kings -fund-may-2011. pdf John Benington & Jean Hartley (2009), Whole Systems Go! Leadership across the whole public service system, National School of Government. Also see the Leadership & Management Portal on Knowledge Network – especially the “Leading for the Future” pages http: //www. knowledge. scot. nhs. uk/home/portals-and-topics/leadership--management/programmes/leading-for-the-future. aspx Quality Education for a healthier Scotland