10 Essential Strategies for Leaders Living in a Complex World

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As someone who has worked in healthcare for over 33 years, and as a leadership, executive and physician development coach, I am well aware of the stressors and challenges facing healthcare leaders. I listen to my clients talk about the rapid pace of change, having no white space in their calendar until the end of the day when they can finally have a moment to breathe, only to find hundreds of emails waiting for them to read and respond to. I hear about ever-shrinking budgets, misaligned incentive systems, mergers and acquisitions and reductions in force.

When it appears that much is out of our control, there are ten behavioral strategies that will help you survive and thrive. I have seen these work with my clients, not to mention they're working for me!

1. Focus on your passion and purpose
There is a powerful 360-degree feedback tool called "The Leadership Circle Profile 360." What this tool does that no other 360 does is measure "reactive" competencies in addition to the usual (creative) leadership competencies, such as: achieves results, mentoring and development, decisiveness, etc. Reactive competencies are grouped under complying, protecting and controlling behaviors. Bob Anderson, the founder of the LCP, describes reactive competencies as those behaviors we demonstrate in response to how we want others to perceive us. We are most effective when we are acting from a place of authenticity and purpose. During challenging times, a constant focus on "the fire in your belly" can provide an anchor that centers us when the world around us is in flux. A passion for what is best for the patient serves as a common platform for discussions between administration and providers.

2. Embrace ambiguity
One of my clients is a former surgeon who left clinical care to become a full-time physician leader. The crises he would occasionally face in the operating room are nothing compared to the ambiguity he now faces in creating a clinical integrated entity within his healthcare system. This is new territory and it requires a spirit of adventure, risk, failure in service to learning (see number 8) and vulnerability. Embracing ambiguity entails acknowledging uncertainty and moving forward in spite of it.

3. Expand your world view 
Healthcare has a history of silos and redundancy. Lean efforts have made significant strides in identifying systems and waste. Getting everyone in the room to map out a process or system is essential to eliminating waste. Population health requires the total system of patient health and care. Pioneers like Virginia Mason, Kaiser Permanente and Bellin Health have figured it out: They've partnered with patients, the community, payers, providers and employers to successfully achieve the triple aim. Look beyond your immediate environment and learn from those who are achieving success.

4. Seek out positive deviance
Who, in your system, has ideas that are so foreign to the current culture that they may be ostracized from the group? Those may be exactly the people you need to talk to!  Each organization may have pockets of success: providers or departments who are getting results. Sometimes, a leader may present ideas that are so foreign to the current way of doing things that the ideas and leader are met with negative judgment. Practice curiosity, probe more and allow room for what may be possible.

5. Be present
Anxiety and self-doubt prosper in the world of the future. It's the cascade of negative thinking and the "what ifs" that can squash creativity and risk taking. When we are anxious, our "reactive" tendencies prosper. In the language of Hogan Leadership Forecast tools, our derailers can emerge that interfere with our being effective. Stay grounded in the opportunities of today and find appreciation for what currently exists.  Where is the gift in the crisis?

6. Take Pause: Reflect
I am always amazed that the only time of day when most executives have time to pause is after 5 pm! There is no white space on their calendar, and neuroscience would say that there is no available space for reflection in their brain. There are too many actors on the stage! Most learning and "ah-ha" moments occur when we are not actively "thinking." Hence the argument for meditation and also the reason you get insights when you're in the shower. Resist confusing "activity" with "productivity." Schedule in those time-outs. You and your company will be glad you did!

7. Celebrate baby steps and small sccomplishments, and remember to laugh
While the road to healthcare reform is long, there is great work being done now. Set milestones and pause to appreciate and celebrate those small achievements. They provide the emotional capital to keep on keepin' on to achieve greater results. Bring people together on a social level and learn to laugh together. If nothing else, it increases your oxygen intake!

8. Create the safety to admit mistakes: Limit judgment
Amy Edmondson, in her book "Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy" talks about her recipe for success in a dynamic world: Aim High — Team Up — Fail Well — Learn Fast — Repeat! She reframes failure to say that failure is a natural byproduct of experimentation. Effective leaders create a culture where everyone learns from intelligent failures and shares the wisdom widely. How are you cultivating a true "psychological safety culture?"

9. Talk less, listen more…Know less, ask more
As experts in our field, we often like to learn and to share that learning with others. Our risk is that we end up "telling" as opposed to listening. As leaders with growing responsibility, it becomes less about what we know and more about hiring or resourcing those who know more than us. Get curious and recognize wherever and whoever the answers come from.

10. Practice self-awareness
If you search "Ben Zander" on YouTube or TED Talks, you'll find his "transformative power of classical music." At first glance, you may think this has to do with music, and you'd be wrong. Ben and Rosamund Zander have a wonderful book called: "The Art of Possibility."  Ben describes an orchestra who is not performing to his standards. Instead of looking for problems with the musicians, he goes off stage, looks in the mirror and asks: "Who am I not being that my orchestra is not performing?" Have the courage to ask yourself how are you contributing to the results you're getting, and when that fails, solicit some trusted friends who will give you an honest response!

Joy Goldman is an executive coach and credentialed physician development coach with over 30 years’ experience working in healthcare. She partners with physicians and other healthcare leaders to create transformational change and improve healthcare delivery and service. Ms. Goldman is president of Viewfinder Coaching & Consulting, is an affiliate coach with Wiederhold & Associates, and is on the board of the ICF Maryland Chapter. For more information or to contact Joy, please visit www.viewfindercoaching.com.

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