by Gena Futral, MHA, RN, CPHQ, FACHE
Senior Vice President, Advisory Services
12/10/19

Our industry is under considerable pressure to improve processes and practices that will result in lower costs, better patient outcomes, and exceptional patient experience. In virtually every article discussing improvement strategies there is one factor that is always noted as critical for success: leadership. Let’s be honest though, many of us in leadership positions do not come to work every day thinking about what theory to model for our organization. And, many without a leader title do not feel empowered to lead. In health care, a different mindset may be called for.

To be agents of change in this complex environment of payment reform, rising costs, regulatory pressures, unprecedented technology, and mergers and acquisitions, health care leaders should consider the traits of Complexity Leadership Theory (CLT). Led by Russ Marion and Mary Uhl-Bien in 2001, the development of CLT introduces the simple premise of creating environments where system interdependencies are appreciated, staff are empowered to innovate, and processes are adaptive in unpredictable environments. It transitions the focus from the leader being the problem solver to the leader creating an environment where problems can be solved through collaboration, empowerment and accountability.

To gain an appreciation for the basic tenets of CLT, consider these theoretical principles:

  • Systems Thinking: The organizational impact of how informal cultures can challenge or perpetuate status quo;
  • Theoretical Biology: Organizations are complex systems and the impact to subsystems must be considered with all changes;
  • Nonlinear Dynamics: Underlying behaviors, assumptions, rumors, and culture can accelerate or create barriers to change and must be proactively managed;
  • Complex Adaptive Systems: Simple rules such as ‘do no harm’ provide organizational focus and when rules are broken, those closest to the work should be encouraged and expected to drive innovative change.

The application of complexity leadership traits to health care is illustrated below.

Developing the leadership skills required to innovate and solve the challenges of complex health care systems requires intentionality and a theoretical leadership framework. As complexity leaders, there is less focus on traditional leader/follower strategies with centralized power and more on appreciating system interdependencies and creating an environment where the workforce is engaged, competent, and empowered to innovatively solve problems.

Health care is a field of highly educated and competent professionals and CLT supports their empowerment to lead. As I lead teams of highly skilled professionals that include nurses, engineers and physicians just like many of you, I see engagement soar and forward movement accelerated when I focus on the environment and get out of their way.

About the author. With more than 30 years of strategic, operational and performance improvement experience, Gena Futral leads the development and execution of solutions grounded in top-performing cultures; clinical, operational, and supply analytics; and improvement strategies that drive results. Dedicated to helping health care organizations achieve performance excellence in the ambulatory and acute care setting, she leads advisory teams that partner with executives to support achievement of performance goals, support reducing harm and readmissions in the acute care setting, prepare physician practices for alternative payment models and support continuous patient readiness. Futral is certified in Total Quality Management and a former facilitator and team leader instructor. She is a member of Sigma Theta Tau International Nursing Honor Society, Fellow with the American College of Healthcare Executives, and Certified Professional in Healthcare Quality.