From ‘sage on a stage’ to ‘guide on the side’
Health transformation requires that we move from a focus on the organization to the system. This requires the ability to work with multiple players and organizations across the system. The healthcare "system" is a complex adaptive system that requires a system leadership approach relying on relationships to drive transformation – where leaders have traditionally relied on hierarchical approaches to drive change1. Provider incentives within the system are not always aligned and therefore require a different approach, for example the differing and sometimes competing payment models for physicians and provider organizations.
This means transitioning from hierarchical management ('sage on a stage') to collaborative leadership ('guide on the side'). Here, leaders cannot dictate change because systems of care challenge positional authority. Instead, success is built through collaboration and relationships. What is it going to take to build collaborative leaders? It requires retraining leaders in collaborative approaches, often referred to as adaptive leadership.
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1 Tsasis P., Evans J., Owen, S. (2015) Reframing the challenges to integrated care: a complex-adaptive systems perspective. International Journal of Integrated Care. [serial online] 2012 Sept 12;18.