Blip-Zip Summary
Feeling overwhelmed by the health system’s volatile, uncertain, complex, and ambiguous (VUCA) environment? Master these 15 critical systems thinking competencies to become a strategic health leader (SHELDR). Embrace complexity, identify patterns, and drive sustainable change for your team, organization, and community.
Blip-Zip Takeaways
- Develop systems thinking to navigate healthcare’s complexity.
- Identify patterns and connections to drive sustainable change.
- Lead with a big-picture perspective for long-term success.
Key Words and Themes
Systems Thinking, Strategic Health Leadership, SHELDR Competencies, Health Leadership, Health System Transformation, Sustainable Solutions, Adaptive leadership
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Table of Contents
Why Systems Thinking Competencies Should be More Prevalent
Those who aspire to be strategic health leaders (SHELDR) and those already holding those positions in the healthcare, public health, and human or social services sectors know that their organizations need to be more organized and organized. Nevertheless, they are required to focus on the bigger picture, investigate patterns to identify possibilities, and make modifications. Only some people can or need to know how to do it. Despite VUCA, we must save America’s Health system now!
Read about VUCA here:
When it comes to addressing issues such as the creation of accountable community health organizations (ACHO) or clinical integration networks (CIN) incentives and penalties, the coordination of community health resources, the addressing of social drivers and determinants of health (SDOH), or the generation of higher patient safety reliability and disease protections, multiple opportunities present themselves to apply a systems approach. For example, my article, Ways Social Determinants of Health (SDOH) Can Boost Health illustrates how and why systems must identify the opportunities to address the SDOH.
Awareness and Leader Development is Required
There should be a greater dissemination of case studies on systems methods, particularly those focusing on integrating health systems. In addition, many materials and examples are available to improve learning and practice systems thinking. The process starts with identifying competencies and then moves on to education, training, and experience in health administration’s functional knowledge and competencies.
When seen from the point of view of a SHELDR, the process of using a systems approach should involve the capability of leading teams to benefit the entire organization. SHELDRs are required to possess the ability to seek out, comprehend, and express how the “whole” system contributes to the desired results within and outside the company.
Otherwise, the same dysfunctional thinking and stove-like mentality will continue to dominate, producing the same embarrassing health outcomes at all levels. Not only does this entail concentrating on the objectives that fall within their sphere of influence, but it also entails using their influence in a way that benefits the entire system. SHELDRs are required to have the ability to work together with clinicians, public health officials, assisting agencies, and local companies in the whole health “ecosystem” to enhance health, increase resilience, increase productivity, and improve quality of life.
For more on Systems Thinking, check out my book Systems Thinking for Health Organizations, Leadership, and Policy: Think Globally, Act Locally
15 Systems Thinking Competencies For SHELDRs
System thinking should be the driving force behind SHELDRs, particularly senior SHELDRs, to create competencies that correlate with essential success criteria and insist on sustainable solutions for the benefit of the business and, in many cases, the communities they serve. The following are examples of critical success factors that are associated with a systems approach to health care:
- reimbursement systems that reward value and outcomes through partnerships
- a supportive culture and organizational structure that produces high reliability
- cross-boundary leadership that improves care coordination
- expanding digital infrastructure to reach patients in the community or region
8 Gutwrenching Questions Every Strategic Health Leaders Must Answer to Catapult Upward As A Coach
Identifying competencies related to systems thinking and incorporating those competencies into educational and training programs and programs for the development of leaders within organizations is a must-do proposition that must succeed. The following table provides a condensed version of the systems thinking competencies for SHELDRs that renowned writers and practitioners have compiled.
| Traditional versus Systems Thinking | Assumes Chaos and Dynamics and Leads Change: Assesses connections, disconnections, and interdependencies in a dynamic health system that is loosely networked; elements such as social determinants of health are related, interact, and adapt to conditions in the environment in order to thrive. Holds the tension of paradox and ambiguity to understand a system’s dynamics before making decisions prematurely. Seeks out opportunities to leverage better health and reliability. Sets the tone, pace, and example to lead change. Aligns and integrates concepts, strategies, capabilities, organizations, and processes into common practice and culture. |
| Micro to Macro View | Envisions the Big Picture, Develops and Communicates Vision: Senses signals; sees the future. Develops aspirational vision, strategy, plans, and capabilities to meet the needs of customers, suppliers, and stakeholders. Seeks out and understands the health (e.g., public and community) and healthcare system interrelationships within the system at any level. Focuses on the health system interconnections first, then the relationships, and then the causes and effects of the relationships. Proactively engages followers, teams, partners, and stakeholders to aspire to a greater vision with inter- and intrapersonal communication or outreach. Makes vision clear, meaningful, and understandable. |
| Disconnected to Connected Networks | Integrates Multiple Viewpoints and Applies Ethics: Explores how mental models create different future views. Looks at multiple perspectives of an issue from various stakeholders and process owner viewpoints. If required, change perspective to see other points of view within a system once a view of the whole system is complete. Serves as a role model for unwavering ethical decision-making and respect for autonomy, non-maleficence, beneficence, and justice. |
| Silos versus Patterns in Network | Actively Listens and Searches for Emerging Patterns or Themes in Dynamic Environments: Suspends judgment; objectively understands cause-and-effect relationships across systems (e.g., departments or organizations); seeks out data, relationships, stories, and hunches on issues between systems (inter- and intra-). Engages in and understands the concerns and needs of individuals and teams; conveys empathy to uncover possibilities; and provides support by removing barriers. |
| Analysis à Synthesis | Expect Second- and Third-Order Effects: Anticipates the ripple effects of their actions and the impact on the organizational culture. To do so, health administrators must involve critical internal and external stakeholders in the decisions that have a widespread impact to achieve sustainable results. Looks ahead and anticipates not only the immediate results of actions but also the second-and third-order effects throughout the system. |
| Single versus Integrated Viewpoints | Integrates Multiple Viewpoints and Applies Ethics: Explores how mental models create different future views. Looks at multiple perspectives of an issue from various stakeholders and process owner viewpoints. If required, change perspective to see other points of view within a system once a view of the whole system is complete. Serves as a role model for unwavering ethical decision-making and respect for autonomy, non-maleficence, beneficence, and justice. |
| Surface versus Deep Dive | Takes Deep Dives to Challenge Assumptions and Status Quo: Is comfortable with questioning other’s and self’s assumptions. Actively listens to go beyond the surface to understand deeper issues: beliefs, values, emotions, facts or lack of facts, and thinking (fixed or silo) about how the world works (mental models) or how an existing problem should be solved. Develops new ideas, concepts, sustainable solutions, and better processes. |
| Ripple versus Multiple Ripples | Lifelong Learner Who Seeks, Leverages, Uses, Generates, and Shares Knowledge: Constantly applies leverage points in a complex system. Is proactive and flexible to address bottlenecks, crazy makers, and constraints. Is mindful of identifying leverage points within systems that result in positive change and incremental performance improvements before they become dysfunctional. Look for small actions or “whispers” that can make significant differences. Uses systems understanding to determine what small actions can produce high-leverage sustainable results rather than quick fixes. |
| Quick Fix versus Leverage System | Applies Systems Approach: Assesses situations systematically; understands interconnections between systems and processes to develop strategy, solve problems, and make complex decisions. Engages in the loop or circular thinking. Looks for interconnected and interdependent issues. Perceives connections between multiple issues, handoffs, or whole organizations within the health ecosystem. |
| Spills versus Flow | Develops Leaders and Teams of Leaders: Minimizes the impacts (non-flows or spillover) of accumulation of stocks over time: Pays attention to potential non- and problematic flows and spillover of resources and valuable and nonvaluable processes that build up (or deplete) over time and contribute (or do not contribute) to planned flows or support goals and objectives. Looks for deeper causes and effects throughout the system.Coaches, guides, and mentors leaders and teams. Encourages self-development and intrinsic motivation. Gives constructive feedback. Assures education and training opportunities. |
| Event versus Loops and Circles | Serves as a Steward of Resources: Checks results and action changes to achieve insight. Constantly assesses progress with a systemic view of the whole system. Assesses for improvement opportunities using benchmarks, exemplars, and innovative ideas. Uses errors and setbacks as a means to learn and adjust. Judiciously allocates and aligns resources (i.e., money, personnel, information, equipment, infrastructure, and environment) with strategy efficiently and effectively from a systems perspective. |
| Incident versus Systemic Causes and Effects | Empower Others to Think Critically About Cause and Effect, Not Positions: It is not just about correlation and static data points. Using circular thinking to understand the dynamic relationship between the connected parts looks beyond primary connections. Look for the virtuous positive and vicious negative spirals or patterns that impact the entire system and design systems to generate sustainable results naturally. |
| Snapshots à Insights | Empowers Others: Shares leadership collectively. Knows structural issues cause change. Builds, aligns, and sustains diverse teams of leaders to achieve the vision and outcomes. Measures progress and results systemically. Be careful not to pin the blame on a specific person. Understand and explain to others that the complexities within the system may take a longer time to correct. Looks for the virtuous positive and vicious negative spirals or patterns that impact the entire system and designs systems to generate sustainable results naturally. |
| Structure versus Network of Processes | Empowers Others to Think Critically About Cause and Effect, Not Positions: It is not just about correlation and static data points. Using circular thinking to understand the dynamic relationship between the connected parts looks beyond primary connections. Look for the virtuous positive and vicious negative spirals or patterns that impact the entire system and design systems to generate sustainable results naturally. |
| Insulation to Collaboration Across Boundaries | Collaborates Across Internal and External Boundaries: Understands boundaries are arbitrary. Checks for consistency of understanding about where boundaries are drawn. Collaborates across boundaries to leverage systems and create synergy. Builds mutually beneficial relationships and common goals within and across organizations. Partners with networks and communities of practice and stakeholders. |
| Disconnected to Mindfulness and Wholeness | Empowers Others: Shares leadership collectively. Knows structural issues cause change. Builds, aligns, and sustains diverse teams of leaders to achieve the vision and outcomes. Measures progress and results systemically. Be careful not to pin the blame on a specific person. Understand and explain to others that the complexities within the system may take longer to correct. Looks for the virtuous positive and vicious negative spirals or patterns that impact the entire system and designs systems to generate sustainable results naturally. |
When the individual’s requirements and the environment’s conditions come together, they generate the need for change and adaptation. A long-lasting impact on the health system can be achieved by cultivating competencies in adaptive leadership and systems thinking strategies. SHELDRs are required to deal with unplanned obstacles; nevertheless, technologies that are always evolving, constantly moving realities, sociopolitical challenges, and innovations that facilitate adaptive leadership and systems thinking help combat these challenges.
SHELDRs can generate meaningful conversations while utilizing systems thinking across functional boundaries, ultimately creating systemness throughout the entire system. Internal integrity, the goodness of fit, seamlessness, open boundaries, team-based, service-driven measures of value, coordinated effort, and sustainable transformation are all components of systemness, a mentality founded on systems thinking. Over time, the commitment of apps that utilize systems thinking develops.
For more on Systems Thinking, check out my book Health Systems Thinking: A Primer
Summary and Conclusion
Those already serving as SHELDRs and SHELDRs will leave behind the responsibility of cultivating future generations of SHELDRs who will facilitate co-creation and adaptive organizations within the health ecosystem. It is unacceptable to use the typical command and control, production, or linear approach to decision-making to address the difficulties currently facing the health ecosystem.
If SHELDRs are to be successful, health ecosystem adaptability needs to become the governing mechanism that encompasses everything from day-to-day management to strategic planning. For instance, strategic management incorporates learning or feedback loops, enabling the company to keep up with rising rates of change and adapt to new circumstances. This method makes it possible for health organizations to operate more interdependently, adjust to the community’s ever-changing requirements, or harness one other’s resources to achieve more excellent positive outcomes.
Because of this, SHELDRs must develop their skills as students of change, thinkers of systems, and strategic planners. Competencies in systems thinking are one of the most critical aspects of strategic management. These competencies are used to identify the overall strategies and to facilitate system improvements for the firm.
To advance in your leadership journey, explore resources, enroll in training programs, attend conferences, or seek mentorship from experienced leaders. This will equip you with the necessary skills to navigate the healthcare landscape and lead your team towards a sustainable future. Begin with a few questions.
Deep Dive Discussion Questions
These questions are meant to prompt reflection and encourage you to apply this article’s leadership concepts. Ponder these questions and consider applying the lessons to your leadership.
- Consider your leadership role when identifying system challenges. Is there a problem that systems thinking could solve? Explain the situation and how you might frame it systemically.
- Building System Knowledge: Consider your company’s structure and culture. How well does it foster cross-border thinking and collaboration? How can you encourage a systemic mindset in your team or organization?
- Promoting Sustainable Change: Reflect on a leadership decision. How has systems thinking changed your approach? How can you ensure your future decisions lead to long-term, sustainable change?
Professional Development and Learning Activities
These practical exercises help you understand and apply systems thinking to leadership.
- Systems Mapping: Create a visual map of a work challenge or project’s interconnected components and influences. This exercise will help you identify stakeholders, leverage intervention points, and anticipate unintended consequences.
- Mental Models: Explore your mental models, or deeply held assumptions, about the healthcare system. How do these models affect your leadership choices? Seek diverse perspectives and talk to coworkers to challenge your assumptions.
- Case Study Analysis: Research successful health, public health, or human and social services organizations that used systems thinking. Analyze their methods, identify lessons, and consider how you can apply them.
- Role Model: Identify a leader you admire for their systems thinking skills. What specific actions or behaviors do they demonstrate?
Resources, References, and Citations
Book Summary: Johnson, James A., Douglas E. Anderson, and Caren C. Rossow. Health Systems Thinking: A Primer. Burlington, MA: Jones & Bartlett Learning, 2020. 138 pp. ISBN 9781284167146
Book: “Thinking in Systems: A Primer” by Donella Meadows – A foundational text offering a comprehensive introduction to systems thinking concepts and applications
Book: “The Fifth Discipline: The Art and Practice of the Learning Organization” by Peter M. Senge
Book: Building Strategic Skills for Better Health
Book: Systems Thinking for Health Systems Strengthening, WHO
Website: The Systems Thinking Institute – Offers a wealth of resources, including articles, webinars, and courses, dedicated to furthering the understanding and practice of systems thinking. https://www.systems-thinking.org/
Report: “The Future of Health” by McKinsey & Company – Features interviews with healthcare leaders discussing innovative approaches to tackling complex challenges in the healthcare system. https://www.mckinsey.com/industries/healthcare/our-insights/the-future-of-healthcare
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About the Author
I am passionate about making health a national strategic imperative, transforming and integrating health and human services sectors to be more responsive, and leveraging the social drivers and determinants of health (SDOH) to create healthier, wealthier, and more resilient individuals, families, and communities. I specialize in coaching managers and leaders on initial development, continuously improving, or sustaining their Strategic Health Leadership (SHELDR) competencies to thrive in an era to solve wicked health problems and artificial intelligence (AI).
Visit https://SHELDR.COM or contact me for more BLIP-ZIP SHELDR advice, coaching, and consulting. Check out my publications: Health Systems Thinking: A Primer and Systems Thinking for Health Organizations, Leadership, and Policy: Think Globally, Act Locally. You can follow his thoughts on LinkedIn and X Twitter: @Doug_Anderson57 and Flipboard E-Mag: Strategic Health Leadership (SHELDR)
Disclosure and Disclaimer: Douglas E. Anderson has no relevant financial relationships with commercial interests to disclose. The author’s opinions are his own and do not represent an official position of any organization including those he consulted. Any publications, commercial products, or services mentioned in his publications are for recommendations only and do not indicate an endorsement. All non-disclosure agreements (NDA) apply.
References: All references or citations will be provided upon request. Not responsible for broken or outdated links, however, report broken links to [email protected]
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