BLIP-ZIP Executive Summary
Lateral leadership, or “leading sideways,” is increasingly recognized as a vital competency in healthcare transformation. This commentary explores the importance of developing lateral leadership skills to navigate complex healthcare systems, emphasizing influence, collaboration, and trust-building across organizational boundaries. Understanding and applying these competencies can drive meaningful change and integration in health services. Check out the questions for discussion, professional development and learning activities, AI prompts, and references and links. Learn more at www.sheldr.com
Table of Contents
Background and Purpose on Leading Sideways
Long, long ago, a colleague challenged me to explore the idea of lateral leadership or leading sideways in the context of healthcare. In his article, he wrote:
“Laval leadership feels like we are violating the basic management principle that you cannot have responsibility without authority. But then, we’re not talking about management. We’re talking about leadership, and maybe that’s the real difference. Management requires authority. Leadership does not. Leading without authority requires influencing others to give their discretionary effort to work toward a goal. And, that just might make leadership the highest art form.”
It sounds lofty and risky. Am I leading without authority and resources but all the responsibility? I can’t empower or delegate responsibility. Accountability? These characterizations give rise to the courage to shift from the familiar vertical or command and control leadership and enter an unknown comfort zone. My colleague challenges readers to assess their past leadership development and experiences and ask themselves: given my current position and responsibilities, do I need to modify my competencies to lead laterally? Answer: yes.
Lateral leadership, or “LEADING SIDEWAYS,” is a growing and recognized form of nonhierarchical leadership used as part of systems thinking competencies, change management strategies, and health system integration or engagement.
This article provides a practical perspective on the competencies of lateral leadership, particularly in the context of healthcare transformation. Whether we call it lateral, horizontal, cross-boundary, collaborative, or network leadership, the name is not as crucial as the development of the right competencies. These competencies are essential for navigating the complexities of health system transformation, especially when it involves working with community health and non-health partners.
Introduction to Lateral Leadership or Leading Sideways
Let’s start by challenging the status quo. Healthcare is a partnership and process leading to a healthy outcome, and in any case, crosses organization silos, right? Shouldn’t leadership be the same? Vertical command and control leadership mentalities drive today’s complex healthcare organizations; if lucky, some form or degree of collegial leadership exists. Creating opportunities for improvement between traditional functional areas and hierarchies or “silos” within and outside the walls of their brick-and-mortar organizations may be stifling momentum. For example, many leaders recognize the need to collaborate and coordinate care and referrals with community health and social services networks to accomplish their missions.
Leaders are typically thought of as those who are followed. It is natural to think leadership is a vertical proposition, where a leader has formal authority over their subordinates. Just think about all the charismatic John Wayne military movies, leader development training PPTs, and the engrained ‘bosses and subordinates’ literature. You know, ‘the few, the proud, the Leaders’ who are rewarded with the next level in organizations containing more subordinates and resources. This is all well and good. However, today’s world is turbulent, complex, and unpredictable, yet it remains rigid, stove-piped, and reinforced by vertical leadership.
Fortunately, the hierarchical and vertical relationship between ‘leaders’ and ‘followers’ gives way to lateral leadership as a council of co-equals, where leadership is more about influence and collaboration than formal authority.
Enter Lateral Leadership—Leading Sideways
The definition is straightforward and challenging to practice. While vertical leadership is still necessary for some situations (not as many as you think), vertical relations work best with (and reinforce) organizational silos. Leading hierarchically tends to sub-optimize human talent and organizational momentum within those silos. However, that’s not how healthcare organizations carry out their duties, especially when they integrate social services as part of their referral patterns. Today, accomplishing organizational goals in healthcare requires more collaboration.
On the other hand, lateral leadership connects healthcare professionals across inter and intra-organizational boundaries to help others see themselves as part of something more substantial within the value stream of care or recovery. They create enlightened leadership – the energizer bunny–toward mutually agreed-upon goals.
No, it is not a “you owe me one” scene. Unlike command and control, lateral leadership is about trust through influence, inspiration, mentoring, and humility. Yes, the “skills” of vertical and lateral leadership overlap. There are differences. The most significant difference is a reciprocal and interdependent relationship that helps others see the whole system, especially when no formal authority and resource constraints exist. Accountability is synonymous with follow-through, and the benefits aretrust and confidence, especially at the speed of change and in the coordination of care.
Lateral leadership is best practiced by building trust as a collateral outcome of accomplishing organizational goals. Trust is the bi-lateral benefit of a reciprocal and interdependent relationship within and across organizational boundaries. Trust and confidence can be built by following through, especially between meetings on tasks and projects. Lateral leadership is about humility, which is knowing (and doing) when to lead and follow or the interchangeability of roles. It is also about being resilient when colleagues opt out or opt into specific requests. It is about sharing knowledge about goals and influencing others to find improvement opportunities between interdependencies. It can be about uncovering blindspots and sweet spots of mutual concern.
Lateral leadership is about inspiring others with no direct control to join you in a common cause. To be an excellent lateral leader, leaders must have the right mindset, actively listen, and mentor so that trust becomes part of the journey.
Lateral Leadership Competencies
Today, leading or collaborating and coordinating within and across silos includes building relationships between systems. It means actively listening to fuse ideas or pinpoint opportunities to improve. What are the emerging skills for lateral leaders? Here are a few ideas on leading laterally:
- Leading in the Intersections or the Seams: Lateral leadership means being an information gatherer, sharer, negotiator, and “nudger.” Lateral leaders look for opportunities to take their organizations to the next level through constant intelligent inquiry, asking the right questions, and actively listening. They use YES AND versus YES BUT to fuse ideas, solutions, and excitement.
- Are Great Storytellers: As active listeners, lateral leaders can package ideas, efforts, and observations as storytellers. They recognize the power of language and how carefully chosen imagery and powerful narratives can reach across the boundaries of conventional thinking. This skill gives lateral leaders the tools to speak on what is difficult to express.
- Leads with an Aspirational Vision: The lateral leader knows that creating positive momentum to articulate commonalities within a vision leads to finding sweet spots for action across the organizational boundaries. They also understand that apathy and negativity plague many organizations. Rather than chase the metric of the moment or a “50 reasons why we can’t do something” culture, they create a sense of vision and destiny. Even mystery, ambiguity, paradox, and surprise create momentum. They present it, and despite the lack of interest or resistance, they keep “nudging” away.
- Leading as a Peer, not Position or Title: Lateral leaders recognize the significance and power of place, positive and negative. These leaders look for answers or solutions, especially when navigating unfamiliar areas or looking for sweet spots with no rules, consensus, or clear way forward. They thrive and humble themselves in helping others develop micro-visions, encourage brainstorming, and help them succeed through informal coaching, guiding, and mentoring.
In essence, lateral leadership utilizes creating shared understanding, shifting roles, and generating trust for one’s own purposes. In this way, leaders can disrupt rigid thought patterns, combine divergent ideas, and build trust.
Leading Peers in a Lateral Fashion
Of particular interest to lateral leadership is leading peers. Aside from followership, this is one of the most challenging and least talked about leader development topics: leading peers. You can succeed departmentally and fail organizationally or community system-wide. Remember, silos are created from a lack of intentional lateral leadership. This approach may challenge your constructs of leadership and an inherent sense of competition. Not good.
Lateral leadership is complex because it builds trust through follow-through and humility. The fact is, functional community leaders, or leaders throughout the community and even corporate headquarters (pick a level), leaders need to have the leverage to lead up or down. Yet, most leaders need the other silos to accomplish their tasks. Go figure.
In most cases, it’s easy to put your head down, work harder, and accept the status quo. When you do, you suffer. Your team suffers. Ultimately, the organization suffers. You can spiral up or spiral down. To spiral up, here are a few mindful or self-reflective questions to ask yourself as you venture into lateral leadership, especially with your peers:
- Am I more loyal to the team as a team member or the team I lead? Define your team; it may be more significant than you think. Do you know when to lead, follow, or bite your tongue?
- Do I willingly share my best ideas with my team? If you don’t feel safe, then how can others feel the same safety? Do you create safe zones within and outside your sphere of influence? Or do I overwhelm them?
- Do I share the credit even when I don’t need to? This one seems obvious, but do you? If so, how willingly? How often? In other forums outside your own?
- Do I say we are more than me? Wouldn’t it be nice to record your conversations for a week to find out? You might discover you’re dreaming of A (we) but reinforce B (me).
- How many times have I gone to someone else’s office, cubicle, community, or social service office just to talk and understand their constraints, pressure points, and aspirations?
- Do I believe the best in my peers or their strengths? If so, how do you draw that out? Are you performing CPR: compliment, praise, and recognize regularly?
- Do I find my significance in always being right? A challenge may be for you to admit you had a bias openly, had outdated information, and clung to your fears.
As you ponder the answers and reflect on the past, you must provide your colleagues with reasons to respect and follow you to succeed as a lateral leader. How do you do that? By helping your peers see the bigger picture, sharing information, helping them uncover their blindspots, and reinforcing their contributions as they relate to the bigger picture by performing CPR. If you can help them win, you support the organization, yourself, and your teams.
Make Lateral Leadership Thinking Habitual
Here is a set of thinking principles to guide you toward leading laterally in a habitual manner:
- Understand, Practice, and Complete the Leadership Feedback Loop: Don’t take shortcuts if you want to gain trust through influence and credibility with others—Follow-through on obligations. The leadership feedback loop begins with caring – taking an interest in people – and ends with succeeding – winning with people across the silos. People with big aspirations want to be on a team who moving forward. Success begets success.
- Put Coaching, Guiding, and Mentoring in some Form Ahead Of Competition: The whole goal of healthy competition is to leverage it for a win. For organizations, the entire team’s success is more important than any individual wins. Therefore, build your teammates and peers up, and they’ll want to win with you.
- Be A Role Model Peer: Good relationships make influence possible. Collegiality is a positive relationship you can develop. The goal should be to be a peer. You must be a resourceful peer even when others don’t reciprocate your efforts. Ultimately, being a role model peer will allow you to influence your peers when the time comes.
- Avoid Petty Office Politics: People who are described as ‘political’ are driven by their desire to get ahead at all costs—d of a passion for excellence, productivity, teamwork, or consistency. To succeed at leading across boundaries, staying true to yourself and not acting differently is essential. Become a statesman with a higher calling and a “go-to” peer.
- Expand Your Circle Of Acquaintances: To get outside your comfort zone, start with those in your comfort zone. New acquaintances can be crucial connections as you grow as a leader. As you build trust and confidence and lead your peers, your relationships will benefit them. You’ll ultimately provide more value and gain influence among them.
- Let The Best Idea Win: Being a lateral leader is about something other than getting your ay. It’s about winning trust, confidence, respect, and influence with your peers so you can create a win. Because you don’t like drones, having a collaborative spirit helps when you discover your idea may not be the best idea or squash other ideas. Recognize that you can add value when you let your ideas go and let the best idea win. That’s when you will win friends and influence people.
- Don’t Pretend You’re Perfect: Nobody is perfect – not you, your peers, or your boss. Quit pretending. People who are genuine with their weaknesses and strengths draw others to them. Pretending we are perfect will get you nowhere. Admitting faults, asking for advice, being open to learning, and putting away pride and pretense are essential steps to building trust within and across entrenched silos.
Overall, these principles showcase the best ways to lead laterally. While each one takes time, they will help you gain influence within your organization from wherever you stand. The hard part is getting in the habit.
What are You Waiting For?
Many opportunities exist for leading laterally. Become involved. When you take the lead and involve others, it is suitable for both the organization and your relationship with your peers. Start with an open discussion or leader development moment. There is always the chance you will be viewed as “pushy” or taking on tasks for personal. Do it anyway. Besides, what will your peers think about you if all you do is work in your silo?
Lateral leadership with difficult colleagues is a negotiation and active listening challenge at best. Do your homework, rehearse, and engage. Make it habitual. For example, if two co-leaders are at odds with each other- a millennial male clinician and the other a baby boomer female administrator- about a crucial issue such as the value of culture survey or ethical dilemmas, a conciliatory agreement may be necessary. It would be troublesome to have different positions on the issues—active listening and finding sweet spots for action through negotiation become the paths to building trust.
Forge strong ties with peers by building momentum. You can build momentum across the silos by leading with inspiring stories and a clear action plan to deliver tangible results. Doing so ignites a virtuous recognition circle by energizing early followers. These days, leaders can interact with others via video and email. However, that’s rarely inspiring. Leading laterally means walking the halls, sharing ideas with peers, actively listening to concerns, and working together to implement plans—purposeful rounding. The best lateral leaders connect directly with as many people as possible across silos in in-person ways and help them connect the dots and succeed.
Summary
The world is not static, nor should leadership paradigms. In a complex world of border-crossing and boundary-spanning, leaders don’t just look ahead; they look laterally to position their organizations to align mission, vision, and values. Lateral leadership resonates in a world where disruptive innovation, unexpected competitors, and new partnerships are emerging. Customers, patients, and families experience organizations laterally. So should leaders. Forget those flamboyant John Wayne movies and hierarchical leadership models. They’re needed when needed, but the style is not the norm.
All leaders should embrace the approach of learning to lead laterally. Today’s leaders must learn to lead laterally, but breaking current habits will not be easy. The future of lateral leadership depends on determining the value of trust, interchangeability of roles, and humility.
WHAT’S YOUR BEST TIP FOR LEADING LATERALLY—LEADING SIDEWAYS?
Check out other SHELDR articles related to LATERAL LEADERSHIP, LEADING SIDEWAYS, AND SYSTEMS THINKING!
From Blind Chaos to Clarity: Master the 5 Systems Thinking Tools for the Next Pandemic
Questions for Discussion
- How does lateral leadership differ from traditional hierarchical leadership in healthcare?
- What are the key competencies required for effective lateral leadership?
- How can lateral leadership improve collaboration between healthcare and community services?
- What challenges might leaders face when transitioning from a vertical to a lateral leadership approach?
- How can trust and influence be built and maintained in lateral leadership roles?
Professional Development and Learning Activities
- Role-Playing Exercise: Simulate scenarios where lateral leadership is essential, such as coordinating care across departments or integrating community health services.
- Case Study Analysis: Review case studies of successful lateral leadership in healthcare settings and identify key strategies used.
- Self-Assessment: Reflect on your current leadership style and identify areas where lateral leadership could enhance your effectiveness.
- Mentorship Program: Pair up with a peer to practice lateral leadership, focusing on mutual support and shared decision-making.
- Workshop: Attend or organize a workshop on lateral leadership, focusing on skills like active listening, negotiation, and collaborative problem-solving.
AI-Prompts
- “Generate AI-driven strategies for implementing lateral leadership in a complex healthcare organization.”
- “How can AI assist in identifying opportunities for lateral leadership within a multi-disciplinary healthcare team?”
- “Develop a lateral leadership training program using AI-powered simulations.”
- “Explore AI tools that can enhance communication and collaboration in lateral leadership roles.”
- “Analyze how AI can support the tracking and measurement of outcomes in lateral leadership initiatives.”
Hashtags
#LateralLeadership
#HealthcareTransformation
#LeadershipSkills
#HealthSystemsIntegration
#StrategicLeadership
