resilient leadership: exploring the most appropriate ... · resilient leadership: exploring the...
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Resilient leadership: Exploring the most
appropriate leadership style for resilient
organizations within the health care sector
Eric Arne Lofquist
15 August 2016
Leading resilient organizations
Resilient organizations
•Complex dynamic-adaptive socio-technical systems in
high risk environments where safety is a priority.
• Civil aviation
• Maritime (Aircraft carrier operations)
• Off-shore
• Health care
Resilience Engineering (2006)
•Resilience Engineering is a multi-disciplinary, theoretical
approach for designing and managing complex, dynamic-
adaptive socio-technical systems, and has become
recognized as an alternative to traditional approaches to
safety management (Hollnagel, Braithwaite & Wears,
2013).
Key concepts• Systems understanding
• Complexity/bounded rationality
• Dynamic-adaptive behaviour
• Performance improvements• Resilience
• Single vs. Double-loop learning (Safety I vs. Safety II)
• Mindfulness (sensemaking)
• Culture (Just Culture)
• System inertia• Quality (continual improvement vs. adaptation)
• Control-based management (Rules, regulations, procedures, processes, targets, etc.)
• Compliance
Research problem
•There currently exists an organizational mismatch
between creating a supportive environment to promote
“resilient traits or qualities” and management
(leadership) mechanisms.
• Lack of understanding of complex, dynamic-adaptive behavior
in socio-technical systems.
• Control-based management mechanisms.
• Reliance on rules, regulations, procedures, compliance, etc.
• Gaps.
Improvement through resilience
•Resilience – the ability of a system to absorb stress and
handle unexpected/unplanned changes in the environment
without collapsing/failing.
•Ability to learn from success vice «trial and error
learning».
•To detect changes through mindfulness/sensemaking.
•Ability to adapt to changes in the system «on the fly».
• Flexibility to deviate when appropriate (without fear).
Research questions
•What do leaders need to understand about the
nature of complex, dynamic-adaptive socio-
technical systems to create a resilient
organization to improve safety performance?
•What leadership styles are best suited to promote
resilient behavior on both the structural and
individual levels?
Organizational leadership
• Theory X/Theory Y
• Transactional/transformational/charismatic leadership
• Leader Member Exchange (LMX)
• Shared/Distributed/Collective leadership
• Self/Super leadership
• Authentic leadership
• Adaptive leadership
• Entrepreneurial leadership
• Ethical leadership
Clinical microsystems (Health care)
•Micro system - small, organized groups of providers and
staff caring for a defined population of patients
• Emergency rooms, trauma centers, primary care clinics,
neonatal intensive care units, renal dialysis units,
diabetes care clinics, etc. (Mohr & Batalden, 2002).
•Meso system
•Macro system
•Global system
Leadership
Style
Attitudes
Self-efficacy
Ownership
Commitment
Satisfaction
Empowerment
Social capital
Resilient
behaviorsSafety
performance
Culture? Individual
traits
Conceptual model
Sabbatical
• 16 Jun 2016 – Helse Vest & Haukeland sykehus
• 15-17 Aug 2016 – Resilient Health Care Net workshop –
Middelfart, Denmark.
•Aug 2016 – Focus group meeting Helse Vest/Haukeland
• 12-16 Sep 2016 Jacksonville, Fla
• 18-31 Oct 2016 Michigan State University/Ohio State
University/Buffalo, New York
•Dec 2016 Sydney, Australia
Resilience literature
• Resilience Engineering: Concepts and Precepts (Hollnagel, Woods & Leveson,
2006)
• Resilience Engineering Perspectives, Vol. 1 (Hollnagel, Nemeth & Dekker, 2008).
• Resilience Engineering in Practice: A guidebook (Hollnagel, Pariès, Woods &
Wreathall, 2011).
• Resilient Health Care Vol. 1 (Hollnagel, Braithwaite & Wears, 2013).
• Safety-I and Safety-II (Hollnagel, 2014).
• Resilient Health Care Vol. 2 (Wears, Hollnagel, & Braithwaite, 2015).