2011 dialogue the language of complex systems v.2

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  • The critical point to get across here is that the systems paradigm assumes that complexity cannot be managed by breaking things down into parts and fixing the bits. The assumption is that relationships between parts are dynamic so when you want to change things you have to consider all the relationships involved. For example, if you decide to set a target that reduces waiting times in A&E, you have to understand not only all of the factors involved in the A&E processes but also the impact on all other hospital departments of changing those processes and how those impacts ‘feed back’ into A&E itself – otherwise you will simply ‘move’ the blockage to another part of the system (eg the admission ward).


  • 1.
  • 2. Intro
    Dialogue: The Language of Complex Systems
  • 3. Intro
  • 4. Intro
    Learning Outcomes
    Understand complexity as it relates to healthcare leadership, collaboration, and innovative change
    Practice systems thinking and inquiry skills to bridge diverse perspectives, strengthen relationships, and collaboration across disciplines
    Use dialogue to navigate complex, ambiguous and rapidly changing environments with less stress
    Explore a real challenge with peers, leaving the program with fresh ideas and practical next steps for building partnerships and leveraging change
  • 5. Intro
    Guiding Principles
    Workshop approach
    Balance reflection and action
    Applied and practical
  • 6. Intro
    Day 1
    Introduction & Context Setting
    A Systems View of Healthcare
    Navigating Complex Systems
    Systems Thinking in Action
    Change Challenge l
    Change in Complex Systems
    Introduction to Dialogue
    Reflection & Summary
    Day 2
    Opening Reflection
    Developing Dialogue & Inquiry Skills
    Using Dialogue in Pivotal Conversations
    Beyond Expert and Silo’s Thinking
    Change Challenge ll
    Project Sharing and Planning Next Steps
    Summary & Evaluation
  • 7. A Systems View of Healthcare
  • 8. Navigating Complex Systems
  • 9. An Increasingly Complex World
    Danish political scientist Bjorn Lomborg heads the Copenhagen Consensus, which has prioritized the world's greatest problems -- global warming, world poverty, disease -- based on how effective our solutions might be. It's a thought-provoking, even provocative list.
    A campaign to change the course of history. Really. It’s time to make a choice. We can let present trends continue and risk almost certain breakdown and collapse.
    Four years is enough time to build that will, to change our direction, even to transform ourselves. And Go because we must start now.
  • 10. Organisation is: Structures Roles Processes Balance sheets
    People are: rational, role-oriented, willing to be a ‘cog’ within a managed system (‘levers’, ‘engagement’, ‘performance maximisation’, ‘human capital’)
    A paradigm so prevalent it is largely invisible
    Machines are predictable, controllable and can be reduced to parts – problems can be solved by taking them apart and looking at the ‘pieces’
    The machine paradigm
  • 11. The complexity paradigm
    Organisation is made of :
    Relationships and feedback loops
    Power interactions, loyalties and rivalries
    Influence systems, in groups and out groups
    Paradigm assumes that reality is complex and that key issues are in relationships, not the parts
    This requires :
    a holistic approach (the system cannot be studied by breaking it down into parts)
    an appreciation of different perspectives (there is no single objective viewpoint)
  • 12. 2
    Qualities of Complex Challenges
    Difficult to frame, not predictable in detail
    Multiple root causes, non-linear
    Multiple stakeholders
    Difficult to Eliminate
    Long Term Nature
    Relational complexity - Relationships are more important than parts
    Dynamic complexity - feedback loops rather than linear cause and effect
  • 13. The impact of complexity on people
    These basic characteristics of complex systems lead to:
    Ambiguity, uncertainty about what is occurring, what others require
    Rapid change: change in information, in events and context
    Unpredictability that is inherent in the situation
    Strong interdependence to other systems that are also complex
    And for individuals, a sense of being overloaded, not in control.
  • 14. What sort of challenge have you got?
    Zone of
    Near AGREEMENT Far
    Mechanistic Worldview
    The Stacey Matrix
    Brenda Zimmerman, Professor of Policy/Strategic Management , Schulich School of Business
  • 15. What sort of challenge have you got ?
  • 16. What can you do about it?
    Some problems are so complex that you have to be highly intelligent
    and well informed just to be undecided about them.
    ~ Laurence J. Peter
  • 17. Systems Thinking in Action
  • 18. Systems thinking is an organised way of shifting your way of thinking so as to escape from mental traps generated by the ‘machine’ paradigm:
    Linear cause and effect thinking
    Search for ‘objectivity’
    ‘Locking in’ of starting assumptions
    All systems thinking tools provide ways of:
    stepping back and seeing a bigger picture
    including multiple perspectives
    representing complex feedback mechanisms
  • 19. Systems Thinking in Action
    What kinds of questions do systems thinkers ask?
    What happens when we don’t think systemically?
    If you see differently, you think differently. And all your actions start to change.
    - Peter Senge
  • 20. Behavior/Events
    Increased Leverage & Opportunity for Learning & Change
    The "Water Line"
    Mental Models/Systemic Forces
    Systems Leverage
    Society for Organizational Learning
  • 21. Systems Archetypes
    Quick Fix That Fails
    Quick Fix or
    Symptomatic Solution
    Problem Symptom
    Side Effect
    Shifting the Burden
    Success to the Successful
    Tragedy of the Commons
    Accidental Adversaries
    Society for Organizational Learning
  • 22. Tragedy of the Commons
  • 23. Systems Thinking & Dialogue
    The system needs to be in the room
    Systems thinking needs a space or container for the “thinking together”
    The container is conversation, and specifically dialogue
    Dialogue aligns us through shared inquiry and a common understanding of the system.
  • 24. I draw conclusions
    and take action
    This becomes a reinforcing loop as we select the same data to focus on over and over.
    I make assumptions
    I select data
    Pool of observable data:
    Things I could choose to focus on
    What gets in the way?
    Ladder of Inference
    Observed event, interpretation, generalization
    This is the way it is!
    Treating initial inferences as facts
    William Isaacs Dialogue and the Art of Thinking Together
  • 25. Change Challenge l
  • 26. Change in Complex Systems
  • 27. Types of Change
  • 28.
  • 29. Simple, Complicated, & Complex Change
    Developmental change
  • 30. Appreciative Inqiury
    Heifitz - Adaptive Change
  • 31. Heifitz - Adaptive Leadership
    Get on the Balcony
    • A place from which to observe the patterns in the wider environment as well as what is over the horizon
    Identify the Adaptive Challenge
    • A challenge for which there is no ready made technical answer
    • 32. A challenge which requires the gap between values, beliefs, attitudes and behaviours to be addressed
    Create the Holding Environment
    • May be a physical space in which adaptive work can be done
    • 33. The relationship or wider social space in which adaptive work can be accomplished
    Give back
    the work
    Disciplined Attention
    the conflict
    • Resume responsibility
    • 34. Use their knowledge
    • 35. Support their efforts
    • 36. Create the heat
    • 37. Sequence & pace the work
    • 38. Regulate the distress
    • 39. Work avoidance
    • 40. Use conflict positively
    • 41. Keep people focussed
    Protect the voices of Leadership from below
    • Ensuring everyone's voice is heard is essential for willingness to experiment and learn
    • 42. Leaders have to provide cover to staff who point to the internal contradictions of the organisation
  • Introduction to Dialogue
  • 43. Low Value Conversations….
    …..do not contribute to positive change
    Telling the history of how we got here
    Giving explanations and opinions
    Blaming and complaining
    Making reports and descriptions
    Carefully defining terms and conditions
    Retelling your story again and again
    Seeking quick action
    Most of what we want to see changed has been explained, complained about, reported upon, and defined for decades. Peter Block
  • 44. Leadership Conversation
    Choice Point:
    What kind of
    conversation does
    this need to be?
    Assumption Testing
    Shared Understanding
    Problem Solving
    Finding Best Answer
    Garmston & Wellman, Cognitive Coaching
  • 45. 35
    A Balcony View
    Choice Point:
    What kind of
    conversation does
    this need to be?
    Assumption Testing
    Shared Understanding
    Problem Solving
    Finding Best Answer
    Leadership Conversation:
    Creative Conflict, Collaboration, Innovation
    Effective Action
    Garmston & Wellman, Cognitive Coaching
  • 46. 36
    Dialogue is a way of conversing and thinking together
    that dissolves barriers, creates collaboration, and builds partnership.
    The outcomes of dialogue are:
    Greater view of the system
    Access diverse perspectives
    Break down silos
    Collaboration and partnerships that foster shared responsibility and accountability
    Team learning
    Leaders talk about what matters - Trust built that surfaces undiscussibles
    Get at root of recurring problems
    New insights leading to innovation
    Dialogue is a core process in complex systems
  • 47. Developing Dialogue and Inquiry Skills
  • 48. Dialogue Practice
    Suspend certainty
    Bring curiosity rather than
    Inquire into your own and other’s reasoning
    Display assumptions rather
    than defend them
    Allow silence for reflection
    Slow down; Speak from “I”
    Speak to the centre rather than
    to the person
    Welcome diversity in ideas and thinking
    William Isaacs Dialogue and the Art of Thinking Together
  • 49. Dialogue Practice
    What conversations are happening now in healthcare that are shaping our practices and changing our lives?
  • 50. Using Dialogue in Pivotal Conversations
  • 51. What is a pivotal conversation?
    Potential to change the course of action and consequently the levels of results
    Crosses boundaries
    Potential for conflict
    Power dynamics
    Outcome matters
  • 52. Left Hand-Right Hand Column
    Conversation Transcript: 4 x4
    Unspoken thoughts & Feelings
    Mental models as barriers to effective communication
    Record what you didn’t say but thought, reflect on assumptions and preconceptions
    - J. Bennecker
    Chris Argyris, Graduate School of Business, Harvard University
  • 53. Leadership Moves in Pivotal Conversations
  • 54. Trio Check-In: Pivotal ConversationsWhat did you observe about yourself in recent pivotal conversation?Which parts of speech do you most rely on?What will increase your effectiveness?
  • 55. Beyond Expert & Silo’d Thinking
  • 56. Ellinor & Gerard Dialogue: Creating and Sustaining Collaborative Partnerships at Work
  • 57.
  • 58. 1920’s Piaget research on stages of child development,
    expanded to include stages of adult development
    (Fowler 1981; Kohlberg 1981; Kegan 1982; Loevinger 1976,
    Wilber 2000; Torbert, 2004)
    Progressive levels of meaning-making, cognitive and
    emotional growth.
    As adults evolve through these stages, they develop the
    capacity for more complex thought and find it easier to
    understand and empathize with different viewpoints.
    Adults do not automatically progress through these stages
    as they age.
    What are the implications for leadership & leadership
  • 59. Robert Kegan
    In Over Our Heads
    McGuire & Rhodes
    Transforming Your
    Leadership Culture
    Joiner & Josephs
    Leadership Agility
    Bill Torbert
    Action Inquiry
    The Secret of Timely
    & Transforming Leadership
    We’ve found that the level of personal development of the leader can have a critical impact on the success of organizational change efforts and, in turn, on the company’s ability to thrive in an ever-more complex business environment.
    ~Torbert & Rooke, Seven Transformations of Leadership (Harvard Business Review, 2005)
  • 60.
  • 61. Expert leaders tend to operate within silos; little emphasis on cross functional teamwork; tend to be overly involved in subordinates work, fighting fires and interacting with direct reports one-on-one; little time to approach their own roles strategically. Organizational improvements are mainly technical and incremental.
    Achiever leaders articulate strategic objectives; have the right people and processes in place to achieve these objectives; develop effective teams, orchestrating them to achieve important outcomes. This patient/ customer centred culture encourages rewards and customer focused cross-functional teamwork. Change initiatives reflect analysis of the larger environment, and consultation with key stakeholders is a cultural norm.
    Strategist leaders animate by a compelling vision that includes high levels of participation, empowerment, and teamwork. Collaboration, decisiveness and candid, constructive conversations are the norm. Senior teams become living labs that create this kind of culture and in the organization. Leaders coach their people, solicit informal feedback and change their behaviors in ways that are beneficial to the organization.
    your capacity
    to meet
  • 62. DevelopmentalTransformations
    Adapted from Harthill UK
  • 63.
  • 64. Change Challenge ll
  • 65. Integration of Learning