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Case Studies

Working With Healthcare Executives

Situation / Participants

We recently conducted a workshop with Health Care Executives--heads of Critical Access hospitals - Leading in Complex Systems.  Rather than being about systems theory, the focus of the workshop is on the leader’s experience working in a system-- how complex systems behave, how they as leaders behave in systems, how the system impacts them as leaders, and how they can increase their positive impact upon the system.

Premises Underlying the Work

  • We each have a core systemic story that has a significant effect on how we operate in the workplace.

  • Our systemic story reflects ways we learned to be effective in the first system of which we were a part.  

  • We can learn to understand that story, see how it is influencing our behavior in professional / leadership situations, and recognize its strengths and limitations.

  • We can learn to create an enhanced story that is more fully aligned with results we want to create as leaders.

Agenda of the Program

  • Describe your most difficult current leadership challenge and how you are addressing it.

  • How complex systems tend to behave

  • How you tend to lead in complex systems:  Your leadership behavior over time

  • Why you tend to lead as you do:  Your Systemic Story

  • Addressing your Leadership Challenge - getting outside the box and broadening your range of options


What Happened with Health Care Executives

Using frameworks and tools from both Systems Dynamics and Family Systems, the executives explored the connection between how they are leading today, particularly in high pressure, difficult situations; how they have tended to lead over time; and their original systemic story—which reflects how they learned to be effective, to establish relationships, to feel safe, to take risks, to be noticed, or to avoid being noticed in human systems.

When the leaders introduced themselves, they described their most challenging current leadership situation and how they are handling it.  Through dialogue, we found that, to a person, the current manner in which they are addressing their challenges was a mirror of how they learned to behave in their deep systemic story.

For example, one executive described her challenge in this way:  “In the system I lead, I have many disparate groups, including doctors, nurses, staff, my board, and my community.  My job is to keep them all happy because that’s the way to hold the system together”.  When asked, “Have you played that role in other places you have worked?” she replied, “I always do, and it sometimes exhausts me.”  After some discussion, we explored together her original systemic story:  “I was the youngest child in a large family.  My brothers and sisters were all away and involved in very different things.  I felt it was my responsibility to hold the family together, and to do that I had to keep everyone happy.”   Then she exclaimed, as people often do in these conversations, “Oh, it’s the same story!”

As we worked through the day, the Executives looked at how their system behaves, their patterns of leadership behavior over time, and how those patterns are rooted in their systemic stories.  They begin to see the assumptions they were making (e.g. the way to make a system work well is to keep everybody happy, and it is the leader’s job to do that”, and what their stories “tell them” to do and not to do in a human system.  They saw that the rules for behavior in their story, while perhaps appropriate for their original system, might not fit well in their current system.  Then, they identified new assumptions and new options, and thereby began to create a new leadership story for themselves, one more aligned with the realities of their current system and with results they want to create there.   Finally, they returned to their Leadership Challenges and crafted a new approach with increased leadership impact.

Take Aways for Health Care Executives

  • They are now able to see their deep systemic story, its influence on their present leadership behavior, and how it may limit them.

  • They have begun to create a new story and have a new set of options for themselves as leaders - a broader range of things they as leaders can do to impact their organizations.

  • They identified new approaches for addressing their current leadership challenges.

Learning about Health Care Executive development

  • Health care executives will participate readily in this kind of systemic work.

  • They can greatly enhance their systemic leadership capabilities through 1/1 or small group story work.

  • They quickly develop deep insight into themselves as leaders, into the systems in which they lead, and into how to dramatically increase their effectiveness as leaders.

© Copyright Steven P. Ober EdD 2010 
Steven P. Ober, EdD For synovations® October  2010

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