Leadership for Health System Transformation Principles, Practices and a Christian Perspective

1. Leadership for Health System TransformationPrinciples, Practices and a Christian Perspective Henry Mosley Presented at the CCIH Conference May 26, 2007

2. Leadership in the Bible • Name some great leaders in the Bible from the Old Testament • What are some of the character traits that made these Biblical heroes leaders? • What did they do that made them leaders?

3. What Do Leaders Do? • Generate a Shared Vision • Enable Others to Act • Create Learning Organizations How does the life of Jesus serve as a model for leadership?

4. Background • Johns Hopkins Leadership Seminars - “Strategic Leadership for Health System Transformation in Developing Countries” • Developed by Ben Lozare and Henry Mosley and presented worldwide since 1998

5. Our Key Reference Book The Fifth Discipline. The Art and Practice of the Learning Organization Peter Senge First edition published by Currency Doubleday, NY, 1990. Revised edition, 2006

6. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

7. STARGuide Strategic Thinking, Action and Reflection GuideA model of leadership development based on Peter Senge’s Five Learning Disciplineshttp://www.jhuccp.org/training/scope/starguide/begin.swf

8. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

9. Core Leadership Disciplines* Systems Thinking Personal Mastery Mental Models Shared Vision Mental Models *Ref. Peter Senge (1990)

10. The STAR Framework Strategic Thinking, Action and Reflection

11. Systems Thinking • “Systems thinking is a conceptual framework, a body of knowledge and tools that has been developed over the past 50 years to make full patterns clearer and to help us see how to change them effectively.” Senge (1990), p7

12. Systems Thinking – STAR Question • How can we see the dynamics, interconnections, deeper patterns and purposes of systems?

14. Personal Mastery Personal mastery is the discipline of continually clarifying and deepening our personal vision, of focusing our energies, of developing patience, and of seeing reality objectively. Senge (1990), p. 7

15. Personal Mastery – STAR Question • How can we live more creative and purposeful lives?

17. Mental Models • Mental models are deeply ingrained assumptions, generalizations, or even pictures or images that influence how we understand the world and how we take action. Senge (1990), p.8

18. Mental Models – STAR Question • How can we continuously open our minds to new ideas?

20. Shared Vision • If any one idea about leadership has inspired organizations for thousands of years, it’s the capacity to hold a shared picture of the future we seek to create….The practice of shared vision involves the skills of unearthing shared “pictures of the future” that foster genuine commitment and enrollment rather than compliance. Senge (1990), p. 9

21. Shared Vision – STAR Question • How can we inspire others to seek goals “beyond imagination”?

22. Where do leaders operate? Beyond Imagination That’s Impossible Looks Difficult Easy to do

24. Team Learning • When teams are truly learning, not only are they producing extraordinary results, but the individuals are growing more rapidly than could have occurred otherwise. The discipline of team learning starts with “dialogue,” the capacity of members of a team to suspend assumptions and enter into genuine “thinking together”. To the Greeks, dia-logos meant a free-flowing of meaning through a group, allowing the group to discover insights not attainable individually. • Senge, p. 10

25. Team Learning – STAR Question • How can we align everyone to learn together how to reach a shared vision?

26. Insert Team Theme

27. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

28. A Leader is a Catalyst for Change The Learning Organization is the Instrument of Change

29. Learning Organizations • In a learning organization, leaders are designers, stewards, and teachers. They are responsible for building organizations where people continually expand their capabilities to understand complexity, clarify vision and improve shared mental models – that is, they are responsible for learning….the first leadership act [is] inspiring (literally “to breath life into”) the vision of learning organizations. (author’s italics) Senge (1990), p. 340

30. The Leader as Designer • “The first task of organizational design concerns designing the governing ideas – the purpose, vision, and core values by which people will live” Bill Bradley, President and CEO, Hanover Insurance Senge (1990), p. 344.

31. The Leader as Steward • “The leader’s purpose story…brings a unique depth of meaning to his vision…this story is central to his ability to lead. It places his organization’s purpose, its reason for being within a context of “where we’ve come from and where we’re headed,” where the “we” goes beyond the organization itself to humankind more broadly. (continued)

32. The Leader as Steward (continued) • “ Out of this deeper story and sense of purpose or destiny, the leader develops a unique relationship to his or her own personal vision. He or she becomes a steward of the vision….Being a steward of a vision shifts a leader’s relationship toward her or his personal vision. It ceases to be a possession, as in “this is my vision” and becomes a calling. You are “its” as much as it is yours. Senge (1990), p. 346

33. The Leader as Teacher • Leaders can influence people to view reality at four distinct levels: events, patterns of behavior, systemic structures, and a “purpose story”….By focusing on the “purpose story” – the larger explanation of why the organization exists and where it is trying to head – leaders add an additional dimension of meaning. (continued)

34. The Leader as Teacher (continued) • When people throughout an organization come to share a larger sense of purpose, they are united in a common destiny. They have a sense of continuity and identity not achievable in any other way. Senge (1990), p. 354

36. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

37. Community Household Production of Health Framework Health Global driving forces Households Government

38. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

39. Practices Organizational Capabilities - Values, Practices and Resources. Values Resources

40. All parts of the health system operate through values, practices and resources Global driving forces Health Values Households Practices Resources Values Values Government Community Practices Practices Resources Resources

41. What are the five frameworks that we use in our leadership seminars? • The STAR Leadership Disciplines • The Learning Organization • The Household Production of Health • Organizational Capabilities • The Guide for Action Learning

42. The top–down, or “blueprint” intervention strategy disconnects learning from action Interest groups Policymakers, planners Managers, providers MIS Communities, households Evaluations Research, pilot projects Health Learning Action

43. The “Learning Organization” strategy will link knowledge to action Communities, households Health Demand Needs Learning Decisions Outputs Managers, providers Policymakers, planners Competencies Tasks Interest groups

44. Learning Organizations • The first challenge is sustained effort….since the practice [of the disciplines] goes on forever. In building learning organizations, there is no “there,” no ultimate destination, only a lifelong journey. Letting go of “the learning organization” as the ultimate state to be achieved is very difficult for us goal-oriented Westerners. ...building learning organizations entails profound cultural shifts. Senge (1990), p. xv

45. The Guide Framework Desired Future Implementation with Accountability Current Reality Strategy Design Root Cause Analysis

46. The Guide Framework - Questions 1. What is the future that we want to create? 2. What is happening now? 3. Why is there a difference? 4. What do we need to change? 5. How do we nurture change and accountability?

48. What we have learned about leadership • Leadership development is a life-long, non-linear process. • Being a leader is a dynamic condition that changes constantly. • Leadership is not a position or role. It is who we are, what we know, and what we do. • We need to nurture leadership at all levels, not just at the top!

49. What is our leadership seminar’s key idea? • We need to nurture a learning organization where continuous learning is a passion, where everyone shares a vision and feels enabled to achieve desired health outcomes.

50. Insert Believe Theme