Innovators and Pioneers in Systems Change

In Utah for Healthier Health Care Systems Now (January 11-13, 2012), we used the 2 Loops Model of Systems Change as one of the framing references for why we were gathered. It is a tool and a framing to understand the work we are individually and collectively in that shifts the shape of health care.  The two loops model looks like this:

 

The first loop represents the old system, the one we often name as the dying system.  The second loop represents the new system, the one we keep claiming we want, the one we think cannot emerge by fiddling with the old, the one we believe is needed to bring our current systems out of crisis.

The problem is, when we begin to think about the complexity of something like health care, where there are so many jurisdictions, so many players, so many interlocking systems,  trying to imagine what this new system or systems could be becomes paralyzing.  The conversation often becomes philosophical and theoretical.  It largely comes from an intellectual and cognitive place focused on all the things that need to shift that are outside our circle of influence.

Some of the frustration in being innovators inside of systems is that the systems begin to push back on the work in small and large ways, leading to the exhaustion, frustration and disillusionment so many leaders in health care experience.  This is all part of the old narrative.  Of course this showed up in our conversations in Utah to greater and lesser degrees depending on the questions, depending on who was in the conversation at any given time.  Any time we were in that conversation, thinking about the new system, it didn’t feel like a new conversation.

So, how could we be in conversation about Healthier Health Care Systems Now without  focusing on the second loop or the new system?  Well, by remembering who we are – pioneers and innovators in health systems – working under the first loop – in the in-between spaces – championing the new or being championed.  We began to focus in on and explore new questions: Where are the edges of my work?  What is the new territory I could begin to walk when I go home?  How can I draw on the resources in the room to expand my thinking, even turn it upside down and on its head – like the person who relies on gift economy in her practice, for her livelihood?  What more becomes possible in generative spaces with other innovators?  This was a different conversation, in tone, texture and energy.  This one did not come from the head. It was embodied in a whole new way – the beginnings of a new narrative of health.

The awareness of the old narrative and of the stuck places infiltrated us in the best of ways at the end of the first day of our three day gathering.   Someone suggested what we needed to do was create a vision of the new.  Ordinarily I might agree.  In this case though, that didn’t feel right.  It felt like it would take us further off track given that our roomful of people were geographically stretched from coast to coast across two countries with countless “systems”?

So, without taking our eye off the intention of shifting the narrative of health, we refocused on innovating and pioneering and guerrilla tactics of  hosting, collaborating and co-creating, engaging those around us in this journey that is health.  We didn’t leave with a specified vision of the new system.  We left heartened in our respective journeys, knowing the way to the future is through new processes, deeper conversations and finding our way with as many of our friends and colleagues as we can attract, engage and embolden along the way.

As we continue to shine the light on the experiments already underway, the successes, the challenges and the “failures”, and tap into the individual and collective resilience that is fighting to emerge, we can remember it is a journey that will shift and change as we go.  We remember life actually wants to help and it wants to heal. If we focus on how to expand our individual systems of influence and share those stories with our friends, our collective system of influence automatically begins to expand.  What seems like isolated work informs pockets of work elsewhere and we grow an energetic field that is part of the new, part of the second loop and is fueled by everyone stepping into innovative, courageous and pioneering ideas and projects.

I still can’t see what that second loop is for health care – other than it is about health and it is healthier.  I’m not sure anyone who showed up for this conversation can see the second loop either.  But I am absolutely sure that the innovators and pioneers are already prototyping what’s possible, what’s new, and in this work more and more of the new and the new narrative will show up.  I am reinvigorated by what’s possible, by the people who continue to explore these questions, who challenge the status quo, despite possible personal risks in doing so and know that there are better and more healthy ways to engage health care.

I and my hosting mates are committed to convening more of these conversations with people compelled to be in them to grow the field.  We envision large gatherings of people convening in new ways, continuing to innovate our way into the new system(s) so that maybe one day we will wake up and see in front of our eyes what we once thought impossible – a new generative system of health resilient enough and healthy enough to be sustainable in unexpected and beautiful ways.   If we take our eyes off the urgent need for something that feels impossible and put it in the places where possibility thrives… well, what more is there to imagine or say?

Steve Ryman, Tenneson Woolf, Kathy Jourdain, Marc Parnes

 

 

2 loops of systems change

Healthier Health Care – Now! A Little Taste of What’s Cooking

We wondered what would happen if we invited friends from across North America to convene in Salt Lake City, Utah around the question of Healthier Health Care Systems Now?  We were amazed.  We began by sharing who we are – the innovator and pioneer in us that  compelled us to come to this conversation.  Then we shared the exciting work we are engaged in.  We talked about the “system” and discovered “it” was never A system and “it” was not about health.  We moved from talking about systemic issues that felt as philosophical as we know they are real and moved into embodying the conversation, coming from a place of deep connection to ourselves, each other and the work that continues to call us in the worlds we work and travel in.  The insights, themes and cool learning are just beginning to percolate for each of us.  More, much more, is cooking.

It was beginning to cook before we even arrived in Salt Lake City.   We discovered healthier health care was such a compelling question people went to great lengths to get there.  Some initially said no and then found a way to come.  Others felt the question so urgently they used vacation days and airmiles to get there.  One person even crowd funded her flight.

Twenty-six of us arrived on January 11, 2012 – physicians, naturopaths, other practitioners, administrators and consultants from heath, public health, dentistry, acute and long term care from Nova Scotia, Ontario, Alberta, Ohio, Minnesota, Winsconsin, Illinois, Texas, Oregan, Washington and Utah.  Everyone an innovator or pioneer already working diligently on shifting the shape of health care within their spheres of influence.  We all brought stories of change and deep and compelling questions. We made instant connections that inspire us to go deeper and to keep at it.

This will continue to simmer and cook for quite some time to come.  I will have more to share here about this conversation at the beginning of 2012, curious to see how it might grow as we convene a community of practice for those who were there, those who wanted to be and couldn’t make it and those who begin to find their way to this particular conversation in their own way.

You can find snippets of harvest on Twitter by searching #HHSUtah.  Thanks to Amanda Fenton, who was with us from afar, for stepping in and compiling our tweets @Storify.

I offer here a little taste of a quick and fun harvest at the end of day 2 as we went around our circle and each of us added a line to the unfolding story of our journey together. I didn’t catch every word, but it will give you some small essence of the experience, recognizing some references are very specific to our experience, and it will have to tide you over til the next post.

“There were a bunch of hooligans in a house by the mountain.  They thought of themselves as pioneers, radically re-engineering, brought together by living systems that taught them how to transfer what they are learning and experiencing into what they are doing now – open to possibility.  In sharing, they saw new connections and unique opportunities.  They described them as opportunities to change and blow shit up.  These hooligans had so much to think about, they sat in circle, played, visualized and created on many levels a new vision of what they were yearning for – simplicity, wellness, with open heart toward the future to bring this new narrative to everyone.  Envisioning systems that bring forth vision and health, letting go of the old to release into timeless universe.  They pondered next action.  In the middle, they went deep into the cellar to share unique fonts and forms of creativity.  They came together to discuss the topic but it was more than the sum of its parts – human nature – own beauty, higher power and purpose run in each of them and each other with gratitude, although we do fear discovering in horror on FB the shaking moments, with brains exploding in chaos, guerrilla gardening and permaculture parties.  But then, a pause for reflection and even more to emerge.  Finished.  No shame.  Amazing thing, working hard to create something different.. but in the end, they were different, a community – and in their differences they found their common humanity from which to go back to the places they came renewed, reinvigorated, inspired to innovate on!”

With gratitude to all who were there, all who held the rim of this gathering from afar and specifically to my fellow hosts Tenneson Woolf, Steve Ryman and Marc Parnes for an experience that will be long remembered, in a gathering where the new narrative of health was activated, the field of innovation in health care where we meet was amplified and shifting the shape of health care in our spheres of influence has been accelerated.

Intentionally Shifting the Shape of the World in 2012

Wow.  2012 is a breath away. When I started the Shape Shift blog I wrote: “the shape of the world is shifting. It is constantly shifting but never more so than now. This is evident in health care, education, finance, communities, technology, organizations and other systems that have become vital to how we function today.  We can be passive recipients of the impact of these shifts in the world or we can become active participants in shaping the future of the systems, organizations and communities that we feel passionate about – that are near and dear to our hearts.”  This was true when I wrote it, and started Shape Shift Strategies Inc, in August of 2009.  It is even more true as we are on the brink of 2012 – a year that has been much prophesied and written about.

If we are paying attention we can literally and figuratively feel the earth shaking underneath our feet as significant shifts take place – in the natural world and the manmade world.  Earthquakes and tsunamis in New Zealand and Japan, the Arab Spring, Occupy to name just a very few.  I say paying attention with the full awareness that there are many of us who see the greater scope of these stories and feel the significance of them in our very beings and there are many who do not yet see the stories under the stories that show up in mainstream media – a medium that is struggling with seeing and understanding the deeper patterns of these movements in the world.

If I am to imagine into 2012, I can only imagine that the chaos and complexity of our systems, our social structures and  our communities will increase.  This because of the reluctance and deep resistance of letting go of what we know, even when we know it doesn’t work anymore, to embrace what is waiting and wanting to be born.  It is so hard to see new ways when all we can see is what we have already built.  I’ve seen it in the conversations surrounding the Healthier Health Care Now gathering set for Utah early in January.  “We want you to be different, but please do it in familiar ways.  Because we don’t know how to support something that looks and feels different, especially when you cannot tell us exactly what it will look like in the end.  We have to be accountable, after all.”

How do we become accountable for our future when we are anchored to what we know, what we have always known, what already exists?  This is why the chaos will increase.  It is already telling us what we know no longer works.  Our collective response?  Hold on tighter.  Don’t let go.  How deeply shaken do we need to be to let go, let fly into the void of the unknown?

Thank God for the growing pockets of people, teams, communities and communities of practice who see a different future and who steadfastly work toward it in the not knowing.  There are so many I can name - because I am part of them – and so many I can’t because I don’t have knowledge of them but I am not so insular as to believe they don’t exist.  Paul Hawken’s work in Blessed Unrest is just one indicator of this world wide revolution that is taking place right under our very noses – whether we see it or not.

Those of us working and living  in the spaces of not knowing the specific shape of the future or of what new systems could emerge from the old as we are shaken free in the chaos, we are Warriors of the Heart.  To be a Warrior of the Heart and be well, we need personal practices that keep us connected with source and allow us to access our own resilience, courage, compassion, strength, joy and love.  There are individual and collective dimensions of practice. We build personal capacity in our individual practice.  We amplify, accelerate and activate so much more when we come together in our collective work and journey.

2012 may show us more and more the intersection between the relational field (love and loyalty) and the strategic field.  We have treated love and loyalty somewhat dismissively – the soft skills side of the equation.  In business we need to be hard – hard nosed, make hard decisions.  What if this is not true?  What  if our greatest path forward is to embrace more fully the relational field so that our choices are actually more strategic, have a longer term view and value all the things that are important to our survival in a time when so much of what we have always known seems threatened?  What becomes possible when we sink into what we’ve known even longer than what we’ve always known – the wisdom and knowledge accessible to us in ancient wisdoms that become more present to us as we pause and listen deeply – to the earth, to the whispers in our own hearts, to the yearning we have to be connected to something that has deep meaning and purpose. What would a world look like that connected through love and loyalty and then developed strategy for the highest good of us all?

The shape of the world is shifting.  It always has been.  Is it shifting faster now?  Feels that way.  What is the intentionality we can individually and collectively bring to amplify, accelerate and activate the shift we desire to see in the world?  What is the shape of the world you want to live in to?

I experience such deep gratitude and appreciation for my friends and colleagues (the ones I know and the ones I haven’t met yet) around the world.  You inspire me.  You lift me up in the moments when I have lost sight of my own light.  You give me great hope for what is possible in a new world order.  I am humbled and honoured to do amazing work in the world with people I care deeply about – from a place of open heartedness and a field of love and connection that makes possible the impossible – only seeming impossible because we can’t always see the how.  The how stops us.  The vision and intention for shaping a future we want to live into compels us all forward.

Walking the path of not knowing.  Setting strong, clear intentions for what I want to see unfold in my own path of shifting the shape of the world in 2012, letting go of the how and inviting what is ready – and urgently wanting – to show up.

Why Don’t Those Occupiers Just Go Home?

The Occupy Movement seems to have hit a perplexing moment – yet another one, that is.  Officials in many cities across North America are trying to figure out how to make the occupiers go home.  Fall is settling in to many places and what many assumed was a passing fad hasn’t yet faded away with the cooler temperatures or fiercer weather.  If they didn’t have any demands like typical protestors and no proposed solutions to the problems that others could then shoot down, then why haven’t they just packed up and gone home?

So now, many officials are trying to figure out how to get them to disburse while opinions of the movement and the occupiers vary dramatically within the media and within communities in each of the cities.  Some people think they are an eyesore filled with people, mostly young, who don’t have jobs and are only looking for a handout.  People who have this perception seem to just want them to go home and find a job like everyone else.  Public officials are certainly playing off of the perceived dangers pointing to drugs, alcohol and even some deaths in some cities as reasons to disband the occupiers.

Other people see them as vibrant communities that people flow in and out of, people with and without jobs, people on traditional career trajectories and those on alternative career trajectories, who are standing up for democracy and “voting” by their very presence in public spaces.  My own bias or world view is that there is something more going on here, something deeper, something fundamental to understanding the shifting shape of the world.

Occupiers have been gathering long enough that minimum structures and process have emerged.  These tent villages include library and food tents as central points of focus.   They have been working with consensus decision making and ways of being heard in large crowds where any kind of speaker system has been denied.  The movements have stayed largely peaceful even in the face of being provoked at times.  They are communities that are taking care of each other in some beautiful and perfectly imperfect ways.

They are example of translocal communities that are learning from and with each other and supporting each other.  They exist in individual cities and they are part of a field of attraction that makes them more than any single city.  That the movement spread so quickly and virally from one place to the next points to its magnetic attraction and the sense that there is something more going on here.

Maybe the occupiers haven’t presented demands or proposed solutions because they know we don’t know what the solutions to our problems are and they won’t be solved by a few people locked away in a room brainstorming or strategizing our future.  The greatest likelihood of deep, systemic solutions appearing is the collective curiosity and discovery of what is possible through intentional dialog the likes of which we may have not seen before – like the 1000 table, 10,000 person cafe conversations that took place in Tel Aviv earlier this year – the first of its kind but surely not the last.

Our culture is such that any one person or group presenting solutions feeds into our predominant public and social structure of debate – giving people something to latch onto to elucidate all the reasons those solutions won’t work and dividing us into camps of right and wrong, good and bad, smart and stupid.  What happens when we invite ourselves to see past the dichotomies to hold the paradoxes and allow all possibilities to exist in the same moment?  The very idea is perplexing in a world that has become beautifully complex and yet where some still want to boil it all down into nifty little compartments of thought and action.  We don’t live in that world anymore.  We haven’t for some time.

Our systems – financial, health care, education, transportation, environment, to name a few – are in deep trouble.  For the most part, they no longer support themselves.  They are out of integrity.  Most of them would be financially bankrupt if we let them be.  Officials can try to make the occupiers go home – in fact, as I’m writing this I got a test message saying police in Halifax are forcibly trying to remove the Halifax Occupiers from Victoria Park right now, in the pouring rain.  But taking them out of public spaces does not change the condition of these systems or the condition of the globe in this moment.  It might allow some to pretend that we can go back to business as usual, but we have long since passed that point.

So, if we opt out of the ways we have always done things, where does that take us?  To the field out beyond right and wrong (to badly paraphrase Rumi)?  If enough of us were able to let go of everything we think we know and allow ourselves to surrender into the edges of our learning and experience, maybe collectively we will begin to imagine what’s next and lean into creating the conditions for that emergence – emergence meaning we all left with something no one brought.

The deliciousness of possibility has me salivating with eternal hope.  The inquiries I am in around stewarding what wants to emerge along with the deeper underlying patterns inherent in the work I am called to do make me deeply curious about the Occupy movement, the staying power of it and how it will influence the shifting shape of the world and the regeneration of its people.

“Soft Skills” – A Real Misnomer!

Ask anyone.  The hardest thing we ever do is relate to other people, especially as leaders in our organizations or communities, but also in our personal relationships.  Ask anyone what the most difficult component of their job is: relationships, interpersonal dynamics, people.  Ask project managers why most projects fail: inadequate communication and team members moving in different directions or having differing priorities.  Ask teams their greatest challenge: getting work done – because of interpersonal dynamics that get in the way.  Because people challenges interfere in getting the job done, slowing us down.

Empathy, leadership, communication, sociability, ability to laugh, optimism, common sense, responsibility,  integrity and motivation are some of the skills identified as soft. Somehow soft has become interchangeable with expendable so when budgets become tight the first thing to go is soft skills.

Soft skills are not about being nicey nice.  They are about creating the conditions for relationships to grow, enabling individuals and teams to engage in difficult and necessary conversations, not so we can all live in some kind of utopia but in service of getting work done, achieving results, having impact, shifting systems, seeing possibility, opening to emergence.  We do our best work with people we like, people we care about and people we love.  We have our greatest resilience in systems that care. We reach our highest potential in supportive environments that encourage growth.  We take our greatest risks when we know someone will help us up and dust us off when we fall so we can all be ready for what’s next.

There is nothing soft about soft skills.  They require discipline, practice and self awareness.  They require risk and letting go of control, trusting others to step up and in when we create the space for them to do so and they require discernment about what is the right amount of leadership, coaching and support required to allow teams and individuals the highest possibility of growth and contribution.

One of the reasons I gravitate to the Art of Hosting Body of Knowledge is because of the emphasis on creating the field or conditions from which wise action, results and impact will flow, flowing out of a well tended relational field.

We will not shift the shape of the world only through projects.  We will shift it by paying attention to the quality of the relational field and our relationships.  The greater the quality of the relational field, the greater the power to engage in actions with such purposefulness that the shape of the world cannot help but shift.

Prototyping Collaborative Leadership at Capital Health – Infusion

In March 2007 Capital District Health Authority (CDHA) in Halifax, Nova Scotia took on a planning process called Strategic Quest.  A significant component of Strategic Quest included public participation in an unprecedented way, shifting the shape of awareness and thinking at Capital Health.  The results were revealing and the impact continues to reverberate throughout the organization today, strongly influencing ongoing public participation in a number of areas and inviting collaborative leadership as a strategy to accomplish many of its goals.

One initiative I was involved with where Collaborative Leadership was an essential part of the process was Infusion: a gathering in November 2008 of 70 leaders from across North America, in our local community and within Capital Health, convened to inform what bold and unique leadership development within Capital Health could look like.

The planning process for Infusion, championed by Lea Bryden and led by Shape Shift Strategies, invited and modeled collaboration, shared leadership and shared responsibility.  A diverse group of people from across Capital Health were invited into the planning process.  Many identified the planning process itself as a leadership development opportunity as they experienced collaborative leadership in new ways, stretching beyond their original assumptions about how and what they could each contribute to this unusual event.

Achieving clarity of purpose was the first task.  It required a significant investment of time – several meetings.  It was a difficult task because there were multiple overlapping components all alive and unfolding as we were in this planning process.  We stayed in the conversation until sharp clarity was achieved and then rest of the planning process unfolded rapidly because it was guided by this clarity of purpose.  We also actively worked with Theory U in the planning process and for the event itself.

The planning process always had a forward momentum, even when people missed meetings.  As they came back in, they found their place in the process and continued to contribute constructively.  They could step into and out of the flow of the process without having to back track and rehash decisions made when they were not present.

The two day Infusion event drew on the talents of everyone on the planning team.  Invited guests: leaders from a vast array of backgrounds, many of whom were leadership consultants, were asked to bring their knowledge and expertise in a participatory way.  It was at times a challenging field to hold.  The team was able to hold its ground as we went through the fire of chaos, adjusting design in the moment and holding space for some anger and frustration that unexpectedly arose within the group because of the collaborative leadership we had been growing throughout the planning process.

Infusion did not end in a nice tidy wrapped up bundle and Lea Bryden, myself and the team were good to leave it that way while taking away the gems that guided the development of My Leadership – a truly unique leadership development initiative inside of Capital Health with a bold vision and goals that has since had 500 leaders complete and won a number of regional and national awards.