Adaptive LeadershipAdaptive LeadershipBeliefs Behind Dr. Ron HeifetzBeliefs Behind Dr. Ron Heifetz’’ work workAdaptive LeadershipAdaptive LeadershipBeliefs Behind Dr. Ron HeifetzBeliefs Behind Dr. Ron Heifetz’’ work work

Problems are embedded within complicated Problems are embedded within complicated and interactive systems.and interactive systems.

Much of human behavior reflects an Much of human behavior reflects an adaptation to circumstances.adaptation to circumstances.

People adapt more successfully to their People adapt more successfully to their environments by facing painful environments by facing painful circumstances circumstances ((aka FEARaka FEAR) ) and developing and developing new attitudes and behaviors.new attitudes and behaviors.

Problems are embedded within complicated Problems are embedded within complicated and interactive systems.and interactive systems.

Much of human behavior reflects an Much of human behavior reflects an adaptation to circumstances.adaptation to circumstances.

People adapt more successfully to their People adapt more successfully to their environments by facing painful environments by facing painful circumstances circumstances ((aka FEARaka FEAR) ) and developing and developing new attitudes and behaviors.new attitudes and behaviors.

Why Apply Adaptive Why Apply Adaptive Leadership in Health Care?Leadership in Health Care?Why Apply Adaptive Why Apply Adaptive Leadership in Health Care?Leadership in Health Care? Describes what people doDescribes what people do Describes what people exercising leadership Describes what people exercising leadership

can do if they see differentlycan do if they see differently A way of developing a shared language to A way of developing a shared language to

describe group dynamicsdescribe group dynamics Describes a way to be an active engaged Describes a way to be an active engaged

organizational citizenorganizational citizen Really resonates with cliniciansReally resonates with clinicians

Describes what people doDescribes what people do Describes what people exercising leadership Describes what people exercising leadership

can do if they see differentlycan do if they see differently A way of developing a shared language to A way of developing a shared language to

describe group dynamicsdescribe group dynamics Describes a way to be an active engaged Describes a way to be an active engaged

organizational citizenorganizational citizen Really resonates with cliniciansReally resonates with clinicians

Opportunities Opportunities Opportunities Opportunities Enhance Enhance capacity capacity to exercise leadershipto exercise leadership

Build a Build a frameworkframework to help others make to help others make progress on tough problemsprogress on tough problems

CreateCreate resiliencyresiliency to withstand the work of to withstand the work of leadershipleadership

Enhance Enhance capacity capacity to exercise leadershipto exercise leadership

Build a Build a frameworkframework to help others make to help others make progress on tough problemsprogress on tough problems

CreateCreate resiliencyresiliency to withstand the work of to withstand the work of leadershipleadership

Productive Productive RangeRange

Threshold of learningThreshold of learning

Limit of toleranceLimit of tolerance

TimeTime

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Based on Heifetz, Ronald A. and Marty Linsky.Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, Harvard Business School Press, , Harvard Business School Press, Boston, MA,2002, pg. 108Boston, MA,2002, pg. 108..

Type of Situations Requiring Type of Situations Requiring LeadershipLeadershipType of Situations Requiring Type of Situations Requiring LeadershipLeadership

Technical -- Apply abilities that already Technical -- Apply abilities that already exist in the systemexist in the system’’s capabilitiess capabilities

Adaptive -- People deeply and broadly Adaptive -- People deeply and broadly within the organization need to learn within the organization need to learn

new capabilitiesnew capabilities

Technical -- Apply abilities that already Technical -- Apply abilities that already exist in the systemexist in the system’’s capabilitiess capabilities

Adaptive -- People deeply and broadly Adaptive -- People deeply and broadly within the organization need to learn within the organization need to learn

new capabilitiesnew capabilities

PRODUCTIVE RANGE PRODUCTIVE RANGE

OF DISTRESSOF DISTRESS

ThresholdThreshold

of learningof learning

Limit of toleranceLimit of tolerance

Technical Technical problemproblem

TimeTime

DisequilibriumDisequilibrium

Technical vs. Adaptive WorkTechnical vs. Adaptive WorkAdaptive challengeAdaptive challenge

Heifetz, Ronald A. and Marty Linsky.Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. , Harvard Business School Press, Boston, MA,2002, pg. 108.108.

TensionTensionofofchangechange

TensionTensionofofchangechange

Adaptive WorkAdaptive WorkAdaptive WorkAdaptive Work

Adaptive work diminishes the gap between Adaptive work diminishes the gap between the way things are and the way things the way things are and the way things

need to be to create a better futureneed to be to create a better future

Adaptive work diminishes the gap between Adaptive work diminishes the gap between the way things are and the way things the way things are and the way things

need to be to create a better futureneed to be to create a better future

The most common cause of The most common cause of leadership failure is treating leadership failure is treating an adaptive problem with a an adaptive problem with a

technical fix.technical fix.

The most common cause of The most common cause of leadership failure is treating leadership failure is treating an adaptive problem with a an adaptive problem with a

technical fix.technical fix.

What is hard about leading What is hard about leading others in improving care?others in improving care?

What is hard about leading What is hard about leading others in improving care?others in improving care?

Adaptive WorkAdaptive WorkAdaptive WorkAdaptive Work

Adaptive work diminishes the gap between Adaptive work diminishes the gap between the way things are and the way things the way things are and the way things

need to be to create a better futureneed to be to create a better future

Adaptive leadership is the activity that Adaptive leadership is the activity that mobilizes people to perform needed mobilizes people to perform needed

adaptive workadaptive work

Adaptive work diminishes the gap between Adaptive work diminishes the gap between the way things are and the way things the way things are and the way things

need to be to create a better futureneed to be to create a better future

Adaptive leadership is the activity that Adaptive leadership is the activity that mobilizes people to perform needed mobilizes people to perform needed

adaptive workadaptive work

Technical and AdaptiveTechnical and AdaptiveTechnical and AdaptiveTechnical and Adaptive

Delivering high quality care Delivering high quality care with optimal stewardship of with optimal stewardship of

resourcesresources

You

Who Cares About the Work?Who Cares About the Work?

Patient

Other team members

Family

Productive Range

Threshold of learning

Limit of tolerance

Time

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Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA, 2002, pg 108.

Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA, 2002, pg. 108.

Are you reading the signals others are sending?Are you reading the signals others are sending?

Adaptive Challenge

Productive RangeHolding Environment

Threshold of learning

Limit of tolerance

Time

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Work Avoidance

Technical Challenge

Work Avoidance

Work Avoidance Signals Being Out of a Productive Work Avoidance Signals Being Out of a Productive Range of TensionRange of Tension

• Displacing responsibilityDisplacing responsibility• Attack authority Attack authority

• Kill the messengerKill the messenger

• ScapegoatScapegoat

• Distracting attentionDistracting attention• Make the problem too bigMake the problem too big

• Make the problem too smallMake the problem too small

• Meetings with only information Meetings with only information exchange when engagement and exchange when engagement and deep conversation is neededdeep conversation is needed

• Ask more consultants Ask more consultants

• DenialDenial• Collude in magical thinkingCollude in magical thinking

Can you imagine some Can you imagine some work avoidance examples work avoidance examples

you might see?you might see?

YouYou

How are you and others reacting to the work?How are you and others reacting to the work?

Delivering high quality Delivering high quality care care with optimal stewardship with optimal stewardship of resourcesof resources

Begin to Plot a StrategyBegin to Plot a Strategy

Help People Make Progress on Adaptive Help People Make Progress on Adaptive WorkWork

Help People Make Progress on Adaptive Help People Make Progress on Adaptive WorkWork

Use yourself differentlyUse yourself differentlyCreate productive tensionCreate productive tensionKeep people engaged who are making Keep people engaged who are making

progress and figure out what you need progress and figure out what you need to do to reengage others.to do to reengage others.

Use yourself differentlyUse yourself differentlyCreate productive tensionCreate productive tensionKeep people engaged who are making Keep people engaged who are making

progress and figure out what you need progress and figure out what you need to do to reengage others.to do to reengage others.

Informal Authority = InfluenceInformal Authority = InfluenceInformal Authority = InfluenceInformal Authority = Influence

Exercising leadership to do Exercising leadership to do adaptive work adaptive work

means means disappointing people’s disappointing people’s

expectations expectations ((that things will stay the samethat things will stay the same))

at a rate they can tolerate.at a rate they can tolerate.(and not muzzle you)(and not muzzle you)

Exercising leadership to do Exercising leadership to do adaptive work adaptive work

means means disappointing people’s disappointing people’s

expectations expectations ((that things will stay the samethat things will stay the same))

at a rate they can tolerate.at a rate they can tolerate.(and not muzzle you)(and not muzzle you)

Leadership is an activityLeadership is an activity

There can be leadership from multiple There can be leadership from multiple positions within a social structurepositions within a social structure

Get on the BalconyGet on the BalconyFundamental Skill in Adaptive LeadershipFundamental Skill in Adaptive Leadership

Reflect in actionReflect in action

Keep the pattern of the dance in mind Keep the pattern of the dance in mind while dancingwhile dancing

Move back and forthMove back and forth

Use Yourself DifferentlyUse Yourself DifferentlyUse Yourself DifferentlyUse Yourself Differently Exercise leadership and use your informal Exercise leadership and use your informal

authority as a resourceauthority as a resource Reflect in action – get on the balconyReflect in action – get on the balcony Set a great exampleSet a great example Celebrate and learn from what is going wellCelebrate and learn from what is going well Talk about why you think this is importantTalk about why you think this is important Ask questionsAsk questions Listen Listen Pay attentionPay attention

Exercise leadership and use your informal Exercise leadership and use your informal authority as a resourceauthority as a resource

Reflect in action – get on the balconyReflect in action – get on the balcony Set a great exampleSet a great example Celebrate and learn from what is going wellCelebrate and learn from what is going well Talk about why you think this is importantTalk about why you think this is important Ask questionsAsk questions Listen Listen Pay attentionPay attention

Behaviors That Build TrustBehaviors That Build TrustBehaviors That Build TrustBehaviors That Build Trust TTalk straightalk straight Demonstrate respectDemonstrate respect Create transparencyCreate transparency Right wrongsRight wrongs Show loyaltyShow loyalty Deliver resultsDeliver results Get betterGet better Confront realityConfront reality Clarify expectationsClarify expectations Practice accountabilityPractice accountability Listen firstListen first Keep commitmentsKeep commitments Extend trustExtend trust

TTalk straightalk straight Demonstrate respectDemonstrate respect Create transparencyCreate transparency Right wrongsRight wrongs Show loyaltyShow loyalty Deliver resultsDeliver results Get betterGet better Confront realityConfront reality Clarify expectationsClarify expectations Practice accountabilityPractice accountability Listen firstListen first Keep commitmentsKeep commitments Extend trustExtend trust

Adapted from The Speed of Trust, Stephen M.R. Covey, 2006Adapted from The Speed of Trust, Stephen M.R. Covey, 2006..

Create Productive TensionCreate Productive TensionCreate Productive TensionCreate Productive Tension

Make it safe to disagree and debate but not OK to opt out Make it safe to disagree and debate but not OK to opt out and disengage.and disengage.

Talk honestly to one another about the challengeTalk honestly to one another about the challenge

Listen with genuine interest to the various points of view Listen with genuine interest to the various points of view

Build trustBuild trust

Have difficult conversationsHave difficult conversations

Make it safe to disagree and debate but not OK to opt out Make it safe to disagree and debate but not OK to opt out and disengage.and disengage.

Talk honestly to one another about the challengeTalk honestly to one another about the challenge

Listen with genuine interest to the various points of view Listen with genuine interest to the various points of view

Build trustBuild trust

Have difficult conversationsHave difficult conversations

Difficult conversations are inevitableDifficult conversations are inevitableDifficult conversations are inevitableDifficult conversations are inevitable

Safety is critical for them to be productiveSafety is critical for them to be productive shared purpose shared purpose mutual respectmutual respect

Be willing to be influencedBe willing to be influenced Be curious rather than judgmentalBe curious rather than judgmental 100% candid100% candid 100% respectful100% respectful Lead with questions not answersLead with questions not answers Engage in dialogue and debate not coercionEngage in dialogue and debate not coercion

Safety is critical for them to be productiveSafety is critical for them to be productive shared purpose shared purpose mutual respectmutual respect

Be willing to be influencedBe willing to be influenced Be curious rather than judgmentalBe curious rather than judgmental 100% candid100% candid 100% respectful100% respectful Lead with questions not answersLead with questions not answers Engage in dialogue and debate not coercionEngage in dialogue and debate not coercion

Productive RangeProductive Range

Threshold of learning Threshold of learning

Limit of toleranceLimit of tolerance

TimeTime

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Create an Environment to Hold Attention onCreate an Environment to Hold Attention on the Workthe Work

Based on Heifetz, Ronald A. and Marty Linsky.Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, , Harvard Business School Press, Boston, MA, 2002, pg 108.Harvard Business School Press, Boston, MA, 2002, pg 108.

People need to feel People need to feel safe enoughsafe enoughto do adaptive work but to do adaptive work but not so safenot so safethat they will do nothing.that they will do nothing.

Productive RangeProductive Range

Threshold of learning Threshold of learning

Limit of toleranceLimit of tolerance

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Distressed SystemDistressed SystemNo Trust, Little Adaptive CapacityNo Trust, Little Adaptive Capacity

Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA,2002.Harvard Business School Press, Boston, MA,2002.

What is a difficult conversation?What is a difficult conversation?

• Any conversation that you dread and perhaps Any conversation that you dread and perhaps seek to avoid, if possibleseek to avoid, if possible

• Three inherent challenges present the source Three inherent challenges present the source of difficultyof difficulty• There are inevitably more ways to understand There are inevitably more ways to understand

the situation than any one participant is aware of the situation than any one participant is aware of or agrees withor agrees with

• The situation is emotionally charged with strong The situation is emotionally charged with strong feelingsfeelings

• The situation is psychologically threatening to The situation is psychologically threatening to one or both partiesone or both parties

Which Condition of Safety is at Risk?Which Condition of Safety is at Risk?Which Condition of Safety is at Risk?Which Condition of Safety is at Risk?

• Mutual purpose or mutual respectMutual purpose or mutual respect

• Conditions make the conversation Conditions make the conversation difficult difficult • much more than contentmuch more than content

• Mutual purpose or mutual respectMutual purpose or mutual respect

• Conditions make the conversation Conditions make the conversation difficult difficult • much more than contentmuch more than content

AdaptedAdapted fromfrom CrucialCrucial ConversationsConversations

Productive Range Productive Range

Threshold of learning Threshold of learning

Limit of toleranceLimit of tolerance

TimeTime

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Shared VisionShared VisionDelivering high quality care Delivering high quality care

with optimal stewardship of resourceswith optimal stewardship of resources

Based on Heifetz, Ronald A. and Marty Linsky. Leadership on Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. the Line, Harvard Business School Press, Boston, MA,2002, pg. 108.108.

Productive Range Productive Range

Threshold of learning Threshold of learning

Limit of toleranceLimit of tolerance

TimeTime

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How Do We Hold the Tension?How Do We Hold the Tension?Delivering high quality care Delivering high quality care

with optimal stewardship of resources – with optimal stewardship of resources – respectfully?respectfully?

Based on Heifetz, Ronald A. and Marty Linsky. Leadership on Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. the Line, Harvard Business School Press, Boston, MA,2002, pg. 108. and adaptationfrom Crucial Conversations108. and adaptationfrom Crucial Conversations

• Conditions of safety Conditions of safety • Mutual purposeMutual purpose

• Do others believe you care about their Do others believe you care about their goals in the conversation? goals in the conversation?

• Do they trust your motives?Do they trust your motives?• Mutual respectMutual respect

• Do others believe you respect them?Do others believe you respect them?

• Conditions of safety Conditions of safety • Mutual purposeMutual purpose

• Do others believe you care about their Do others believe you care about their goals in the conversation? goals in the conversation?

• Do they trust your motives?Do they trust your motives?• Mutual respectMutual respect

• Do others believe you respect them?Do others believe you respect them?

Widening the Productive RangeWidening the Productive RangeWidening the Productive RangeWidening the Productive Range

Adapted from Crucial Adapted from Crucial ConversationsConversations

Productive RangeProductive Range

Threshold of learning Threshold of learning

Limit of Limit of tolerancetolerance

TimeTime

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Increased Trust, Increase Capacity for Adaptive WorkIncreased Trust, Increase Capacity for Adaptive Work

Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Based on Heifetz, Ronald A. and Marty Linsky. Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. 108.Harvard Business School Press, Boston, MA,2002, pg. 108.

Keep people engaged who are making Keep people engaged who are making progress and figure out what you need progress and figure out what you need

to do to reengage others.to do to reengage others.

Keep people engaged who are making Keep people engaged who are making progress and figure out what you need progress and figure out what you need

to do to reengage others.to do to reengage others.

Heifetz, Ronald A. and Marty Linsky.Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, Harvard Business , Harvard Business School Press, Boston, MA, 2002, pg. 108.School Press, Boston, MA, 2002, pg. 108.

Work avoidance signals being out of a productive Work avoidance signals being out of a productive zone relative to the workzone relative to the work

Adaptive ChallengeAdaptive Challenge

Productive RangeProductive RangeHolding EnvironmentHolding Environment

Threshold of learning Threshold of learning

Limit of toleranceLimit of tolerance

TimeTime

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Work AvoidanceWork Avoidance

Technical ChallengeTechnical Challenge

Work AvoidanceWork Avoidance

Lowering the HeatLowering the Heat• Validate feelings, acknowledge lossValidate feelings, acknowledge loss

• Simplify and clarifySimplify and clarify• Address the technical aspectsAddress the technical aspects• Break problem into partsBreak problem into parts

• Restore, add, or reallocate resourcesRestore, add, or reallocate resources• Temporarily reclaim responsibility for tough Temporarily reclaim responsibility for tough

issuesissues• Give your attention Give your attention • Take stock of what is availableTake stock of what is available• Allot more time, enrich knowledge and skillsAllot more time, enrich knowledge and skills

Raising the HeatRaising the Heat

• Raise the standardsRaise the standards

• Increase accountabilityIncrease accountability

• Change the task to something more Change the task to something more motivatingmotivating

• Refocus on higher, more widely Refocus on higher, more widely shared and yet compelling purpose shared and yet compelling purpose

Exercising leadership to do Exercising leadership to do adaptive work adaptive work

means means disappointing peopledisappointing people’’s s

expectations that things will stay the same butexpectations that things will stay the same butat at

a rate they can tolerate.a rate they can tolerate.

Exercising leadership to do Exercising leadership to do adaptive work adaptive work

means means disappointing peopledisappointing people’’s s

expectations that things will stay the same butexpectations that things will stay the same butat at

a rate they can tolerate.a rate they can tolerate.

PRODUCTIVE RANGEPRODUCTIVE RANGE

HOLDING HOLDING ENVIRONMENTENVIRONMENT

WorkWork avoidanceavoidanceThreshold of learningThreshold of learning

Limit of toleranceLimit of tolerance

Technical Technical challengechallenge

TimeTime

Adaptive ChallengeAdaptive Challenge

Heifetz, Ronald A. and Marty Linsky.Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. 108., Harvard Business School Press, Boston, MA,2002, pg. 108.

Work avoidanceWork avoidance

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Give Work Back to People Give Work Back to People at a Rate They can Tolerateat a Rate They can Tolerate

Exercising leadership requires Exercising leadership requires keeping an experimental mindsetkeeping an experimental mindset

Exercising leadership requires Exercising leadership requires keeping an experimental mindsetkeeping an experimental mindset

Work avoidance looks the same when the Work avoidance looks the same when the heat is too high or when the heat is too heat is too high or when the heat is too low.low.

If what you try makes things worse try If what you try makes things worse try the opposite.the opposite.

What looks like laziness may be What looks like laziness may be exhaustion.exhaustion.

Keep rechecking your assumptions.Keep rechecking your assumptions.

Work avoidance looks the same when the Work avoidance looks the same when the heat is too high or when the heat is too heat is too high or when the heat is too low.low.

If what you try makes things worse try If what you try makes things worse try the opposite.the opposite.

What looks like laziness may be What looks like laziness may be exhaustion.exhaustion.

Keep rechecking your assumptions.Keep rechecking your assumptions.

PRODUCTIVE RANGEPRODUCTIVE RANGE

HOLDING HOLDING ENVIRONMENTENVIRONMENT

WorkWork avoidanceavoidanceThreshold of learningThreshold of learning

Limit of toleranceLimit of tolerance

Technical Technical challengechallenge

TimeTime

Adaptive ChallengeAdaptive Challenge

Heifetz, Ronald A. and Marty Linsky.Heifetz, Ronald A. and Marty Linsky. Leadership on the Line Leadership on the Line, Harvard Business School Press, Boston, MA,2002, pg. 108., Harvard Business School Press, Boston, MA,2002, pg. 108.

Work avoidanceWork avoidance

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Keep an experimental mindsetKeep an experimental mindsetWhen you try something and things get worse try the When you try something and things get worse try the

opposite!opposite!

Building Your Practice of LeadershipBuilding Your Practice of Leadership

Adaptive leadership helps people to make progress Adaptive leadership helps people to make progress on difficult problemson difficult problems