Embarking on Equitable Embarking on Equitable Change in Turbulent TimesChange in Turbulent Times

A Study on Enabling Conditions for A Study on Enabling Conditions for Dialogic Organizational Dialogic Organizational DevelopmentDevelopment

Rachael BanksRachael BanksJune 9, 2012June 9, 2012

Social Inequities in Public Service

Persistent health inequities

Unjust

Costly

Preventable

Many Organizational Development (OD) Efforts Underway

Previous efforts partially successful Bounded, distinct efforts Separate programs

Organizational complexity increasing Increased Need Wicked Challenges Environment transforming

Two Types of OD Diagnostic

Problem identification Diagnosis Time limited

Dialogic Solutions oriented Inquiry overlaps with

intervention Continuous and

cyclical

OD Methods out of Touch

Dialogic seems better for complexity and turbulence Literature

EMPA coursework

Organizational experience

Research QuestionResearch Question

What conditions must be in place to What conditions must be in place to initiate dialogic OD approach that initiate dialogic OD approach that can address wicked challenges like can address wicked challenges like health inequities?health inequities?

Are there different enabling conditions Are there different enabling conditions for the two types of OD?for the two types of OD?

Literature ReviewLiterature Review

Literature on Diagnostic OD, Literature on Diagnostic OD, enabling conditionsenabling conditions Need and urgencyNeed and urgency Top management commitmentTop management commitment Multi-level involvementMulti-level involvement Resource allocationResource allocation Openness to learningOpenness to learning A planA plan

o Gap in Dialogic enabling conditionsGap in Dialogic enabling conditions

Research MethodologyName Position Agency

Jeanine Beatrice Project Manager Oregon Health Authority

Kristin Chung-Mei Lensen

Owner Kristin Lensen Consulting

Deborah Cockrell Clinic Manager Multnomah County Health Department

Christopher Hamilton

Program Analyst Oregon Health Authority (OHA)

Alana Heines Owner Heines Consulting

James Mason Director Culturally Competent Care

Providence Health and Services

Selena Mason Administrative Director

Western States Center

Angela Mitchell Patient Advocacy Coordinator

Providence Medical Group

Paul Potter Project Director Oregon OD Network, OHA

Data AnalysisData Analysis

Wicked?

Yes No

Dialogic?

YesNo

(Diagnostic)

Dialogic +

Wicked

New dialogic preconditions?

diagnostic & dialogic (hybrid)?

Phase 1: Determine wickedness using wicked scale

Phase 2: Identify wicked challenges that used dialogic OD

Phase 3: Determine pre-conditions for dialogic changes that addressed

wicked challenges

Study LimitationsStudy Limitations

Small, convenience sampleSmall, convenience sample

Varying OD content areasVarying OD content areas

Limited generalizabilityLimited generalizability

Preliminary studyPreliminary study

Does not control for all variablesDoes not control for all variables

Findings

Dialogic used for wicked challenges

Health inequities are wicked challenges

Findings Dialogic Pre-conditions not

in literature Committed to disrupt status quo

Empowerment-focused

Strengths-based

Reflective Culture

Dialogic pre-conditions are different than diagnostic Hybrid

Implications

If working with wicked challenges: Consider using Dialogic OD Enabling conditions Tools

Agencies sponsoring OD efforts: Assess pre-conditions Learn dialogic approach Recruit people with dialogic skills,

experience

Future Study

Develop method to assess enabling conditions

Solidify Dialogic OD competencies

Study enabling conditions and link to OD outcomes

Discussion