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Charting a New Course: Leading Teams to Solve Wicked Problems

Sharon Murphy Enright, MBACEO & Change AgentEnvisionChange LLCAtlanta, Georgia

[email protected]

Meghan Swarthout, PharmD, MBA, BCPSDivision Director, Ambulatory & Care TransitionsAssociate Director, Clinical Outpatient Services

The Johns Hopkins HospitalBaltimore, [email protected]

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Collaboration: Pharmacy Leadership Academy & Section on Pharmacy Practice Management

Welcome to the New Normal

VolatileUncertainComplexAmbiguous

VUCA World https://youtu.be/9yg_BLNSYZU

FLOW

More to life than just happiness Engagement, achievement, human

relationships drive purpose Impact on stress reduction, longevity,

health outcomes

Gibbons P. The Science of Successful Organizational Change. Pearson; 2015

SustainableWorld

HumanFlourishing

Science & Wisdom

Ethical Enterprise

GreatLeadership

22nd Annual ASHP Conference for Pharmacy Leaders

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Change Failure

70‐ 90% of change efforts fail Good ideas, bad execution Presumption that team understands &

knows how to act on change Locked in the past

• Lewin: Freeze‐unfreeze‐refreeze• One by one, by one• Hindsight view• Change is not an exception


Change Failures

Benefit SHORTFALLS Cost OVERRUNS Unintended CONSEQUENCES KILLED programs SUSTAINABLE results

Here’s to the Crazy Ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who seethings differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree withthem, disbelieve them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things.They invent. They imagine. They heal. They explore. They create. They inspire. They push the human race forward. Maybethey have to be crazy. How else can you stare at an empty canvas and see a work of art? Or, sit in silence and hear a songthat hasn’t been written? Or, gaze at a red planet and see a laboratory on wheels? We make tools for these kinds of people.While some may see them as the crazy ones, we see genius. Because the ones who are crazy enough to think they canchange the world, are the ones who do.

Wicked Problems

Incomplete, contradictory changing requirements Broad mix of skills, knowledge, talent Different language, context, perspective Technical/professional perception gaps Behaviors shaped by beliefs, values, culture Archaic team concepts & behavior Failure of knowledge sharing Poor behavioral skill sets in relationships & groups

Camillus JC. Strategy as a Wicked Problem. HBR http://hbr.harvardbusiness.org/2008/05/strategy‐as‐a‐wicked‐problem/ar/pr

80% of leaders headaches caused by wicked problems & managing change


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Problems Are Increasingly Wicked . . . Clear problem definition Single organization/unit Traditional leadership, single solution

Clear, finite problem, urgent need New solutions, permission for action & innovation Directive leadership, take control for action

Problem not finite, unclear Demands innovative learning, multiple units Agile leadership

Camillus JC. Strategy as a Wicked Problem. HBR http://hbr.harvardbusiness.org/2008/05/strategy‐as‐a‐wicked‐problem/ar/pr

Simple

CRISIS

Wicked

Change Myths

Cummings S, etal. Unfreezing change as 3 steps: rethinking Kurt Lewin’s legacy for change management. Tavistock Institute. http://journals.sagepub.com/doi/pdf/10.1177/0018726715577707

Change Agility

Replaces change management Point of view changes focus & balance Be the disruptor NOT the disruptee

.

The ability to execute programmatic & non‐programmatic business change in response to disruptive threat or

strategic opportunity


How to Build Agility into our DNA

Mindset Readiness capability Flow of ideas Adaptability Find affinity


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Change Agility Assessment What percentage of leadership are competent at

leading change? Are people curious in the face of paradox? Are previous change lessons learned &

incorporated? To what extent is change welcomed or feared? Do leaders perceive their role to be creating change

by fostering agile workplaces? Do flexible structures & processes exist to enable

quick response to change demand? Do ideas permeate the business, relying on

outsight, insight, foresight? Is there a culture of learning, experimentation,

piloting & iterative improvement?

Creating Change Agility

Interrelated• Changing mindset: skills, behavior,

structures, culture• Changing behavior demands culture &

structural change• Changing hard aspects – culture,

mindset, behaviors – facilitates process & structure change

Change can only happen as quickly as the weakest link allows

CultureNetworks

Relationships

BehaviorSkills

Performance

ProcessStructureStrategy

Mindset

What is your weakest link?


The Concept of Agility

The ability to execute programmatic & non‐programmatic business change in

response to disruptive threat or strategic opportunity

Nurture or Nature?

Change is not a cascade Harvest from the ground up Focus on

• Nurturing growth culture• Neo‐behaviorism• Habit change• Skill building for agile leadership

Taking Agility Way Beyond Software. BCG. http://view.bcg‐email.com/?j=fe4b177970620c757313&m=fe5b15707c62037c7013&ls=fdc615767d64057a7117757760&l=fe5c15787162037d7d15&s=fdf3157873610179741c7675&jb=ff66167173&ju=fe22127874600179731176&r=0

Growth Mindset Essential to Growth Culture

Fixed• Intellectually static• Avoid challenge• Give up, effort fruitless• Ignore feedback• Threatened by change

Growth• Knowledge developer• Embrace challenge• Resilience• Clear path to mastery• Learn from feedback• Find lessons & inspiration in success



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From Growth Mindset to Growth Culture

Perseverance Creativity in face of challengeWillingness to dedicate to persistence Learn from experience Results focus

• “A for effort isn’t good enough” Growers not knowers


Behaviors Leaders not specific about desired behaviors Competency challenge: missing behavioral anchors Hearts & minds not enough, need to trigger

behavior change Behavior drives action for change Behaviors too often driven by habit


Habits

Pronovost Central Line Infection• Wash hands with soap• Clean skin site with chlorhexidine• Sterile drape entire patient• Sterile mask, hat, gown, gloves• Sterile dressing over catheter site

Gawande• Checklist Manifesto

Duhigg C. The power of habit. Random House. 2014

Behavioral Change is Hard . . . But Key to Success

How leaders set strategy, influence behavior, change habits impacts agile culture

Reason & logic don’t work Behavior change is the gap between

good idea & execution for results Back‐fire effect: facts strengthen bias Changing hearts & minds doesn’t

result in delivery success Habits transcend motivation


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So What Can a Leader Do?

Narratives, storytelling Developing guided mini‐habits 30 day challenge Choice architecture Behavioral specificity Pay attention to cultural paradox

• Words v behavior Create cultural cathedrals in the sky

Transformation

Behavioral Change & Human Flourishing

Many ways to be happy Not relative to anyone else Exhilaration, purpose, maximal engagement FLOW Good life concept Are we working on the right things?

Is all this happiness talk making us miserable?


Human Flourishing & Behavioral Specificity

Combining impact of science & technology for scalability

Environment that dignifies us in our work Value to humankind Expert v humble learner Evidence imperative Focus on values Community of people, doing what they

can’t do individually

Is work designed to promote human flourishing?


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Questions Every Leader Should Be Always Asking

Wait, what?I wonder . . . . (who, what, why, where, how, if)Couldn’t we at least . . . .?How can I help?What truly matters?

Agile Leaders Start From Why

What you do dilutes over time & with growth How differentiates your value propositionWhy defines purpose, cause, beliefs, creating

cohesion & alignment

Sinek S. https://www.youtube.com/watch?v=IPYeCltXpxw

WHY

WHAT HOW

Teaming in a VUCA World Syndicating Leadership

Fundamental shift in thinking Redefinition of roles & responsibilities Change leaders exist at all levels

throughout the organization Collective action for change through

agile change and leadership agility

Hamel G. https://www.youtube.com/watch?v=EUOGFZIm_Gg


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Personal Leadership Skill for Self & Situational AwarenessDiSC Concepts for Personal Awareness & Growth

Doing what’s natural v agility Improve communication Enhance team performance Reduce conflict Get results

Each of us is multidimensional How you interact sets the tone for

transactions, relationships and trust Knowing yourself and your style is

essential knowledge Two questions

• Is the situation favorable• Where is power/control base

You have the power to assess & adapt

Ritchey T. I’m stuck, you’re stuck. Berrett‐Kohler. 2002

DiSC helps increase personal insight & empathy so teams can build trust more easily

DiSC: Dominance Style

Fast paced, results oriented High task focus Directing others Focused on new opportunity & challenge Achievement focused Crave freedom to operate independently/creatively

DiSC: Influence Style

Optimistic & outgoing• Meetings are great!• Work should be fun• Details ‐‐‐ egh!

Enthusiastic, energized, upbeat, motivated & motivating

Fast paced, lower task orientation Lets make all this work fun!


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DiSC: Supportive Style

Cooperative with others, always Stick with the tried & true, don’t rock the boat Slower paced, lower task Honor service, responsibility, authority Orderly, predictable expectations Friendly, informal & “it’s all good’

DiSC: Conscientious Style

Oh so right, always, with logic & confidence Slower paced, high task orientation Quality, accuracy & performance: everything Feedback is vitalMore reserved, challenged by social interaction Perfectionist Silence is not golden

Becoming Wicked Problem Solvers Using DiSC

Keep an inventory of team communication styles and preferences

May combine with other self‐assessment tools, such as Strengths Finders

As priorities and challenges shift, be flexible with shifting leadership responsibilities

Collaborate with non‐pharmacist experts –focus on cross‐functional team development

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Leading Others in Teams


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Care is Delivered in Teams

The physician’s, nurse’s and pharmacist’s ethical imperative to do no harm is no longer dependent only on their domain competence, rather on their understanding and contribution to systems improvement, working collaboratively in teams and response to the unexpected.

Schyve P. Teamwork: the changing nature of professional competence. J Qual & PtCare. TJC . Vol 31; #4. 2005

Teaming is a Verb

Edmondson A. Teaming: How organizations learn, innovate & compete in the knowledge economy. Jossey Bass 2012.

Managing the Tension of Wicked Problems

Clarity of purpose

Shifting goals

Edmonson, Amy. Wicked Problem Solvers, HBR. June 2016 (52‐59).

Leadership


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Teaming to Collaborate, Learn, Innovate

Foster an adaptable vision

Promote psychological safety

Enable knowledge sharing

Foster execution as learning

Edmonson, Amy. Wicked Problem Solvers, HBR. June 2016 (52‐59).

Highly Functioning & Cohesive Teams

Are your teams cohesive & highly functioning?

While it takes effort, does it have to be complicated to build & lead teams?

Team members need meaningful understanding of themselves & others

Five behaviors define a cohesive & highly functioning team

Lencioni P. Five Dysfunctions of a Team. Jossey Bass. 2002

Team Dysfunction


What Makes for Great Team Function & Achievement?

Established TRUSTMastering CONFLICTSharing COMMITMENTEmbracing mutual ACCOUNTABILITYFocus on RESULTS



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Building TRUST

Confidence among team members that their peer’s intentions are good & that there is no reason to be protective or

careful within the group.

Teammates are comfortable being vulnerable with one another.

As a leader, how will you nurture trust within the team?


TRUST

Teams Without/With Trust

Conceal weakness & mistakes Hesitate to ask for help or provide

feedback Jump to conclusions about intentions

& aptitudes of others Hold grudges

Admit weakness & mistakes Ask for help Accept questions & input Give the benefit of the doubt without

negative conclusions Unhesitatingly offer & accept apologies

Without With


Mastering CONFLICT

When there is trust, team members are able to engage in unfiltered, constructive debate.

Healthy conflict focuses on concepts & ideas to produce the best possible solution.


CONFLICT

Mastering CONFLICT A Team That Fears Conflict...

• Has boring meetings • Creates environments where

personal attacks thrive • Ignores controversial topics that are

critical to team success • Fails to tap into all the opinions and

perspectives of team members • Wastes time and energy with

posturing and interpersonal risk management

A Team That Engages In Conflict... • Has lively, interesting meetings • Extracts and exploits the ideas of

all team members • Solves real problems quickly • Minimizes politics • Puts critical topics on the table for

discussion



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Mastering CONFLICT

In some cultures, there is very little direct disagreement and debate during meetings, while in others people tend to “get in one another’s faces.” In some families, parents and siblings rarely engage in raw,

emotional dialogue, while in others people argue passionately and then make up with equal passion. Which is better on a team?

The only thing that really matters is—are people holding back their opinions?

Members of great teams do not.

• Lencioni P. Five Dysfunctions of a Team. Jossey Bass. 2002

Achieving COMMITMENT

When team members are able to offer opinions & debate ideas, they are more

likely to commit to decisions

It is not necessary to achieve consensus, ;but clarity & ownership are key to

commitment.


COMMITMENT


The bottom line is, if people don’t commit, they’re just half‐heartedly going along with decisions.

The two greatest causes of a lack of commitment are the desire for consensus and the need for certainty, which are just not possible in all situations. Great teams understand that they must be able to commit even when the outcome is uncertain and not everyone

initially agrees.



A Team That Fails to Commit... • Creates ambiguity among the team

members about direction and priorities

• Misses opportunities due to excessive analysis and unnecessary delay

• Breeds lack of confidence and fear of failure

• Revisits discussions and decisions again and again

• Encourages second‐guessing among team members

A Team That Commits... • Creates clarity around direction

and priorities • Aligns the entire team around

common objectives • Develops an ability to learn from

mistakes • Moves forward without hesitation • Changes direction without

hesitation or guilt



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Embracing ACCOUNTABILITY

Accountability is the willingness of team members to call their peers on performance or behaviors that might hurt the team.

The usual source of dysfunction in this area is the unwillingness of team members to tolerate the interpersonal discomfort that accompanies calling out a peer on his or her behavior. This includes the more general tendency to avoid difficult conversations.

Functional teams overcome these natural inclinations, opting instead to “enter the danger” with one another.

ACCOUNTABILITY

What it Looks Like When Team Members are Accountable

DON’T call out poor performance: • Team members lack confidence

and are paranoid about what others may not be saying.

• People feel a sense of unfairness when others perform at a subpar level.

• Passive‐aggressive approaches start to thrive.

DO call out poor performance:• People know what others think so they

don’t have to waste time and energy wondering.

• Team members own their shortcomings and accept suggestions.

• There is an increased sense of being part of a team.

Focus on RESULTS

The ultimate goal of encouraging trust, healthy conflict, commitment, and accountability is to achieve results. And yet, as it turns out, one of the greatest challenges to team success is the inattention to results.In the context of a cohesive team, results refer to the collective goals of the team and are not limited to financial measures, but are more broadly related to expectations and outcome‐based performance, not status.

RESULTS

Challenges for Focus on Results

Teams have difficulty staying focused on results because of self‐interest and self‐

preservation.

Personal v team goals Lack of shared rewards Personal focus on career goals, progress Goal ambiguity Lacking process/structure Lack of drive/urgency



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Action to Achieve Results

A Team That Is Not Focused on Results... • Stagnates/fails to grow • Rarely defeats competitors • Loses achievement‐oriented

employees • Encourages team members to

focus on their own careers and individual goals

• Is easily distracted

A Team That Focuses on Results... • Retains achievement‐oriented

employees • Minimizes individualistic behavior • Enjoys success and suffers failure

acutely • Benefits from individuals who

subjugate their own goals/interest for the good of the team

• Avoids distractions


Leaders Adaptability Transformation

Stages of Leadership Agility

Explorer

Operator

Enthusiast

Conformer

Expert

Catalyst

Achiever

CoCreator

Synergist

Child & Adolescent Behavior

Adult Behavior

Joiner B, Josephs S. Leadership Agility. Jossey Bass. 2007

Stages of Leadership Agility

Can’t skip stages Demand & agility level varies

within the day Both vertical & horizontal

development opportunity Retain capability from earlier

stages Downshifting can be intentional

or not GOAL: expand your repertoire in

VUCA world Awareness‐


Expert

Achiever

CatalystExpert

Achiever

Catalyst


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Distribution of Leadership Agility Stages


Expert Leading Change

• Focus on incremental improvement• Tight unit boundaries• Little attention to stakeholders

Leading Teams• Supervisor, not even manager• Team is a group of individuals• One‐on‐one with direct reports• Too caught up in details of personal work for

strategic goals Pivotal/Crucial Conversations

• Strongly assertive or totally passive• Wide style swings, based on relationship• Avoids giving/receiving feedback

Tactical, problem‐solving orientation, believing that leaders are respected & followed because

of authority and expertise, showing modest reflective capacity, dealing with one problem/person at a time


Achiever Organizational Change

• Focus on external environment• Attention to stakeholder buy‐in using both

one‐way communication and active communication to solicit input

Leading Teams• Operates as a manager• Strategic & organizational meetings focused

on buy‐in/consensus to personal view/objective

Pivotal/Crucial Conversations• Assertive or accommodating• Some ability to compensate for weaker style• Solicits/gives feedback to achieve goals

Focused on a strategic outcome orientation, believing that leaders motivate by creating

challenge to contribute to larger purpose with

robust reflective capacity & systems view


Catalyst Organizational change

• Focus on culture for teamwork, participation and engagement

• Proactive relationships with diverse stakeholders• Belief that input increases quality of decisions &

engagement

Leading teams• Focus includes industry environment• Facile one‐on‐one, team & organizational

relationships

Pivotal/crucial conversations• Focus on development of culture• Value for teams, engagement, ownership• Input increases quality of decisions and results

A visionary facilitator, believes that leaders share vision & build teams for transformation, engaging

others in personal development & ownership of purpose, always reflecting in the moment, realizing human “flourishing” opportunity



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Agility Competencies & Anchors• Self leadership

• Self awareness• Developmental motivation

• Context setting• Situational awareness• Sense of purpose/vision

• Stakeholder focus• Understanding/ownership• Power style

• Creative capacity• Reflective judgment• Connective awareness


A New Way of Approaching Strategy

WillShould

Could

30/30

Reframe Why, then What .. .

Agile Strategy

Link, leverage, align outcomes

Here and now

WHY?

How do we get there?

Where are we going?

Traditional Strategy

Leadership Agility Scenario Dinner with Ed

You are a good friend of Ed’s who lives across the country You are visiting the area and plan to have dinner with Ed seven months after he took

the new CPO role You ask Ed how the new job is going, and the scenario is his description to you Each scenario is the same Ed at the same point in time at different levels on the

Leadership Agility spectrum – think of Groundhog Day


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Self‐Assessment Questions

As you read through the scenarios, consider these questions in your self‐assessment:

Do you function at different levels in different situations? Does your level of agility change when you move from one practice area to

another? Are you satisfied with where your leadership agility is now? Can you identify and shift agility levels (downshift and upshift) nimbly?

Group Discussion Questions

How does Ed think it is going? How did he get started and what is his strategy for changing/turning around the

organization?What has it been like working with the team? Have there been any crucial conversations that stand out to signal challenges or

opportunities?

Expert Scenario Achiever Scenario


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Catalyst Scenario Key Takeaways

Key Takeaway #1• VUCA world creates different leadership demand for new thinking, behaviors,

skills, capacity, perspective & mental model realignment Key Takeaway #2

• Wicked problems are increasingly common & are not easily resolvable, particularly in the context of past experience

Key Takeaway #3• Collaboration & effective teaming, with agile leadership, strategy & problem

solving will be essential to the ability to survive & thrive in a VUCA environment


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