Leadership for Health Leadership for Health System TransformationSystem Transformation

Principles, Practices and a Principles, Practices and a Christian PerspectiveChristian Perspective

Henry Mosley Henry Mosley Presented at the CCIH Conference Presented at the CCIH Conference

May 26, 2007May 26, 2007

Leadership in the BibleLeadership 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?

What Do Leaders Do?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?

BackgroundBackground

• 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

Our Key Reference BookOur 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

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

SStrategic trategic TThinking, hinking, AAction and ction and RReflection Guideeflection Guide

A model of leadership development based on A model of leadership development based on Peter Senge’s Five Learning DisciplinesPeter Senge’s Five Learning Disciplines

http://www.jhuccp.org/training/scope/starguide/begin.swf

STARGuide

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

Core Leadership Disciplines*Core Leadership Disciplines*

Systems Thinking

Personal Mastery

Mental Models

Shared Vision

Mental Models

*Ref. Peter Senge (1990)

The STAR The STAR FrameworkFramework

Strategic Thinking, Action and Reflection

Systems ThinkingSystems 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

Systems Thinking – STAR QuestionSystems Thinking – STAR Question

• How can we see the dynamics, interconnections, deeper patterns and purposes of systems?

Personal Mastery 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

Personal Personal MasteryMastery – STAR Question – STAR Question

• How can we live more creative and purposeful lives?

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U N I V E R S I T Y U N I V E R S I T Y

OHNS HOPKINS OHNS HOPKINS J J

Mental ModelsMental 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

Mental Models – STAR QuestionMental Models – STAR Question

• How can we continuously open our minds to new ideas?

Shared VisionShared 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

Shared Vision – STAR QuestionShared Vision – STAR Question

• How can we inspire others to seek goals “beyond imagination”?

Where do leaders operate?

Beyond Imagination

That’s Impossible

Looks Difficult

Easy to do

Team LearningTeam 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

Team Learning – STAR QuestionTeam Learning – STAR Question

• How can we align everyone to learn together how to reach a shared vision?

Insert Team ThemeInsert Team Theme

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

A Leader is a A Leader is a CatalystCatalyst for for ChangeChange

The Learning Organization is the Instrument of Change

Learning OrganizationsLearning 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

The Leader as DesignerThe 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.

The Leader as StewardThe 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)

The Leader as Steward The Leader as Steward (continued)(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

The Leader as TeacherThe 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)

The Leader as Teacher The Leader as Teacher (continued)(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

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

GovernmentGovernment

HouseholdsHouseholds

CommunityCommunity

Household Production of Health Household Production of Health FrameworkFramework

Global Global driving driving forcesforces

HealthHealth

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

ResourcesResources

ValuesValues

PracticesPractices

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

All parts of the health system operate All parts of the health system operate

through values, practices and resourcesthrough values, practices and resources

Global driving forces

Values

PracticesResources

Households

Values

PracticesResources

CommunityCommunity

Values

PracticesResources

GovernmentGovernment

HealthHealth

What are the five frameworks that What are the five frameworks that we use in our leadership seminars?we use in our leadership seminars?

1. The STAR Leadership Disciplines

2. The Learning Organization

3. The Household Production of Health

4. Organizational Capabilities

5. The Guide for Action Learning

Interestgroups

Policymakers,planners

Managers,providers

Communities, households

MIS

Evaluations

Research,pilot projects

The top–down, or “blueprint” intervention strategy disconnects

learning from action

Health

Learning Action

Policymakers,planners

Managers,providers

Communities, households

Needs

Tasks

Outputs

Competencies

Dem

and

Dec

isio

ns

The “Learning Organization” strategy will link knowledge to action

Interestgroups

Learning

Health

Learning OrganizationsLearning 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

The Guide FrameworkThe Guide Framework

The Guide Framework - QuestionsThe 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?

What we have learned about What we have learned about leadershipleadership

• 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!

What is our leadership What is our leadership seminar’s key idea?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.

Insert Believe ThemeInsert Believe Theme