Finally! The recent US Supreme Court deliberations about the constitutionality of some components of the Affordable Care Act (the Act) have focused the American public’s attention on what is the single most significant healthcare policy innovation in our country since Medicare was put in place in 1963.  Thankfully, hype doesn’t cut it in this venue. While political viewpoints were insinuated into some of the briefs, in the end, all parties must present a coherent argument—for or against.  From their questions to the lawyers arguing their case, it’s clear our Supreme Court Justices grasp the importance of issues before them.  The American Society of Healthcare Risk Management (ASHRM) has provided an objective, succinct summary of the issues and questions raised, with more detailed information embedded in various links in the article.

Now we wait for their ruling—due out sometime this summer. The underlying assumption most people are making is that a judiciary decision will determine whether or not our healthcare system gets a much-needed overhaul. No question about it, broad policy and subsequent regulations play an important role in shaping the parameters of change, but that is but one factor in play.

Innovations Are Already Operational At The Local Level

In February 2012, PBS aired a new 2-hour special by respected journalist and documentary filmmaker T.R. Reid, who happens have deep knowledge about the US healthcare system.  The film, US Healthcare: The Good News, presents several new models of local care delivery that are already operational.  ( A short 2-minute video previews the film’s content.)

Turns out that, rather than waiting for final answers to come about the future of  the Act, several US communities have embraced the challenge of designing and implementing new models of care. In response to local conditions these pioneers are rewriting how healthcare providers, employers, community advocates are coming together to create local solutions that are resulting in improved access, improved quality performance on objective quality measures while also lowering costs. These local innovations have much to teach us…if we only take the time to become informed and let go of preset conditions.

Implications for Local Leaders

While each new model of care is born out of local conditions and players, a common ingredient across all examples is the  the vital role of local leadership plays not only in planning but implementation.  Members of the local medical community, employers, and community members have demonstrated sustained leadership.

It’s  not just any leadership, but a particular kind of leadership; transformational leadership to be specific. A few key attributes of  whose characteristics include: Systems Thinking Applied to Strategic Management; Superior Communication Skills; and the  Ability to Align Incentives Across Diverse Constituencies.

Accelerating Local Delivery System Transformations

I’m convinced we have a once-in-a-lifetime- chance to improve the care people receive throughout the United States. But the transformation of healthcare delivery has always been a local service; and true transformation will only happen at the local level. I’ve dedicated much of my professional career to this process, and remain strongly optimistic that we are creating better answers. To help make the most of this opportunity, my company, the Callaway Leadership Institute, has joined forces with the Thunderbird School of Global Management to offer a series of executive education opportunities for leaders committed to local transformation of their delivery system. Our first offerings are Transformational Healthcare Leadership Certificate Course, followed by an  International Conference for Healthcare Leaders.  These two related programs will be offered on Thunderbird’s Glendale, Arizona campus the last week of February, 2013. I hope you’ll consider attending.

Until next time…Keep the faith, you can be sure I am!

Marguerite Callaway

Turned out that lovely Sam was returning home, having spent the past two weeks of her school’s spring vacation training with the Italian Olympic swim team to improve her technique and her times. She will face school exams and and time trials to qualify for South Africa’s Olympic swim team in two weeks. When asked about her chances, Sam was realistic: “Many of the swimmers are older/stronger than I am. but if I don’t qualify now, I’ll be a much better competitor for the 2016 Games. Getting to be really good at something takes a lot of hard work and time.”  She’s got time…she’s just 16.

Harry, a native Londoner, was coming to South Africa as a volunteer soccer (football) coach to teenage kids living in the township next to Port Elizabeth. He’ll be staying with a family for the three months he’s set aside to share his passion for the game and his own expertise with complete strangers. When asked why he decided to take this on, his answer was straightforward; “I want to see another part of the world and I think it’s important to reach out and connect with other kids who share my passion for the game. It took me two years to save the money to come. I’m a bi nervous, but I’ll learn as much as I’m teaching.” Harry’s got time too–he’s just 19.

And who said young people are only interested in the here and now?  In fact, leadership qualities begin to surface, at an early age, a positive fact when thinking about the future.

Scientific facts are true…until they’re not. Just one example will make my point. In the mid-70s when I was in graduate school studying cognition, how our brain is formed and actually works, the prevailing ‘scientific truth’ was that our brain tissue and all the neurological connections that make it work have been laid down by the time we are 5 or 6 years of age. From that point on, we have to work with what we’ve got. Today we know that ‘truth’ is only a partial truth. With the advent of more advanced technology, like MRIs, that allow us to study brain function real-time and over an extended period of time, we have solid scientific evidence that our brain is far more pliable than we ever thought. With focused effort, new neural pathways are formed even at the later stages of our life. In fact, something as basic as our perception–how we actually see the world–is a learned skill, determined by our culture. With focused effort, perception can also be modified.  These new insights are redefining our understanding of human nature, and their implications are profound. Most importantly, they make me hopeful about where we’re headed as human beings. Moving beyond where we are today is not impossible, we don’t have to be stuck.

Lynne McTaggart and The Bond

These are just some of the scientific facts that award winning author, journalist and thought leader Lynne McTaggart has pulled together in her just released book, The Bond: Connecting through the Space Between Us. Yesterday,  I had the pleasure of a live conversation with Lynne on my weekly online radio program, Leadership Every Day. We talked about the implications of what all this new revelations from frontier scientists–those brave men and woman with the vision, passion and courage to pursue a unanswered scientific question–means for us all.

I can’t begin to do justice to the book or our conversation here, but what I really appreciate is that Lynne provides us with ways to apply this new science.  She shows how incorporating practices suggested by new scientific discoveries can foster more holistic thinking, more cooperative relationships and more unified neighborhoods. For instance:

• Cultivating a love of flea markets, whodunits or other practices that stimulate curiosity turns on the “seeking” mechanism of the brain, which helps us to discover the hidden connections between things and overcomes latent inhibition, our tendency to screen out detail.
• The way in which we see the world is not inherent but a learned skill. Although our modern culture, so obsessed with individual things, has taught us to see in a piecemeal and highly focused way, all of us have the capacity to recover our capacity to see the subtlety of the relationships that make up our world.
• Certain simple activities that cause mirror patterns in the brains of each party foster deeper relationships between individuals.
• People who fire together wire together; whenever a group works together for a common goal, the brains of all parties begin to get entrained — strengthening the bond within the group.
• Shared activity also creates a ramped-up endorphin release in us, raising pain thresholds, improving individual efforts and ultimately raising our game.
• A new way of speaking and listening, inspired by quantum physics, can overcome polarization, helping the staunchest of enemies to become close friends — as it did among pro-life and pro-choice activists.
• A single act of kindness — change left in a Coke machine for the next person, in one instance — can set off an enormous wave of generosity throughout an entire community — up to three degrees of separation along the social network.
• Fairness is a stronger phenomenon than unfairness; all it requires is a small group of individuals committed to strong reciprocity to “invade” a population of self-interested individuals and create a fairer society.

Implications for Leaders

Lynne has done a terrific job synthesizing a great deal of information into a coherent whole, with a resounding conclusion. All human beings–irrespective of various differentiating characteristics such as ethnicity, age, sex, socioeconomic status–are hard-wired to collaborate, treat each other fairly and derive great satisfaction of being part of something greater than ourselves. In fact, in the long run, the strategy: ‘survival of the fittest’ is not even a winning strategy. (As Mahatma Gandhi so eloquently stated more than eighty years ago: ‘An eye for an eye, and soon the whole world is blind.’ Hardly the eyesight needed to find new solutions or new ideas.)

We now have concrete evidence that many of our most strongly held beliefs about human nature need to be modified. Yes we like to compete… but that is only part of the story. We also like to contribute to something worthwhile and can learn to enjoy people quite different from ourselves. By finding ways to create deep connection with one another we can move beyond ‘common ground’ or ‘shared interests’ into entirely new territory where new creative answers to old problems lie. Lynne stated it succinctly the end of our hour-long conversation: “If we can embrace the alternative impulse (cooperation and sharing, rather than always competing), many of our intractable problems become solvable.”

I hope you will take the time to get to know the book’s content. A good starting place is my interview with her. To listen, click on the link’s show: Leadership Every Day.

Meanwhile, keep the faith, you can be sure I am.

Marguerite

“Real Collaboration: The give-and-take of human beings who are so dedicated to a mission they will set aside the politics of organizations, share the difficulties, and invent solutions together.”  William H. Foege, MD, MPH

Dr. Foege should know. Through his leadership and commitment solve some of the most significant global health challenges, he’s been credited, among other things with devising the global strategy that led to the eradication of smallpox in the late 1970s. This is just one example of the impact he’s had throughout his illustrious career, as an American epidemiologist and global health leader and original thinker. In 2007, Dr. Foege was named among ‘Best Leaders’ by US News and World Report.  As he approaches his 75th birthday, he remains an important voice in global health, even as  in 2011. Dr. Foege’s a Senior Fellow in the Global Health Program at the Bill and Melinda Gates Foundation in Seattle and a Senior Fellow at The Carter Center in Atlanta.

Dr. Foege concepts about collaboration were the foundation  for recently released book: Real Collaboration: How Global Health Can Succeed. Elizabeth Hayes, a recent guest on my Leadership-Everyday radio program, is one of the book’s four co-authors.  We spoke of the book’s key findings and recommendations. It is a great book with a companion DVD with videos to share a practical toolkits with relevant forms in PDF. Very user friendly. I’ll be writing more about collaboration and 21st Century leadership in future posts. It does take practice, but is well-worth it.

Marguerite

In fact, collaboration is a hallmark of the underlying capabilities that today’s leaders must master.  It is one of the capabilities that our leadership development framework–Effective 21st Century Leadership: The 7 Aspirations–actively cultivates in the Leadership Work of Self, Reality and Relationships. One reason we put so much effort into cultivating the ability to collaborate among our clients and students is because most people in leadership positions assume they already know how to do it. My own experience working with leaders for almost four decades is has taught me that many people consider themselves capable collaborators without actually knowing what is involved.

My own experience has been validated the research conducted during the development of a book on collaboration in the field of global health: “Real Collaboration: what it takes for Global Health to Succeed.” In reality, most people DON’T know how to collaborate and have to learn how to become effective collaborators. The book, the research behind it and its contents are the subject of next Tuesday’s radio show on January 18th when I’ll be having a conversation with Elisabeth S. Hayes, one of the book’s co-authors. It’s a topic and a book whose time has come. You don’t have to be involved global health or even in healthcare to garner very useful insights from what they’ve learned and collaborative framework they’ve developed. You should listen in if you are serious about becoming a better collaborator…and a more effective 21st Century leader. Here’s the link for this show:

http://www.voiceamerica.com/voiceamerica/vepisode.aspx?aid=51358

I’m also providing a good synopsis of the book, and links where you can go to learn more, or buy it. It’s certainly become a part of my own Leadership Library.

Real Collaboration: What it Takes for Global Health to Succeed, written by Mark L. Rosenberg, Elisabeth S. Hayes, Margaret H. McIntyre, and Nancy Neill, with a preface by Task Force founder William F. Foege and global health leader and collaborator extraordinaire. http://www.ucpress.edu/book.php?isbn=9780520259515

“In global health there is a compelling need for what we call “real collaboration,” the give-and-take of human beings who are so dedicated to a mission they will set aside the politics of organizations, share the difficulties, and invent solutions together. Yet, collaborations in global health often fall short of what they hope to achieve. The difficulty comes in translating the attitude and concept of collaboration into concrete applications.  This practical handbook focuses on what might be the most important lesson of the last fifty years: that collaboration is the best way to make health resources count for disadvantaged people around the world. Designed as a learning resource to catalyze fresh thinking, Real Collaboration draws from case studies of teams struggling to combat smallpox, river blindness, polio, and other health threats. In honest appraisals, participants share their missteps as well as their successes. Based on these stories, as well as on analyses of many other enterprises, this book distills the critical factors that can increase the likelihood of success for those who are launching or managing a new partnership.”

The book is available from most online retailers.  At amazon.com it is available in the kindle version as well.  Real Collaboration includes a DVD with a documentary about global health collaboration, featuring President Jimmy Carter and global health visionary Dr. William Foege, as well as an interactive toolkit for building collaborations.

http://www.amazon.com/Real-Collaboration-Succeed-California-Milbank/dp/0520259513/ref=sr_1_1?ie=UTF8&s=books&qid=1295143765&sr=8-1

http://www.ucpress.edu/book.php?isbn=9780520259515