Putting LEADS to Work: Top 10 Highlights

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First released in 2014, Bringing Leadership to Life in Health: The LEADS in a Caring Environment defined the five domains and the 20 capabilities of the LEADS framework, that are both memorable and measurable: with both face and construct validity that have resonated with all leaders, irrespective of position or authority.  The uptake of LEADS as a preferred leadership learning platform and as a common vocabulary of health leadership has been remarkable. This second edition profiles health leaders from across Canada and abroad. They share their lessons of leadership, and how those lessons bring LEADS to life: in practice, not theory.

Highlight #1: LEADS is even more relevant today.

Bringing Leadership to Life in Health 2020 documents just how important high quality. modern leadership is to integrating services across the continuum of care, creating psychologically healthy workplaces, and prioritizing people-centred service.  It builds on over 35 featured stories of how LEADS has been put to work in practice.  It reflects a carefully crafted curation of well over 200 health specific research articles on the importance of leadership to organizational and system performances.  And, it provides independent evidence of the ongoing construct and face validity of the LEADS framework. 

Highlight #2: LEADS stands the test of time.

LEADS 2020 systematically reviews the historical and theoretical underpinnings of the LEADS framework.  Chapters 2 through 4 describe just how important time, place and circumstances are to effective leadership, both in terms of structures and in terms of people.   Bringing Leadership to Life in Health 2020 looks at the importance of resiliency and how both organizations and individual leaders can build resiliency, like building muscles, through experience over time.  We describe the fundamental differences between a capabilities framework and more common competency frameworks.  And, in Chapter 4, Bringing Leadership to Life in Health 2020 describes why learning leadership is different from learning anything else. “ Leadership and learning are indispensable to each other.”  (JFK)

Highlight #3: Deepening our understanding of LEADS in health care: LEADS being ‘Put to Work’.

“L”ead Self: Leading others starts with leading self. The Lead self domain of LEADS has four capabilities. This chapter provides a far deeper dive into each of these: self awareness and its dark side, self delusion; managing self in terms of owing what you do and maintaining your own health; developing self in terms of life-long learning; and, always, demonstrating character in terms of honesty, integrity and building trust over time: “ (Trust) arrives on foot and leaves by Ferrari” (Mark Carney, former head of Bank of England). What’s new? Each of the five core chapters stresses the need to see your leadership through the lens of advancing gender, diversity and inclusivity as well as providing self directed learning tools, including a LEADS self assessment for that capability.

“E”ngage Others: There is teamwork, the work, and then there are teams that work.  This chapter looks at each of the four capabilities, starting with what more we know about the importance of fostering others in terms of succession planning. Bringing Leadership to Life in Health 2020 then looks at what each of us can do to create physically and psychologically healthy workplaces: “ There is no health without mental health”. With the growing presence of social media and the 24/7 news cycle, effective communications or the 3rd capability under the “E” has never been more challenging or important.  It has never been more important to think twice before hitting the reply all and it is still wise to “seek first to understand, and then be understood”.  (Steven Covey).  LEADS-based self-directed learning tools and a self assessment tools is provided.

“A”chieve Results: The LEADS framework is all about making a positive impact and leaving a legacy:  better leadership, better healthcare. “ All of us want to make a positive difference when we get up in the morning. Who doesn’t like checking off their to-do list at the end of the day?” This chapter takes us through each of the four capabilities, starting first with the need for leaders to set clear direction, inspiring others with a clear and compelling vision for a better future.  This first step is followed by aligning your action with personal and organizational values, by taking action guided by the public interest and finally by assessing and evaluating progress. What’s new?  Like the traditional Plan, Do, Study, Act or PDSA action model, order matters when putting “A” in LEADS to work.

“D”evelop Coalitions: Since 2014 we have seen healthcare leaders coming together to form issue specific, often time limited coalitions or partnerships.  Bringing Leadership to Life in Health 2020  looks at three case studies that demonstrate how the four capabilities of under the “D” come together in terms of navigating socio-political challenges; mobilizing or translating knowledge into action with an increased focus on patients.  The three case studies provide important insights into the art of ‘carpooling’ (Carpooling Image?) and how to manage both the small “p” politics or working together and the big ”P” politics of working with others poses some challenges however in terms of sharing or sacrificing control and taking the time to ensure others are ready. “If you want to go fast, go alone.  If you want to go far, go together” (African Proverb).

“S”ystem transformation. “ Healthcare care systems are complex, confusing, multi-actor entities, sometimes described as “VUCA” environments: volatile, uncertain, complex and ambiguous.”  This is why leading in the healthcare system is not easy; it’s not for the faint of heart.  This chapter provides a much deeper understanding of the need for leaders capable of critical thinking that encourages innovation, helps champion and orchestrate change, always with an eye to the future.  The updated “S” lays out the limits of linear thinking.  It also describes and assesses in detail the two essential two kinds of strategic challenges leaders face:  technical and adaptive leadership challenges.   As in the case of the other core chapter updates, Chapter 9 provides features a number of stories, case studies and helpful self-directed learning tools.

Highlight #4: LEADS as a Change Model.

“There is a difference that is very fundamental and it’s very big between what is known today as change management and what we have been calling for some time change leadership”. (John Kotter)  One of the most pleasant surprises since the publication of LEADS 1.0 has been how the framework has been increasingly used as a change leadership tool, starting with the “A”…a clear and compelling description of a better future state, and then working to assemble the right team (the “E”), work with similarly concerned other organizations (the “D”), working hard to personify the values that support relationship-build (the “L”) and doing so in a VUCA world (the “S”).  This chapter elaborates on the differences between health leadership and management but also how they must come together to sustain the transformational changes needed in healthcare systems.  Once again, several helpful case studies are featured where leaders are “living LEADS”, both at work and after work is done.

Words from the Wise: Invited Author Chapters
Given the explosion of interest in health leadership and in LEADS as a common vocabulary of leadership, Dickson and Tholl invited a number of senior leaders across health systems to tell their stories and share their experiences directly, in their own words.  There were many possibilities to giving life to LEADS, but five rose to the top.  > These highlights feature these stories.  

Highlight #5: LEADS gone Viral?

There can be little doubt that LEADS has taken off across Canada and increasingly abroad through the power of partnering.  Chapter 11 chronicles the adoption of LEADS across Canada and the growing interest in other countries. The invited authors identify some of the key factors that help to explain how LEADS has “gone viral” and what were some of the critical success factors that had to fall into place. It explains the coming together and growth of the Canadian Health Leadership Network and the importance of adopting a “leadership without ownership” or win-win approach to leveraging up the LEADS framework. This chapter also describes the establishment and growth of LEADS Canada as the primary distribution channel so as to ensure a high level of understanding of those practicing LEADS and a continuous quality improvement approach to sharing LEADS-based programs and tools. 

Highlight #6: Regionalized Leadership

Most jurisdictions across Canada have moved to province-wide or regionalized administration of health services delivery to provide for more people centred, integrated healthcare services. As chronicled in Chapter 12, the regionalization of healthcare across Canada has increased both the propensity and ability to adopt a common health leadership vocabulary: the LEADS framework.  Two detailed Canadian case studies are compared and contrasted:  Alberta Health Services and the formation of the Saskatchewan Health Authority.  Colvin and Bishop complement their direct experience with regionalization with that of New South Wales in Australia and with interviews bringing in the shared experiences in other provinces in Canada. Key success factors include consolidating authorities and accountabilities and balancing people and process issues.  The invited authors set out a ten-step. LEADS-based process for maximizing to maximize the value of leadership development in talent management efforts.

Highlight 7: People-centred Care

“Living LEADS means putting the needs of patients and families first “. As invited authors (Cole, Thiessen and Andreas) describe in Chapter 13, this is easier said than done. Drawing on the World Health Organization Framework on Integrated People-Centred Health Services, we learn how important it is to engage patients and their families early and often in any change process. Three case studies are presented. We learn that structures and processes at three levels: direct care, organizational design and governance, and policymaking. In applying the LEADS framework “…your behaviour must be consonant with who you are and embedded in the values that connect you to the human experience”.

Highlight 8: Seeing with Two Eyes

All leaders, by virtue of our training and experience have blind spots. In this invited chapter written from a Indigenous peoples’ perspective, Lafontaine, Lidstone-Jones and Lawford, : (1) identify why Indigenous health leadership differs from leadership in non-Indigenous health; (2) provide context to why health leaders who excel in other areas of transformational change struggle in Indigenous health systems; and (3) highlight how three aspects of the LEADS framework (Lead self, Engage others, and Develop coalitions) provide a roadmap to critically assess and predict health leaders’ success to affect organizational change in Indigenous health. Our invited authors describe Indigenous health transformation like: “driving a bus that’s on fire, down a road that’s in the process of being built.” And leave us with an ongoing leadership question: if health leaders are responding to perpetual crises with little to no time of recovery, why do we keep approaching Indigenous health transformation in the same way?

Highlight 9: LEADS and the Health Professions

Potential is nothing without opportunity.” (Napoleon) The final invited chapter documents how the common vocabulary of LEADS is serving as an antidote for systems fragmentation. Citing several examples, Van Aerde, shows how engagement is a two-part process of healthcare professionals gearing up to take on leadership roles and then the organizations creating meaningful opportunities to put thee leadership skills to work. We learn how mental mindsets can get in the way of bringing health professionals together as a team and how LEADS is beginning to break down these barriers to forming teams. Based on 5 case studies or stories, Van Aerde concludes: “LEADS provides a simple entry point to understanding the research and evidence base behind best practices of leadership. It can help unite stakeholders with a collectively accepted understanding of leadership and encourage adoption of the leadership behaviour needed for health system sustainability and transformation.

Highlight 10: Where to from Here?

Bringing Leadership to Life in Health 2020highlights five key lessons. They are: LEADS works; caring leadership is gaining ascendancy in modern health systems; context shapes leadership; the speed of change demands a culture of leadership; and it’s time to professionalize health leadership. The professionalization of leadership has three essential requirements:  a known and accepted body of knowledge; a means of controlling entry into the profession; and an ongoing commitment to the public interest and adherence to a code of ethics. Given the broad-based acceptance of LEADS and the increased attention is being given to embedding LEADS in professional curriculum and credentialing, there is now a clear line of sight to the professionalization of health leadership in Canada.

The Final Word: “LEADS is empowering. The framework helps lift leaders and leadership up. It helps women (and all) leaders to lead from where they are and who they are; to effect change from where you and your colleagues are on the ladder of leadership.”  (Dr. Ivy Bourgeault)

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