Hello from Guangzhou China where I am exploring a joint venture with some physicians to open a Home Care Company here and in Singapore. The Asian culture is so rich in history, traditions and approaches to problem solving. While I was talking to some of the physicians here, I had a little epiphany. I started to see the difference in how some of the companies I work with think and the unique way that Asians approach problems or opportunities.

This blog post talks a little about System Thinking and how this approach to communication and problem solving could be a new tool and approach to help hospice and home care executives lead their companies.

Over the past months, I have discovered one thing when working with some of hospice and home care companies. There isn’t a real clear and articulated collective vision on the part of leadership yet the entire organization on their strategic direction and specific program elements such as how to use the GIP level of care to build relationships with hospitals, the pros and cons of starting a palliative care program and so on. Does this sound like your organization??

One common theme I noticed was there was not a lot of productive dialogue occurring in these organizations. Yes, there was much debate and conversation, but not productive dialogue that could help lead an organization to solve a problem and or leverage an opportunity. I have several examples of where CEOs would lecture on their vision or opinion, but never fully engaged their senior staff in dialogue. Or in another example, I could see the senior leadership group tactically positioning themselves so their position was heard the loudest. No dialogue!!! In true system thinking and with the use of dialogue one “First Seeks To Understand, Before Seeking To Be Understood”. Without this simple but powerful way of communicating, the collective wisdom of the group is severely diminished thus leading to a lack of an organizational common vision. This all may sound like 101 undergrad stuff to some and while it may be, dialogue is not being practiced (at least in the some of the groups I work with) to its fullest.

The art of dialogue in my humble opinion should be a leadership skill that is developed, practiced and invested in on a much larger scale! It is a fundamental first step to the practice of System Thinking. Back in the 90s, a gentleman by the name of Pert Senge contributed a great deal to the field of System Thinking and wrote a book some of you may be familiar with called the “Fifth Discipline”.

Simply put, Systems thinking means the ability to see the synergy of the whole rather than just the separate elements of a system and to learn to reinforce or change whole system patterns. Many people have been trained to solve problems by breaking a complex system, such as an hospice or home care organization, into discrete and separate parts and working to make each part perform as well as possible. However, the success of each piece does not add up to the success of the whole. In fact, sometimes changing one part to make it better actually makes the whole system function less effectively.

We have a tendency to do that in health care; especially in home care and hospice. For example, in trying to improve the referral inquiry to admission process, we break out the parts that deal with this process, i.e. intake coordinator, admission nurse, etc. instead of engaging the entire organization to work on improving the process, we break it down. I can guarantee this approach with result in unintended consequences and actually lead to a decrease in the organizations’ ability to convert a referral to an admission.

I truly believe that an organization’s ability to serve more people and grow is based in its ability to engage in productive dialogue, not debate. And to practice system thinking. To learn more on how to start on both paths (dialogue and system thinking), please drop me a line. I can share some resources to get you going!

The Best!