In the final video this week we explore the possibility of alternative leadership roles that are not concerned with management and directing operations, but are more about brokering and facilitating change. This short lecture by Professor Rick Iedema, Monash University, describes his recent work on emerging new forms of leadership that support healthcare improvement.
As we saw in Week one, new policies and guidelines in healthcare are never simply translated into practice, even when they are strongly informed by evidence. In practice, clinical professionals always need to engage in learning and “articulation work” to make new policies or resources fit their own situation. This, in turn, depends on the ability of individuals or teams of clinicians to reflect on their own practice in creative ways.
As Professor Iedema explains, this type of creative thinking and the ability to understand complexity does not always come naturally. Partly, this is because clinicians are not trained to consider the organisational or systems dimensions of their work. It may also be because clinicians are often too busy treating individual patients or dealing with emergencies to step aside and engage in this kind of reflection.
It is in this context, according to Professor Iedema, that an alternative kind of leadership role emerges – what he describes as “the clinalyst”. This is shorthand for “outsider-analyst-catalyst”, or a role that is all about enabling frontline clinicians to engage in the kind of critical reflection and learning described above. Clinalysts may straddle specialities and professions with the ability to work across disciplinary boundaries and understand the priorities of management. They display experience with quantitative and qualitative data collection, data analysis and the skills to present such data and make it meaningful and relevant. Most importantly, clinalysts have facilitation and mediation skills, enabling them to act as catalysts in situations where change is necessary, and create forums where clinicians and patients can engage in articulating and renegotiating the complexities inherent in their work. By initiating a role such as the clinalyst, health-policy makers and managers acknowledge the importance of frontline staff taking the lead in creatively adapting and translating rules, procedures and guidelines to fit their own practices and ensure that they are more sustainable.