Our educational process has conditioned us to assume that analysis is the primary way to think. We believe if we get the right data and analytics, the resultant insights will lead to the best answer for all problems at hand.
But analysis is only one way of thinking. It is a three-step process in which for something to be understood it must first be taken apart. Next, an effort is made to explain the behavior of each of its parts, taken separately. Lastly, the insights gained about each of the parts is re-assembled in an attempt to describe the whole. This approach has inherent limitations because it seeks to understand “a thing” by reducing it to its parts. Too often, essential properties are lost in this process and along with it the ability to explain the larger dynamics surrounding a decision or desired strategy.
Synthetic or systems thinking, however, can lead to a more complete understanding. It is similarly a three-step process. In the first step, the larger whole or system is considered. Next, the behavior of the system is documented. And lastly, with an understanding of the whole in place, it is dis-aggregated to explain the behavior of the parts. Ultimately in search of leverage to achieve the desired outcomes.
The analysis reveals the structure of a system, and how it works. Its product is knowledge. Synthesis yields why a system functions as it does. Its product is understanding. In combination, the probabilities for making better decisions and executing them will improve significantly.
A number of years ago, at the healthcare system I led, we were trying to improve the poor performance of our seven emergency rooms. All the previous efforts had yielded minimal sustained results. This third attempt was not faring any better. I met with a group of nursing managers across the organization in an open dialogue. “How are things going?” I asked. “Terrible,” came a quick response from the clinical leader two seats over. “Quality is really going down.” “Why do you think that is so,” I asked. “Because I used to be able to give my nurses a rest before accepting new patients to our floor, but now the ED wants to send patients up as soon as a bed is ready. So, to protect my nurses time I wait a while before entering our available capacity into the bed management system.”
If you are like me, your first thought is, this sounds like obstruction, sabotage or worse. But on reflection, the real problem was not the nurse manager, it was me. I was focused on the ED and breaking it into its parts (analysis) instead of considering the hospital in which it functioned (synthesis). This nurse manager “believed” she was doing the “right” thing to resist lowering quality. It took understanding the larger operation and context to begin to help the nurses on the floor to realize their critical role as part of the larger patient care process, that started in the emergency room.
It was systems thinking combined with analysis that led to the dramatic and sustained performance in the emergency room and across the organization. It takes time and involves both the “art” and science of leadership. This is one example of what it means to lead with imagination.
Brian Paradis is a senior partner at CSuite Solutions, a strategic advisory firm serving health system leaders across the U.S. Most recently, Paradis served as President of Florida Hospital’s Central Region and as the Chief Financial Officer for the Florida Division of Adventist Health Systems. To learn more about imaginative leadership get your copy of Brian’s newly released book, Lead with Imagination, in which he shares his experience and insights on how all leaders can regain the power to lead and live in a changing world.
CSuite Solutions, LLC was founded by an elite group of former healthcare system CEOs and C-Level executives in response to a growing need for fresh solutions and new strategic insights into issues faced by healthcare systems. The national strategic advisory firm works alongside industry leaders to offer healthcare consulting, healthcare revenue cycle management and advise on clinical integration and patient-centered care.
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