Leading with Strategic Thinking. Olson Aaron K.

to his broader definition of systems thinking:

      ■ Dynamic Thinking: Involves recognizing patterns and trends that materialize over time rather than focusing on isolated factors, events, or circumstances.

      ■ Closed-loop Thinking: Involves recognizing that systems consist of connected and interdependent processes that do not flow one way but, rather, interact in dynamic and constantly changing ways. An important facet of closed-loop thinking is that it helps you recognize the role the individual plays in influencing the system.

      ■ Generic Thinking: Involves recognizing the broad-based and multifaceted implications of people, processes, systems, mechanisms, and events. Using an example common in business school courses, what might have happened if the railroad companies had considered themselves to be part of the transportation industry rather than merely being railroad companies? Might Southern Railway now be responsible for transporting supplies to the International Space Station?

      ■ Operational Thinking: Involves thinking in terms of how a system, process, or mechanism actually works rather than how it was intended to work. This helps one avoid falling into the trap of assuming that the system designed in the planning process will perform “in accordance to plan” simply because that was the original intent.

      ■ Continuum Thinking: Involves recognizing that what seems like opposing forces typically are connected and have certain commonalities or interdependencies. Such recognition allows one to find common ground upon which to build rather than continuing to focus on the boundaries and disconnections.

      Each of these examples provides concrete ways to apply systems thinking to avoid the checklist mentality and to understand more accurately the dynamics typically at play in a given situation.

Systems Thinking in Groups

      Just as systems thinking can help individuals think more strategically, it can also help teams and organizations. In the 1980s, Peter Senge conducted research to discover how organizations build learning capacity and why some organizations are better at learning than others. The practices that differentiate the effective learning organization are referred to as the Five Learning Disciplines, all of which we consider to contribute to strategic thinking:

      ● Shared Vision: Involves formulating a compelling vision to create commitment among a group to “pull” individuals toward the envisioned future state.

      ● Mental Models: Involves surfacing the values, assumptions, and expectations that determine the way people think and behave. We will describe tools later in this chapter that can help challenge existing assumptions and ensure that contributors working together to turn the vision into reality do so in a consistent and mutually supportive manner.

      ● Personal Mastery: Involves taking steps to strengthen self-awareness about how we think, draw conclusions, make decisions, and manage conflict, as well as how we apply these to establish, manage, and strengthen relationships.

      ● Team Learning: Involves teams working together to review situations and gain mutual understanding of what they had hoped to accomplish, how things progressed, and how they handled unexpected and unplanned events. Doing so can reveal underlying and contributing factors, and identify necessary steps to increase effectiveness and efficiency in the longer term. Again, we will describe tools later in this chapter that can help teams work together to identify lessons learned and establish new best practices.

      ● Systems Thinking: Helps teams and team members recognize interconnected factors and forces that influence or impact events, analyze events to understand related and contributing challenges and opportunities, and identify ways to leverage the opportunities and mitigate the challenges.11

      The Five Learning Disciplines contribute to strategic thinking and help organizations build learning capacity by emphasizing the importance of planned and purposeful thinking; the benefit of teamwork and teams composed of self-confident, self-motivated, and capable team members; and the importance of individuals and teams thinking through issues, considerations, and related implications prior to drawing conclusions and making decisions.

Applying Systems Thinking

      A case involving a multifacility medical center that provides “full life cycle” health care services showcases how the effective use of systems thinking might lead to better outcomes. In this scenario, the Emergency Services Department is a well-known and highly recognized trauma center, seeing scores of patients every day who are experiencing some type of physical distress.

      The department operates in an environment of continuous improvement, measuring success through a variety of internal and regulatory-driven metrics. The director of the Emergency Services Department conducts quarterly patient satisfaction surveys to gain insight into the overall impact of its policies and procedures, and to measure the effectiveness and efficiency of its operation. A special recognition program includes cards that patients and their families can easily complete and submit to recognize exemplary performance.

      The director of the Emergency Services Department, troubled by a decreasing Patient Satisfaction Index, or PSI, decides to take action. The director's strategic intent is to take steps to address concerns raised by patients with the ultimate goal of increasing the department's PSI. Upon analyzing the data revealed through the quarterly patient survey, she realizes that approximately 80 percent of the concerns raised relate to wait time. Patients are spending two to four hours in the waiting room per visit. The director's examination of the data reveals that concerns are being raised by “single appointment” patients and recurring patients who receive extended care.

      Further examination reveals that the concerns being raised mostly center on the fact that patients entering the department at certain hours miss meals. Those entering after 3:00 or 4:00 AM miss breakfast, those entering after 9:00 or 10:00 AM miss lunch, and those entering after 2:00 or 3:00 PM miss dinner. The director weighs the options and decides to begin offering breakfast, lunch, and dinner to patients in the waiting room during the appropriate hours.

      Time passes, and new patient satisfaction surveys and comments suggest the director's solution is working. Single-appointment and returning patients are pleased with the meals they now receive. The department's PSI is climbing, primarily as a result of increased satisfaction relating to the catered meals. Happy to see this key performance indicator returning to historical levels, the director takes satisfaction in a job well done.

      If the director had applied systems thinking concepts and principles, how might have her considerations, conclusions, decision(s), and subsequent actions been different? In terms of her general considerations, the director might have broadened her level of analysis to include local, regional, and national emergency services departments. She might have shifted her focus from attempting to increase patient satisfaction by providing catered meals to attempting to increase patient satisfaction by decreasing wait times. In terms of the questions she asked, the director might have explored how effectively and efficiently the Emergency Services Department operates within the context of other similar emergency services organizations. Perhaps she might have investigated how the department's structure, systems, processes, policies, or staff capabilities affect the department's efficiency and effectiveness. In terms of the conclusions she drew and decisions she made, the director and her colleagues might have attempted to tackle the issue of patients using the Emergency Services Department as their primary health care provider through patient education. Alternately, they might have taken steps to strengthen the integration of systems and processes to enhance efficiency and effectiveness. Perhaps they might have taken steps to bolster controls and incentives to ensure employees at all levels are committed, engaged, and motivated to work together to achieve the Emergency Services Department's goals and objectives.