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  1. Harvard University HARVARD SCHOOL OF PUBLIC HEALTH AND THE KENNEDY SCHOOL OF GOVERNMENT Meta-Leadership Mid-America Regional Public Health Leadership Institute St. Charles, Illinois October 18, 2007 Joseph M. Henderson, MPA Centers for Disease Control and Prevention

  2. Public Health Leadership Challenges • Public Health has gone from 9 to 5 to 24/7 – new partners • From evolving science to fast science • Planned communication to data overload • National scope to global involvement

  3. Public Health Leadership Challenges Funding Curve Crisis Curve Performance Expectation Intensity Time

  4. Public Health Leadership Challenges • Recruiting and retaining a competent workforce • Getting, being, and staying prepared for every possible public health emergency • Dependency on accidental leadership A System of Continuous Improvement A System of Continuous Improvement

  5. The Challenge of Non-Quality Hours * Email, unstructured meetings, time management, lack of focus, long discussions, interruptions, lack of issue ownership, open door policy.

  6. WADOH and MI Score Card • Greatest opportunities: • High sense of purpose • Dedication to the cause • Public awareness increasing • Political will • Greatest weaknesses: • Difficulty with “No” • Impatience • Self-confidence • Delegation & follow-up • Greatest challenges: • Escalating commitments • Funding to support commitments • Fluctuating priorities • Fear of failure • Greatest strengths: • Ability to adapt to changing political environment • Power of vision and generating action • Commitment to good science

  7. How can you transform yourselves and your organization to address the challenges and capitalize on opportunities?

  8. Consider Meta-Leadership • Defined as: • Purpose: Meta-Leaders connect the intentions and the work of different organizations or organizational components to achieve a shared purpose. • Process: Working without direct authority they motivate often overlooked opportunities to facilitate interaction, encourage communication, build confidence, and foster collaboration. • Outcome: Of significance Meta-Leaders, by virtue of their willingness to venture beyond the usual, are able to achieve outcomes that would not otherwise be realized. Leaders must transcend traditional structures working with a larger set of partners to solve complex problems and achieve success…

  9. The Event Perceptions The Person of the Meta-Leader The Problem Reality Consider The Fundamentals of Meta-Leadership The Factors The Framework • Time • Energy • Perception • Behavior • Systems • Relationships

  10. The Framework of Meta-Leadership The Event Lead Up The Context The Person of the Meta-Leader The Culture The Problem Lead the Silo Lead Connectivity

  11. Factor Focus: • Time • Energy • Behavior • You and others The Person of the Meta-Leader

  12. THE MIND, THINKING & ACTION OF THE LEADER Intellect/ Creativity Protocol/ Familiar Primitive Reaction

  13. REACTING TO A CHALLENGE • Fear (yours/others) • Unorganized • Fatigue • Lack of Experience • Poor Information • Failure The situation can take leaders to the “basement”

  14. TAKING COMMAND • Structures • Procedures • Priorities/Goals • The Familiar • The Comfortable This is the box! To get O.O.T.B., the leader can gain control by implementing protocols

  15. GENERATING ACTION • Connected • Wide view • Decisive • Results obvious The “meta-leader” Drives dynamic adaptability KEEP IN MIND THE PROCESS IS DYNAMIC

  16. Discussion Energy/Time Behavior • Influence vs. control • Champion vs. authority • Security & Confidence • Risk taking & Risk Aversion • Power of priorities (Build-immunity) • Escalating commitments • Follow through and follow-up • Non-quality vs. quality hours

  17. Factor Focus: • Time • Energy • Perception The Event Perceptions The Person of the Meta-Leader The Problem Reality

  18. Closing the Gap • Perception vs. Reality • What creates the gap between P & R - How do we find the truth? • What drives understanding? • What can the leader do to close the gap? • How do we de-mystifying rumors, address conjecture, hype (the media) • Remember, perception does become reality especially with less intensive events vs. crisis events

  19. Challenges in Defining the Event: Understand the Escalating Potential – ONE EXAMPLE High 1,000 – 100,000+ Command and control – vital to assure wide area containment Pandemic Flu Activate community-wide mass care system – manage great loss Potential for Chaos Increases Katrina Manage high volume of data and information Number of People Affected Leadership Pressure Deliver mass intervention – call up reserve workforce SARS Communicate to stakeholders and public – enhance surveillance & reporting Anthrax 10/01 Report – Mobilize Response – Investigate – Prophylaxis 1 LOW Assess – Diagnose – Isolate – Treat – Manage MORE LESS Time To Solve Problems/Make Decisions

  20. Challenges in Defining the Event: The Impact of Chaos • Defined as a “perceived” state of extreme confusion and disorder • What feeds chaos: • Lack of control of: • Information (coming in and going out) • Resources • The decision process • Command pressures or pressures from other groups • Failure of the leader to empower members to engage • Failure to understand the consequences (good and bad) of decisions (short and long-term) • Failure to assume command and assert control

  21. Challenges in Defining the Event: One Solution - Create an Operational Picture • Step 1: • Establish “operational awareness” get information • This is people, information systems, the media, other sources • Develop a process to question reliability of the information • Step 2: • Create a framework to organize incoming information based on time, place, scale and scope of the event • Use maps, graphs and pictures to portray knowledge – update often • Step 3: • Based on your operational picture and incoming data begin to develop predictions about how the event might evolve • Build decision-process around the operational picture

  22. BREAK “No man is good enough to govern another man without that man’s consent”Abraham Lincoln (1864) “The greatest leader is not the one who does great things. He’s the one who gets people to do great things”Ronald Reagan

  23. Factor Focus: • Behavior • Perception • Relationships The Event Lead Up The Context The Person of the Meta-Leader The Culture The Problem

  24. Leader Organization The Cause The Challenge of Leading Up • Orders of Preservation: What’s the order in your organization?

  25. The Challenge of Leading Up • Be a good subordinate • Earn positive reinforcement – increase desired behavior • Work to the cause/guided by a clear set of priorities • Ask good questions • Assure your motivation tracks to leader’s priorities • Meet your commitments • Consider orders of preservation • Develop a professional/personal relationship • Demand clear performance expectations… • Do your leaders prefer written, verbal, or some other form of communications – find out! Remember the value of the harness..

  26. Factors that apply: • Energy • Behavior • Impact • Relationships The Event The Context The Person of the Meta-Leader The Culture The Problem Lead the Silo

  27. The Silo – This is a good thing! • Promotes a related set of functions • Controls a related set of workers • Is the sum of all the parts - Newtonian Systems • Supports a structured/familiar Organization • Operates under a defined set of principles • Is tied together by a unique culture supported by a common set of values LEADING IN THE SILO

  28. Define Your Organizations Leadership Environment • The Charge • Common understanding vs. various interpretations • Does it currently map to a relevant issue, challenge or set of priorities? • Motivation • Yours • Others including your boss • What defines your organization? • Greatest moments (Successes) • Worst moments (Short of Success)

  29. Three Phases of Leadership PHASE I PHASE II PHASE III Operations & Execution Vision & Strategy Impact & CQI Plan Execute Connect Pieces Monitor Change Measure Productivity Assure Systems to Support CQI See Big Picture Know Desired Outcomes Build Coalitions WHERE DO YOU LEAD?

  30. Drive the Learning Curve PHASE I PHASE II PHASE III Operations & Execution Vision & Strategy Impact & CQI Leaders drive the learning curve across all three phases – especially during a crisis This is done best when the team is tuned…

  31. 5 Dysfunctions of Team* • Absence of Trust • Teams must be comfortable being vulnerable with each other • Capable of being open and honest • Fear of Conflict • Teams must be able to disagree, challenge, and question each other • In the end they find ways to master conflict • Lack of Commitment • Effective teams consider all ideas and opinions of the group • Team members may not agree with approach but all are confident in the process • Avoidance of Accountability • All team members must be recognized as accountable • The team leader cannot be the primary source of accountability • Inattention to Results • To focus on results the team must consider what’s best for the team and not the individuals • All energy is then placed on the larger goals *Patrick Lencioni, Overcoming the Five Dysfunctions of a Team, 2005

  32. Factors that apply: • Relationships • Impact • Energy The Event The Context The Person of the Meta-Leader The Culture The Problem Lead Connectivity

  33. The Challenge of the Pieces • How do your organizational components connect? Sec/Dep. Secretary of Health Community & Family Health $ Human Resources PHEPR Epi. / Labs Public Policy I.T. Health Systems Quality Assurance Systems Development & Planning Communication Environmental Health Performance & Accountability CDC SMO

  34. Leading Connectivity COMPLEX ADAPTIVE SYSTEMS More than the sum of the individual parts LEADING CONNECTIVITY LEADING IN THE SILO • Big picture • Multi-dimensional perspective • Comfortable with the unfamiliar • Recognize different values • Works to integrate diverse goals • Focus on relationships

  35. Leading Connectivity Across the Silos Dedicate Energy to: • Enabling STRATEGIC CONNECTIVITY – Be curious! • Valuing the other organization’s MOTIVATION • Recognizing and Resolving CONFLICT • Taking RISKS and Managing CONSEQUENCES • Working with the UNCOMFORTABLE or UNFAMILIAR • Identifying and INTEGRATING shared goals • Guiding the process and focusing on RESULTS • Being Tolerant of and Learning from MISTAKES

  36. The Practice of Meta-LeadershipDynamic Adaptability QUICK STRATEGY COMMAND! BUILD RELATIONSHIPS EMPOWER!

  37. Wrap-up

  38. The Fundamentals of Meta-Leadership Key Take Aways: • The Person as Leader • Know how to get out of (stay out of) the basement • Manage your behavior and emotions and be aware of those around you • Empower others and be empowered • Avoid managing the details • Map behavior to set priorities • Follow-through REDUCE NON-QUALITY HOURS!

  39. The Fundamentals of Meta-Leadership Key Take Aways: • Know the Event/Environment you’re Leading In • Acknowledge and manage chaos/ confusion • Know the P & R Gap - Find the truth • Consider an operational picture to map perception to reality and link your decisions to that picture of reality • Remember this is a very dynamic and moveable dimension

  40. The Fundamentals of Meta-Leadership Key Take Aways: • Leading Up • Understand the orders of preservation • Learn to be a good subordinate • Remember this requires energy from you and the boss resulting in the most effective relationship – must be nurtured

  41. The Fundamentals of Meta-Leadership Key Take Aways: • Lead the Silo • Drive the learning curve through the 3 Phases of Leadership • Build and sustain a functional team • Celebrate success • Identify and resolve conflict • Build both individual leader and system capacity – Consider current and future challenges

  42. The Fundamentals of Meta-Leadership Key Take Aways: • Lead Connectivity: • Work to connect the purposes of many individuals to achieve a greater good • Be willing to take risks and manage the consequences • Recognize when shared goals are achieved • Build connectivity that will survive when key personalities move on

  43. Consider The Fundamentals of Meta-Leadership The Factors The Framework The Event • Time • Energy • Perception • Behavior • Impact • Relationships Perceptions The Person of the Meta-Leader The Problem Reality

  44. The Fundamentals of Meta-Leadership Quick Summary - Things you can do now • Buy back non-quality hours • Map priorities to current effort and test this routinely with staff – build immunity • Avoid the “Pleaser” approach • Yes = drives escalating commitment • No = allows a focus on priorities • Understand individual motivation/drive • Use the M/L Framework to drive discussion

  45. “A good plan, violently executed now, is better than a perfect plan next week.“ General George S. Patton “One cool judgment is worth a thousand hasty counsels. The thing to do is to supply light and not heat.” President Woodrow Wilson

  46. Joseph M. Henderson jfh0@CDC.GOV Centers for Disease Control and Prevention Dr. Lenny Marcus, Dr. Barry Dorn, and Dr. Isaac Askenazi Harvard University HARVARD SCHOOL OF PUBLIC HEALTH AND THE KENNEDY SCHOOL OF GOVERNMENT National Preparedness Leadership Initiative