Partnering to create sustainable futures

By Sara Horton-Deutsch, Kathryn Kuehn, and Gwen D. Sherwood | 10/01/2015
 
This chapter from Reflective Organizations: On the Front Lines of QSEN & Reflective Practice Implementation explores how organizational leaders reflect on and cultivate their own strengths to act in partnership with others to create a sustainable future.


Reflective Organizations book coverThroughout this book, we introduced reflective models and theories. Stories and practices relate how using these reflective approaches facilitates and embraces transformation. In each chapter, the authors demonstrated the reflective process of learning from experience to craft future transformations. Sherwood and Horton-Deutsch (2012) presented reflection as a systematic way of thinking about actions and responses to create a preferred future. In this chapter, we explore how organizational leaders—particularly those who work at professional and service organizations—reflect on and cultivate their own strengths to act in partnership with others to serve the greater good. Successful leadership within the organizational context requires self-knowledge and skills (Pesut, 2007), an appreciation of evolving trends in organizations (Coerver & Byers, 2011), and engaging members in intentional ways to create a sustainable future.

Strength-based leadership to transform organizations
Pesut (2007) states, “[U]nderstanding and intentionally using one’s strengths in an organizational context are among the keys to successful organizational leadership and governance” (p.157). Knowing one’s individual talents and strengths accelerates ability to work more efficiently and effectively with others. Strength-based leadership (Rath & Conchie, 2008) identifies and values the individual strengths of group members, recognizing the collective whole is greater than any part. Diversity among organization and/or team members increases the overall capacity; organizations gain strength through the collection of diverse talents of group members. The Gallup Organization has researched signature strengths of leaders for more than 30 years (Rath & Conchie, 2008), and its work is currently portrayed in 34 signature strengths that cluster into four domains: executing, influencing, relationship building, and strategic thinking.
 
Applying leadership domains
To become a more effective leader, Rath and Conchie (2008) advocate three approaches. First, leaders need to recognize their own strengths, and leaders must also invest in helping others develop their strengths. Second, leaders need to identify the strengths needed to accomplish the goals of the organization or team and then recruit people with the right strengths to meet those goals. Third, effective leaders must understand and ensure that the four basic domains of executing, influencing, relationship-building, and strategic thinking are well represented in the organization or team. The following list describes these domains:
  • Executing. Leaders whose strengths lie in the executing domain make things happen. They are action-oriented and work tirelessly toward a goal.
  • Influencing. These leaders ensure the larger organization is heard by reaching out to members.
  • Relationship building. These leaders hold the team together and ensure that the organization is greater than the sum of its parts.
  • Strategic thinking. These leaders keep everyone focused on what is possible. They constantly analyze information as it is gathered and help the team make good decisions.

The most effective teams have representation of strengths in each of the four domains. Complementary teams value all contributions and drive organizational growth.


REFLECTING ON … LEADERSHIP DOMAINS
  • Consider a team/group/professional or community service board with which you currently are working. Can you identify characteristics of each domain among the members?
  • How can you use your and your team members’ unique strengths to maximize contributions?


Tran
sforming organizational culture
Transforming organizational culture is complex and challenges even high-functioning teams. Internal and external intersections impact organizations. Evolving trends in the external environment directly or indirectly affect internal organizational cultures, and long-established values, beliefs, and behaviors that characterize group members are often deeply embedded, and thus difficult to replace. Societal trends also influence culture. Coerver and Byers, in “Race for Relevance” (2011), identify how six marketplace realities that occurred over the past 25 years have significantly influenced the way people function in organizations:

  • Time. Americans are working more and longer hours, and face increasing demands on their time, making “work/life balance” an elusive goal.
  • Value expectations. The growth in products and services in the past two decades has fueled consumer demand and expectations. People want what they want when they want it—and if they don’t get it, they turn elsewhere.
  • Market structure. Consolidations, mergers, and buy-outs are the status quo—increasingly so, since the Great Recession.
  • Generational differences. For the first time, Coerver and Byers maintain, there are five living generations: four of them working together in the workplace, and each with different values, styles, and expectations.
  • Competition. Organizations are competing for an increasingly savvy consumer who is dictating the delivery channels of products and services.
  • Technology. The birth of the Internet has forever changed how organizations operate and serve their employees, members, and markets, and influenced information management and distribution.


REFLECTING ON … THE EFFECT OF MARKETPLACE REALITIES
  • Which of these marketplace realities impacts your team/group/organization?
  • How do these realities affect your internal organizational culture?

Most professional and service organizations have a passionate commitment to make their associations better, stronger, and more relevant to members. At the same time, most organizations are driven by tradition where change occurs slowly and members avoid risk. This traditional drive often results in a broad range of programs, services, and activities. Coerver and Byers (2011) recommend a sequence of radical changes that move from association governance, member market, program and product mix, to technologies to delivery of services. These sequential changes aim to ensure organizational relevance. And even though their work focuses on the structure and activities of nonprofit professional organizations, it can be applied broadly to organizational relevancy overall.

These recommendations include (Coerver & Byers, 2011):

  1. Right-size the organization’s governance structure to create a small, competency-based board or leadership team where members’ presence and attention are essential. A board composed of members who know their strengths and collectively possess all four leadership domains helps to ensure the competencies needed to govern the organization.
  2. Streamline committees and retain only those that do valuable and relevant work. Consider the mission of the organization, determine the committees really needed, and retain only those that are useful and productive.
  3. Empower the CEO and enhance the contributions of the staff. Because professional organizations have become more complex through expanded programs, services, and activities, they require increased management competencies and the need to delegate responsibilities previously done by volunteers.
  4. Focus on the needs of a definable group that helps members perform and succeed. This approach allows organizations to concentrate resources for maximum performance.
  5. Concentrate resources on a tightly focused menu of services and member benefits so the organization can excel in a few key areas.
  6. Embrace technology, including information, communication, delivery systems, and infrastructure. A comprehensive technology plan that improves efficiency and productivity and meets the needs of members is essential for an organization’s relevance and performance.


REFLECTING ON … ORGANIZATIONAL STRUCTURES AND GOVERNANCE

  • Consider your organization: What structures or processes need to be changed or adopted to address these challenges?

 
After leaders establish the organization’s strengths and clarify the need for changes to ensure relevance, they must engage members in intentional ways to achieve sustainable futures. According to Chait and colleagues (2005), three modes of governance together foster effective leadership: fiduciary, strategic, and generative. Although the first two may be more familiar, the latter is essential for organizational relevance and growth. Before an organization can strategically solve problems and make the most fiscally sound decisions, it must engage in sense-making. Taken together, generative thinking and sense-making—combined with thoughtful consideration of market trends and realities—provide the foundation for both strategic and fiscally sound decisions.
 
SidebarTherefore, the remainder of this chapter will visit ways to engage members of an organization in sense-making: a reflective dialogue and conversation that aims to gather what members know, believe, and value. The outcome of this exercise is used to both inform and guide leadership teams within an organization, as well as the iterative process of providing ongoing communication and gathering additional feedback from members to engage them in creating a preferred future. The overall approach to leadership for guiding this process is discussed with questions to facilitate personal reflection for transforming organizations in a way that is responsive to current members. Finally, readers are invited to reflect on ways to bring new life and new connections to their organizations to create relevant and desirable futures to positively influence health and healthcare.
Leadership strategies that invite engagement, reflection, and action
Creating desired futures within organizations, as highlighted in the previous chapter, is about transformation that is supported by futures literacy (Miller, 2011). Members are invited to create and share stories about the future to inform current practices. Futures-literacy guides professional healthcare organizations on how to bridge from their current realities to a preferred future by reflecting on trends and consequences likely to impact forthcoming research, education, and practice affecting the organizational enterprise.
 
Liberating structures: Complexity science for futures-thinking to transform organizations
Organizations that want to remain relevant must engage in futures-thinking (Pesut, 2000; Pesut & Pesut, 2010) by considering how the past and present influence the future. Liberating Structures (Lipmanowicz & McCandless, 2013) are nonhierarchical methodologies based on complexity science designed to unleash futures-thinking and improve performance. Liberating Structures include and engage everyone in an organization to shift the pattern of interactions and unleash the collective wisdom. For example, at a recent International Society of Psychiatric Mental-Health Nurses interactive closing keynote address, “Creating Desired Futures” (Pesut, 2014), members were asked to engage in a Liberating Structure called 1-2-4-All (Lipmanowicz & McCandless, 2013) and consider the following questions suggested by Anne Deering, Robert Dilts, and Julian Russell (2002) as a means for leaders to create a future state for an organization:
  • If a time traveler from 25 years in the future could give you the answer to one question, what would it be?
  • If you were looking back 10 years from now and telling the tale of the organization’s greatest success, what would the story be and why?
  • If you were looking back 10 years from now and telling the tale of the organization’s greatest failure, what would the story be and why?
  • What does the organization need to forget? What must it always remember?
  • What are the most important strategic decisions we will have to make as an organization?
  • What will prevent us from succeeding? What are the greatest risks and dangers?
  • If you had the power to do one thing for the organization, what would it be, and why?

The 1-2-4-All exercise took about 12 minutes and engaged the audience as participants in generating questions, ideas, and suggestions for future directions of the organization. Participants broke into small groups, discussed and prioritized a prompt for two minutes, and then moved to a new group to address a new prompt. Participants engaged in a lively conversation about what is possible, included everyone, and tapped into know-how and imagination. Most importantly, participants (members of the organization) own the ideas, so no buy-in strategy is needed later on.

Wicked questions: Revealing entangled challenges and possibilities not readily obvious
Wicked Questions is another provocative example of using Liberating Structures. A think tank of leaders in the Quality and Safety Education for Nurses (QSEN) project used Wicked Questions to consider how this loosely constructed group could achieve sustainability, remain current and relevant, and deliver resources to continue to improve quality and safety in nursing education and practice. The following sidebar is an exemplar of the session of Wicked Questions.
 

WICKED QUESTIONS IN ACTION

Shirley Moore, PhD, RN, FAAN and
Mary A. Dolansky, RN, PhD, Director, QSEN Institute, Frances Payne Bolton School of Nursing, Case Western Reserve University

The Quality and Safety Education for Nurses (QSEN) Steering Team from Case Western Reserve University School of Nursing held a think tank as a part of the annual QSEN National Forum with key leaders to consider future directions and influences. Recognizing all groups and movements undergo periodic change, as QSEN approaches 10 years, having a conversation to maintain relevancy and sustainability can help determine continued sources of support, engagement, and influence. The session was shaped using the Wicked Question exercise from Liberating Structures (www.liberatingstructures.com/4-wicked-questions/). The group was divided into four tables. Each person would read the question and follow the format of another Liberating Structure, 1-2-All:

  • 1 minute: Each person silently reflects on the question to collect his or her thoughts.
  • 2 minutes: Discuss in pairs.
  • 10 minutes: Engage in whole table discussion.
  • 20 minutes: Tables report key thoughts to the entire group.

Wicked Questions highlight a pair of opposites or paradoxes at play regarding a particular issue or situation. In this case, it was in regard to academic-practice partnerships. A Wicked Question stimulates discussion of the tension that underlies our work together when a pair of opposites are true at the same time. This discussion can reveal innovative strategies for producing change.

The Wicked Questions for this session were:

  1. If both nursing practice and academic organizations have considerable knowledge regarding how to improve systems, how is it that we don’t apply that knowledge to improve our academic- practice partnership systems?
  2. Assurance of basic competency is a major mission of academia. Delivery of highest quality care is the mission of healthcare delivery organizations. How do these differences in mission play out in our academic-practice partnerships on a daily basis?
  3. Given that a purpose of academic training for nurses is to help them to conceptualize and give ideal care, how do they learn to give/alter that care within the resource constraints of practice environments?
  4. If a key feature of successful partnerships is that any partner should feel free to challenge an assertion or raise a concern, how is it that the avoidance of open disagreement is a key normative feature of relationships between nursing practice leaders and academic faculty?

 
Leadership as reflective practice
The purpose of engaging members of an organization in futures work is not to predict the future but to envision desirable futures and avoid or prevent tragic ones. When leadership teams gather ideas from futures-thinking tools, such as Liberating Structures, they have a launching pad for moving forward. They can move forward with these ideas by discerning logical consequences of trends, stimulating strategic conversations about preferred visions, and considering the value of an integrally informed future.
 
Beyond this, leadership teams (boards of directors, in this illustration) must become a reflective community of interpretation where they talk seriously about members’ feedback and consider it in light of the organizational purpose. “A board’s capacity for retrospective sense making–acting then thinking, making sense of past events to produce new meanings” (Chait, Ryan, & Taylor, 2005, p. 1) relies on effective governance and is key to strategic visioning for the future. Models and assessments that can help board members reflect on the organization’s past to create new meanings include Robert Dilts’ Logical Levels of Assessment and Reflection Guide (Dilts, 2014), the Purpose-To-Practice Liberating Structure process (Lipmanowicz & McCandless, 2013), and Ecocyle lessons (Hurst, 2012).
 

REFLECTIVE COMMUNITY OF INTERPRETATION

Working with a team to bring knowledge and wisdom to bear on feedback from others.


 
Dilts’ Logical Levels of Assessment and Reflection Guide
Dilts’ Logical Levels of Assessment and Reflection Guide (1996a, b) directs leaders of an organization to consider different levels of leadership (micro, macro, meta) and different levels of change (environment, behaviors, capabilities, beliefs and values, identity, organizational mission, and vision) through reflective questioning (see Table 17.1). Microlevel leadership requires attention to task, relationship, behavior, and environmental opportunities and limitations. Macrolevel leadership comprises attention to path-finding, culture-building, and sensitivity to beliefs, values, and roles. Metalevel leadership requires higherlevel attention and mindfulness to issues of identity, mission, and vision. Leaders who work toward alignment of all three levels contribute to the greater good of the organization and those they serve.

The following questions typify the alignment guide and uncover the change an organization is attempting to influence.

  • From an environmental perspective: What is the external context around strategic planning?
  • From a behavioral perspective: What specifically must the board of directors do, or what behaviors must it develop to support realization of the strategic plan?
  • From capabilities: How will the board organize itself to accomplish goals and behaviors? What skill sets are needed?
  • From the perspective of belief and values: What motivates the board toward aspiration and renewal?
  • From identity: Who will the board be if it engages those particular beliefs, values, capabilities, and behaviors?
  • From organizational mission: What does the organization contribute to the larger system or greater universe in which it operates?
  • From vision: How does clarity about the desired greater purpose influence the identity, mission, values, beliefs, capabilities, behaviors, and environment in which the board and organization finds itself? (See Table 17.1.)


Table 17.1:
Dilts’ Logical Levels of Assessment and Reflection Guide


Levels of Leadership

Levels of Change

Types of Questions for Reflective Learning

Micro

Environment, behavior, and capability

Where?
When?
What?
How?

Macro

Beliefs, values, and role identity

Why?
Who?

Meta

Mission and vision

Who?
What else?

These questions get to the core of different levels of change; they influence and help board members to identify and address issues at all levels. Each level of change involves progressively more of the organization. Each level involves different types of interactions that incorporate information from the level above it. Effective leadership addresses issues at all levels.

Purpose-To-Practice Liberating Structure
The Purpose-To-Practice (Lipmanowicz & McCandless, 2013) Liberating Structure enables board members to generate a shared purpose, detailed at www.liberatingstructures.com/33-purpose-to-practice-p2p/. To clarify the organization’s purpose, each board member should answer the following question: “Why is the work important to you and the larger community?” The next step is, as a group, to compare, sift, sort, and amplify the top ideas. Then, integrate themes and finalize the ideas for purpose.
 
Then, repeat this exercise by addressing questions (shown in Figure 17.1) for the following additional elements, which help to achieve the newly defined organizational purpose: principles, participants, structure, and practices. By using these five elements together, board members clarify how they can organize themselves to adapt in creative ways and scale-up for success.
 
Click here for Figure 17.1, Purpose-To-Practice
 
For example, through formal facilitation (Pesut, 2014), one organizational board recently applied the Purpose-To-Practice process to begin to illuminate key components of transformations. Using Dilts’ Logical Levels of Assessment and Reflection Guide, board members identified the need for and components of a new mission that was a more accurate reflection of the current activities of members. The board further applied the Purpose-To-Practice process using the Ecocyle activity (described in the next section), which helped recognize that the organizational structure had met maturity. This discovery was consistent with recommendations received from members during their 1-2-4-All Liberating Structures exercise and further confirmed the need for a new organizational direction. Finally, through engaging in the Purpose-To-Practice liberating structure activity, it became clear what a new structure might look like.
 

THE BACK STORY OF QSEN: LEADERSHIP THAT CHANGED NURSING EDUCATION

Gwen Sherwood, PhD, RN, FAAN, ANEF

Reflecting on the models and frameworks presented in the chapter leads me to recall the story of the Quality and Safety Education for Nursing (QSEN) project funded from 2005–2012 by the Robert Wood Johnson Foundation. Linda Cronenwett at the University of North Carolina–Chapel Hill School of Nursing is the thought leader who pulled the pieces together (Cronenwett, 2012; Cronenwett et al., 2007), who developed the vision of how nursing could begin to craft a response to the Institute of Medicine Quality Chasm series (IOM, 1999, 2001, 2003). The 2003 Health Professions Education: A Bridge to Quality provided a blueprint with a competency framework for all health professionals if we are to improve healthcare delivery systems: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. Many were asking, “How do we define these competencies in nursing? What will be the vision?”

Looking back, I can see that in fact the development of QSEN followed the Purpose-To-Practice model (P2P) (shown earlier in Figure 17.1) and will share the story within that framework.

  1. Purpose: Why is the work important to you and the larger community?
    In thinking about developing quality and safety competencies for nursing, we were quick to recall the startling data revealed in the 1999 IOM report, To Err is Human. We were all struck by the numbers; where did such events occur? How could this many people be dying in our hospitals without our realizing the collective impact? Now that the data had been released, we could not turn back. We had to act, and now the IOM provided a way forward with the 2003 report on health professions education. Ethically, we cannot ignore this imperative: We had to tackle the problem. Linda’s idea was to invite an expert panel of national experts in each of the competencies and pedagogical experts who could help to drive the change we knew we needed. Knowing we would need policy changes, leaders from key organizations, including physicians, were invited to participate in an Advisory Council. The purpose of QSEN was to reform nursing professional identity to include a focus on quality and safety to be able to lead and work in redesigned healthcare systems.
  2. Principles: What rules must we obey in pursuit of our purpose?
    We agreed we would meet together about twice per year; we committed to being present, engaged, and participative. Our work would be mostly completed using online and telephone communication. When we met, we agreed to have no long lectures. We would use theory bursts followed by table top discussions. Each session was carefully planned for small groups so that the people with the content knowledge were appropriately assigned. We would all respect diverse views, listen to each other, engage in the sessions, and complete all assignments in a timely manner.
  3. Participants: Who must be included to achieve our purpose?
    I have already described the direct project participants for the National Expert Panel and Advisory Council. However, the project was about all of nursing, so it was important to include a broad diversity of nurses. First, the project distributed an electronic survey to all BSN Schools of Nursing and ADN programs in North Carolina for a baseline of what schools already had in the curriculum to address the six competencies. Then, Linda led nine focus groups with nursing faculty at national meetings of nurses and nurse educators (Cronenwett, 2012). The focus groups revealed more detailed information and confirmed the need for extending the QSEN project to include faculty development and pilot projects (Cronenwett, Sherwood, & Gelmon, 2009).
  4. Structure: How will we organize to distribute control?
    This poses an interesting question because the power paradox helps us to realize that to increase power, we need to let go. Three strategies tell the story of how QSEN was restructured. First, QSEN was funded for Phase 2 to launch a Pilot School Learning Collaborative of early adopters to test the change. These 15 schools were competitively selected, based on projects they would complete in the coming year (Cronenwett, Sherwood, & Gelmon, 2009). These schools became the launching pad for the initial spread of the competencies. A second power distribution was the selection of 40 early adopters who were named QSEN Facilitators who would be available to other schools to help integrate the six competencies into their curriculum. The third power distribution was to offer free global access to QSEN materials on a robust website (http://qsen.org/), which offers multiple types of resource material.
  5. Practices: What are we going to do? What will we offer to our users/ clients? How?
    The generous funding of the Robert Wood Johnson Foundation made it possible to follow a basic tenet of QSEN: free access of all our products. The website was built with peer-reviewed teaching strategies, annotated bibliography, teaching modules, videos, and presentations. The goal was to provide faculty and others the resources needed to integrate the QSEN competencies into their curriculum. We initiated the annual QSEN National Forum; collaborated with the American Association of Colleges of Nursing, which offered regional faculty development workshops; and worked with publishers to integrate QSEN competencies and teaching strategies into textbooks. As the grant phase completed, QSEN transitioned to a new home at Case Western Reserve University School of Nursing to be able to maintain sustainability.

 
Ecocyle
The Ecocyle (Lipmanowicz & McCandless, 2013) is another tool that organizational leaders can use to make sense of and honor the past, as well as produce new meanings and guide the future. Lessons from the Ecocyle include:
  • Change is continuous along the cycle.
  • Renewal requires creative destruction.
  • Need for crisis (root word “to sift”).
  • Need for firebreaks (don’t burn everything).
  • Balance in activities is the key to long-term survival and adaptability.
  • Create conditions for renewal and more “births” (Pesut, 2014).

Ecocyle planning encourages “leaders to focus on creative destruction and renewal in addition to typical themes regarding growth and efficiency” (Lipmanowicz & McCandless, 2013, p. 295). See Figure 17.2.

Click here for Figure 17.2, Ecocyle
 
The Ecocyle begins with birth (growing) and moves toward maturity (harvesting). When maturity has been reached, the cycle moves toward creative destruction (plowing) and creates space for renewal (sowing). In contrast, the conventional cycle includes birth, growth, and maturity but does not allow for creative destruction or renewal. These later cycles are often neglected; yet, without creative destruction, there is little opportunity for leaders to envision new options and create new opportunities. Traps leaders often fall into are not letting go of something after it has reached maturity (rigidity trap) and not funding new innovations (poverty trap). Using this cycle to consider where different aspects of an organization lie along the Ecocyle can unearth what immediately can be done to move one important element forward in an organization.
 

REFLECTING ON … ECOCYLE PLANNING
  • What new benefits, services, programs, and technologies are your members seeking?
  • What aspects of your organization (committees, structures, and services) have reached maturity?
  • What does your organization need to let go of to make space for something new?
  • What aspects of your organization would benefit from renewal? How can you change a structure, an activity, a service, or a program to revitalize your group?

 
The partnership of leaders and followers: Ongoing engagement and honoring of members
While leaders of an organization sift, sort, and work through the process of organizational transformation, it is essential to keep members informed and engaged along the way. Consistent, continual, and transparent communication is essential, whether face to face or virtual through electronic means.
 
In the preceding example, the key to the communication from the board was messaging that the organizational transformations the board had identified through its own work were based on and the result of the generative work the members had done through the 1-2-4-All Liberating Structure exercise. All messaging to members, regardless of communication vehicle (email, newsletter, website, verbal, print) consistently related the proposed organizational transformations to recommendations generated from members themselves.
 
In addition to traditional communication methods, the board engaged members by appointing a task force to study a proposed change to a membership benefit that had deep roots in the organization. The task force ultimately recommended the termination of the benefit, which the board approved. In communicating this action to members, the messaging recognized and honored members’ longtime relationship with this benefit, and then reiterated the decision in part reflected the generative work of members.
 
The next step in engaging and honoring members was through more generative work—a survey to garner members’ input on their vision of a new benefit approved by the board. The board valued their feedback—what they knew, believed, and valued—and used it as a foundation for defining and shaping the next iteration of the membership benefit. Clear messaging was that while the past was put to rest, the future was in the hands of members.
 
According to Chait and colleagues (2005), many nonprofit boards confront problems of purpose over performance and require leadership over management. Seen in this light, the board is a crucial and generative source of leadership for the organization. A board with a defined purpose is more engaged and able to work more meaningfully and partner with members around shared goals. Partnered or collaborative leadership—where the board values and relies on members’ generative work as a basis of its own futures-thinking and visioning— will increase buy-in, minimize fear often associated with change, and lead to more productive outcomes in creating a preferred future.
 
To ensure the success of this process, it is important that board members attend meetings, participate in sense-making activities, engage in dialogue, provide feedback, and work through differences by helping to negotiate conflicts. Pesut (2007) states that polarities exist in every situation: Tensions exist between fear and aspiration, scarcity and abundance, greater purpose and deepest fear, and slow death and deep change. Managing polarities (Johnson, 1996) requires supporting organizational dialogue as members uncover the multiple dimensions—the upsides and downsides—of each stance.
 
Polarity management contributes to successful organizational leadership by seeking to understand all sides of an issue or stance. Johnson (1996) likens polarity management to breathing and asserts that leaders are charged to help organizations breathe. Thus, when leadership teams take time to unpack polarities with one another and members, they work toward solutions for all. For example, consider the polarity of tradition and innovation. Members of each camp have a position they wish to advance. Often, the tradition bearers want to maintain the status quo, whereas the innovators want change. Each stance has some upsides and downsides. When both stances are considered in light of the purpose of the organization, it makes explicit the deepest fears of both, and then there is room for dialogue. Wesorick (2014) offers insights and suggestions about the use of polarity management skills for fostering interprofessional dialogue and reflection.
 
Final reflections
The purpose of this chapter was to promote thoughtful consideration and reflection on organizational leadership where members are engaged as partners in creating a sustainable future. The value of leader self-knowledge and building teams with complementary versus similar strengths was emphasized. An exploration of the evolving trends within organizations as well as what it will take to prosper moving forward was addressed. Specific activities aimed at engaging members in generative thinking and sense-making were outlined to support futures-thinking and ensure an organization’s prosperous future. Partnered-collaborative leadership emphasized incorporating members’ generative work into futures-thinking and visions, along with the need for ongoing communication and clear messaging. Finally, through questions, readers were invited to reflect on ways to engage members and bring new life and new connections to their organizations to ensure a viable future.
 
Successfully engaging members as partners in organizational change requires leaders who know how to reflect on and cultivate their strengths while simultaneously empowering others to build and act upon their own. Partnered-collaborative leadership that emphasizes the importance of process-centric thinking through reflection, generative work, futures-thinking, visioning, ongoing communication, and clear messaging is essential to creating flexible, responsive, and viable organizations. As new opportunities for organizational innovation arise, leaders and teams who work together and value each member’s strengths, contributions, and creativity will be well situated to thrive. It is by reflecting on what we have learned from past experiences that we can engage in creative thinking for sustaining the future through continual change and transformation. RNL
 
Sara Horton-Deutsch, PhD, RN, PMHCNS, FAAN, ANEF, is professor and Jean Watson Caring Science Endowed Chair at the University of Colorado College of Nursing.
 
Kathryn Kuehn, BA, is executive director of the International Society of Psychiatric-Mental Health Nurses.
 
Gwen D. Sherwood, PhD, RN, FAAN, ANEF, is professor and associate dean for academic affairs at the University of North Carolina at Chapel Hill School of Nursing.
 

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References
Chait, R. P., Ryan, W. P., & Taylor, B. E. (2005). Governance as leadership. Hoboken, NJ: John Wiley & Sons.

Coerver, H., & Byers, M. (2011). Race for relevance: 5 radical changes for associations. Washington, DC: ASAE: The Center for Association Leadership.

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., … Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122–131.

Cronenwett, L., Sherwood, G., & Gelmon, S. (2009). Improving quality and safety education: The QSEN Learning Collaborative. Nursing Outlook, 57(6), 304–312.

Cronenwett, L. (2012). A national initiative: Quality and Safety Education for Nurses (QSEN). In G. Sherwood, & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 49–64). Hoboken, NJ: Wiley-Blackwell.

Deering, A., Dilts, R., & Russell, J. (2002). Alpha leadership: Tools for business leaders who want more from life. New York, NY: John Wiley & Sons.

Dilts, R. (1996a). The new leadership paradigm. Capitola, CA: Meta Publications.

Dilts, R. (1996b). Visionary leadership. Capitola, CA: Meta Publications.

Hurst, D. (2012). The Ecocycle: A mental model for understanding complex systems. Leading forth: Strategy, leadership and change. Retrieved from www.davidkhurst.com/
the-ecocycle-a-mental-model-for-understanding- complex-systems-2/

Institute of Medicine (IOM). (1999). To err is human: Building a safer health system. Washington, DC: National Academies Press.

Institute of Medicine (IOM). (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academies Press.

Institute of Medicine (2003). Health professions education. A bridge to quality. Washington, DC: National Academies Press.

Johnson, B. (1996). Polarity management: Identifying and managing unsolvable problems. Amherst, MA: HRD Press.

Lipmanowicz, H., & McCandless, K. (2013). The surprising power of Liberating Structures: Simple rules to unleash a culture of innovation. Seattle, WA: Liberating Structures Press.

Miller, R. (2011). Futures literacy: Embracing complexity and using the future. Ethos, 10, 23–28. Retrieved from www.cscollege.gov.sg/Knowledge/
ethos/​​Issue%2010%20Oct%202011/Pages/Opinion%20F

Pesut, D. (2000). Looking forward: Being and becoming a futurist. In F. Bower (Ed.), Nurses taking the lead: Personal qualities of effective leadership. Philadelphia, PA: W. B. Saunders.

Pesut, D. (2014). Creating desired futures. International Society of Psychiatric Nurses 16th Annual Meeting, Greenville, SC, March 29, 2014.

Pesut, D. J., & Pesut, E. Z. (2010). Future forces affecting 21st century health professions education: Mastering the knowledge, skills, and abilities to support 21st century learning. In L. Caputi (Ed.), Teaching nursing: The art and science, Second Edition (Vol. 1) (pp. 198–228). Glen Ellyn, IL: College of Dupage Press.

Pesut, P. (2007). Leadership: How to achieve success in nursing organizations. In C. O’Lynn, & R. Tranbarger (Eds.), Men in nursing: History, challenges, and opportunities. New York, NY: Springer Publishing Co.

Pesut, D., & Thompson, S. (2015). Building academic cultures with reflective practice in mind: Leadership agility and transformational learning. In G. Sherwood, & S. Horton-Deutsch (Eds.). Transforming organizations using principles of QSEN and reflective practice. Indianapolis, IN: Sigma Theta Tau International.

Rath, T., & Conchie, B. (2008). StrengthsFinder 2.0: Strengths-based leadership. Great leaders, teams and why people follow. New York, NY: Gallup Press.

Sherwood, G., & Horton-Deutsch, S. (2012). Reflective practice: Transforming education and improving outcomes. Indianapolis, IN: Sigma Theta Tau International.

Wesorick, B. L. (2014). Polarity thinking: An essential skill for those leading interprofessional integration. Journal of Interprofessional Healthcare, 1(1). Retrieved from www.jihonline.org/jih/vol1/iss1/12

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