operating-room-nurseDefinition of a leadership system: The system that connects leaders, and organizes the elements they control with critical relationships, which will produce a desired outcome.

Every organization has a leadership system. It might be a good one or a bad one, but there is a leadership system built into every organization.

In her book, Thinking in Systems, author Donella Meadows writes: “A system is an interconnected set of elements that is coherently organized in a way that achieves something. If you look at that definition closely for a minute, you can see that a system must consist of three kinds of things: elements, interconnections, and a function or purpose.”

A leadership system, therefore, is the theory of systems applied to leadership. Using Meadows definition any leadership system is going to exhibit three component parts – elements, interconnections, and function or purpose.

Elements of a Leadership System can be:
• The leader;
• Organizational Mission;
• The current system;
• The unique product or service being provided; and
• Governance including the regulatory environment.

Interconnections (critical relationships) of a Leadership System can include:
• Reporting structure;
• Core business processes; and
• Customer requirements.

Function or Purpose of a Leadership System may include:
• The customer;
• The way in which the customer will be served; and
• Plan on execution of organizational mission.

Though not immediately recognized, every organization of any size has a leadership system. The question is, does it work? As others, have noted, systems have a way of driving behavior that is not intended. This is probably at least one answer as to why a leader can go from one organization and produce transformational improvement and go to another organization and fail miserably.

In his book, The Power of Habits, author Charles Duhigg tells the story of the Rhode Island Hospital. At the time, it was a leading educational hospital and Level 1 Trauma Center. Its intensive care unit was considered one of the best in the country. It was also a place of feudal fights where nurses were pitted against surgeons and usually lost the battle. Dhuigg tells the true story of an elderly man who was brought in with a Subdural Hematoma. Immediate surgery was necessary. Only the surgeon, ignoring input from nurses in the OR operated on the wrong side of the man’s head. He eventually died. The man was not the last. Within a few months, others died to simple system procedural failure.

The good news is that changes were made. While it might be easy to say, they implemented check lists and other procedural changes, the reality is that they challenged, broke and then changed the entire leadership system. The result was a dramatic drop in errors and a prestigious award for Critical Nursing. Where the old leadership system put the surgeon at the top of the pyramid with virtual unquestionable authority, the new system empowered everyone around the care of the patient. Dhuigg concludes with an example of a routine surgery performed by an experienced and well trained surgeon. Before he started he went through a check list but missed a minor point. In response, the youngest and least experienced nurse pointed out the error which was welcomed by the surgeon.

A leadership system, therefore, is the system that connects leaders, and organizes the elements they control with the critical relationships to produce the desired outcome. With the example of Rhode Island Hospital and the old system, surgeons had enormous and even dictatorial power, which often came at the expense of the nurses. Under the new system, the surgeons (leaders) recognized and organized the nurses as both a critical element and relationship in the care of a patient (desired outcome). The perspective and input of nurses become  valuable relationship that would make the whole greater than skill of the individual parts. The result was more intellectual and practical care given to the patient and not less. It was not a matter of surgeons winning or losing power and control. It was the patient receiving the best possible care.