Petrie David A, Swanson Robert Chad
1 Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
2 Provincial Emergency Program of Care, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
Healthc Manage Forum. 2018 Sep;31(5):206-213. doi: 10.1177/0840470418778051. Epub 2018 Aug 22.
After a decade of calls for healthcare transformation, there is a convergence of themes in our general orienting models. The core metaphor of health system as machine (with closed boundaries, linear functions, and controlled predictable outputs) has given way to health as ecosystem (with open boundaries, non-linear functions, multiple interdependencies, and no single locus of control over outcomes). Current developmental psychology theory suggests that people construct their reality, and interact with their world, based on the epistemology (or "action-logic" or "mindset") of their stage of development. Through this lens, the skills for leading large-scale change in our increasingly complex world require significant cognitive and interpersonal development. The concept of vertical development may be an underemphasized aspect of system change. This article will discuss a new set of leadership skills and frameworks that emerge in the nexus of complex adaptive systems and adult development theory.
在呼吁医疗保健转型十年之后，我们的总体导向模式中出现了主题趋同的情况。将卫生系统比作机器（具有封闭边界、线性功能和可控制的可预测产出）的核心隐喻已让位于将健康视为生态系统（具有开放边界、非线性功能、多重相互依存关系且对结果没有单一控制点）。当前的发展心理学理论表明，人们基于其发展阶段的认识论（或“行动逻辑”或“思维模式”）构建自己的现实并与世界互动。通过这一视角，在我们日益复杂的世界中引领大规模变革所需的技能需要显著的认知和人际发展。垂直发展的概念可能是系统变革中一个未得到充分重视的方面。本文将讨论在复杂适应系统与成人发展理论的交叉点上出现的一套新的领导技能和框架。
