How to Make Better Decisions About Healthcare Reform

The outcome of the healthcare “debate” (more of a shouting match really) will be flawed because the process of decision making is flawed. A solid structure built on a soft foundation will not stand. So, unless “we the people” take a stand by insisting that “they the politicians” change their polarized, decision-making process, healthcare reform is moribund.

We must demand that our politicians frame the healthcare debate around four fundamental questions that will improve the decision-making process. Each of these questions is associated with one of the four leadership styles of the eXpansive Leadership Method (XLM) seen below. The XLM cannot tell us what to do; it can frame the process of how to think about what to do (i.e., the decision-making process).

1. VISIONARY QUESTIONS -- begin by asking, "What would be an eXtraordinary outcome?" Visionary thinking invites contemplation of a broad perspective, strategic implications, and long-term considerations. When dealing with a difficult challenge, such as healthcare reform, probe deeper by answering visionary questions, such as…

How does this challenge relate to our nations priorities? (What about two wars, the economy, energy dependence, the environment, atrocious k-12 educational performance…?)

Is this a problem worth investing resources to solve at this time? (Can you say debt?)

What might be the downstream negative and positive consequences?

Are we too invested in the status quo? (Why is everyone talking about the British and Canadian systems? What lessons can we adapt from Germany and some of the Asian countries?)

2. RATIONAL QUESTIONS – explore how we know what we know. We therefore ask, "What are the facts and expectations of those affected?" Rational thinking helps us monitor our environment and be in touch with the facts, without the irrational hype we see night after night on television. In deciding how to address a complex challenge, this means being aware of the external and internal context of our decision by asking...

Do we have the correct information about quality, cost, and access? (Americans spend twice as much on entertainment as we do on out-of-pocket healthcare expenses. 50% of the US hospitals are losing money.)

What assumptions we making? (Can we really fix a nonexistent system? Healthcare “system” is an oxymoron. Healthcare in the U.S. is a fragmented cottage industry.)

How will we monitor the implementation of this decision?

How can we make this process of deciding transparent?

3. EMPOWERING QUESTIONS -- concerns themselves with the moral code and values we use. We begin by asking, "What's the right thing to do, especially for others?" This is an empowering question because it focuses our attention on serving those whom we lead. When we’re dealing with thorny issues, consider asking…

If everyone in the world had to do exactly what we are contemplating doing, what type of world would we have?

What is the right thing to do for the greatest number of people without violating individual rights? (Is it right for people who choose to smoke, drink, and eat poorly to pay the same healthcare expenses as those who exercise, practice prevention, and maintain their weight via healthy eating?)

What is the most honest and fair thing to do?

Is what we are deciding to do consistent with who I aspire to be?

4. COMMANDING QUESTIONS -- remind us that human beings have free will and therefore are responsible for their actions. It leads us to the question, “What are the consequences of our options?" This commanding question compels us to refuse victim thinking and accept responsibility for our choices. Eventually you must choose what to do or not to do. (That is the question!) Here are a few more questions that will help you think expansively as you access your free will responsibly:

Have we solicited the opinions of those with whom we often disagree?

How risky are the alternatives?

Can we test the alternatives on a small scale before we decide?

What are our best options based on the answers to all of these questions?

Peter Drucker reminds us that while leadership used to be about having answers, it is now about asking questions. The best approach to meeting daunting challenges and solving perplexing problems is therefore, to use a consistent methodology that helps us ask expansive questions. The XLM doesn’t tell us what type of healthcare system we need, it does show us how to frame the conversation.

What other questions should we be asking in the healthcare debate?

Keep eXpanding,
Dave

http://www.DaveJensenOnLeadership.com

P.S. The web-based eXpansive Leadership Method (XLM) assessment measures 4 fundamental leadership styles, 16 core competencies, and 8 essential leadership skills. Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to http://xlmassessment.com/ to learn more.

Harnessing the Power of Paradox at Work

I wrote an article for Advance Magazine, titled “Harnessing the Power of Paradox at Work,” published on their website. Click on the link below (or paste it into your browser):

http://imaging-radiation-oncology.advanceweb.com/article/harness-the-power-of-paradox-at-work.aspx

Feel free to share it with your team. AND take a moment to Post a Comment… because we can all learn from each other.

Keep eXpanding,
Dave
http://www.DaveJensenOnLeadership.com

P.S. The web-based eXpansive Leadership Method (XLM) assessment measures paradox in leadership by assessing 4 fundamental leadership styles, 16 core competencies, and 8 essential leadership skills. Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to http://xlmassessment.com/ to learn more.

How to Leaders Manage a Paradox Over Time - Part 1

In a previous blogs, I discussed how to make a diagnosis of a paradox, as well as map, and measure a paradox. (1, 2, 3, 4) I also pointed out that the best way to manage a paradox is to follow the four M’s seen below. This blog will focus on number IV.

The Four M’s of Managing Any Paradox

I. Make a Diagnosis

II. Map the Paradox

III. Measure the Paradox

IV. Manage the Paradox Over Time

As you deal with both issues of a paradox, over time many decisions will be made regarding allocating resources, expenditure of funds, assignment of tasks, and so forth. For example, I was teaching a group of bankers to manage their paradox (increase retail sales AND implement a new commercial loan strategy). After creating the paradox map and plot, the team needed to decide how to increase the emphasis on commercial banking. Should they increase training, design new marketing material, have a sales contest, hire more commercial bankers...? Yet at the same time they increased commercial banking sales, it was critical that the retail side not be neglected. Otherwise, they would experience the down side of over-focusing on the commercial side at the expense of the retail.

Managing the tension between the two issues of a paradox is analogous to sailing a small boat on windy day. If the wind grabs your sails and starts tipping the boat, you need to jump to the other side of the boat and hang over the edge while holding the ropes. You don’t pick one side and stick to it for the entire trip or drop the rope (Gilligan’s island here we come?). You get where you want to go by managing the tension between the rope and the wind (via the sails). That’s what keeps everyone moving. The same is true when you’re dealing with a paradox.

Unfortunately, according to the theory of cognitive dissonance (and common sense), we usually want to resolve tension when we feel it. Thus, leaders often find themselves favoring one issue of a paradox and then justifying or rationalizing their bias. This dangerous proclivity to pick sides - to see issues as only black or white - is what researchers Porras and Collins labeled the “tyranny of the either/or” in their book, Built to Last.

To resist the simplistic slide into either/or thinking when dealing with a paradox, instead of choosing side, leaders need to manage the paradox over time by placing their attention on the tension.

"Managing paradoxical tensions denotes not compromise between two, but awareness of their simultaneity." (5)

Manage the Paradox Over Time
To manage the tension between the two issues, conduct a “manage the paradox meeting.” (In my coaching and consulting work, this meeting is often an extension of the map and measure meeting discussed in the previous blogs.) In this meeting, explain to the team the importance of paying attention to both issues over time. Remind them of the side effects of overemphasizing either of the issues. Show them the paradox map and plot, illustrating what happens when there is a lack of balance. Then, invite them to follow the steps outlined below. We’ll focus on step 1 in this blog.

1. Create a paradoxical vision statement
2. Develop norms that build trust
3. Balance the power
4. Pay equal attention to each issue
5. Identify your smoke signals

1. Create a paradoxical vision statement
To understand the cause of the nurse’s strike at the New Zealand hospital discussed earlier, researchers analyzed 196 leadership assessments on 20 nurse leaders and conducted over 80 hours of observations and interviews. They found that a narrow-minded view of the issues led to “divergent realities.” In other words, because the nurses and hospital administrators focused only on their individual goals, the overall organization suffered. (6) These leaders mistook their tunnel-vision for vision. By fixating on their own side, that they couldn’t see the value of both sides. This limited perspective is analogous to letting go of the rope in the sailboat on that windy day. It’s also why the bible teaches that “without vision, the people parish.”

Researchers at the hospital also discovered that the strike was finally resolved when both groups agreed saw the value of pursuing a common goal - improve the functioning of the hospital – while still making progress on their individual goals. Hospital management recognized that a pay rise for the nurses could improve the functioning of the hospital. Nurses felt that the pay raise demonstrated recognition for their work and would also motivate them do their jobs better. Progress was made only when both parties had a common vision. Unfortunately, everyone had to suffer through a strike before they opened their eyes. Pain pushes, vision pulls.

When Dodd and Favaro analyzed the paradoxical tensions of 1,000 companies over a 20 year period, the found that the "best performing companies strengthen the factor that unites the two sides." (7) They called it a common bond. Others call it a shared purpose statement. I call it a paradoxical vision statement because of the importance of emphasizing both issues over the long haul. Regardless of what you call it, avoid the pain of myopia by creating a paradoxical vision statement with your team. Here’s how:

Explain that each person will soon write his or her own paradoxical vision statement. This statement is a brief sentence that captures the spirit of the paradox and embraces the importance of both issues. It often has a marketing slogan type of feel to it. However, before they actually write their own statement, provide some examples. For example, when I was working with the team that had just mapped the commercial banking strategy and the retail sales paradox, they wrote the following statement, Big and Small, We Need Them All. That statement captures both sides of this paradox because it honors the large sales/loans associated with commercial banking and the often smaller sales from the retail side.

Several other examples of paradoxical issues and their corresponding vision statements (in parenthesis) that leaders have created in our classes are seen below:

Centralize Loan Processing AND Decentralize Decision Making
(Best Little Scorehouse in Banking)

Decrease Time to Market AND Increase Product Quality
(Get ‘er Done… Right!)

Care About Employees AND Hold Employees Accountable
(Know When To Hold ‘Em and Fold ‘Em)

Increase Sales AND Decrease Expenses
(GROW Me the Money)

Honor Our Traditions AND Embrace Our Future
(Building the Future On Our Foundation)

Improve Customer Service AND Grow the Business
(Service Is Our Guide to Growth)

Decentralize AND Centralize
(Caring Locally While Providing Globally)

Meet My Goals AND Coach Others
(The “I” In TEAM Is Me)

The statements in these examples may not mean that much to you, but that isn’t important. All that matters is that your statement serve as a reminder to everyone (i.e., those involved in the paradox you are working on) that both sides need to keep the big picture in mind as they make decisions that affect the paradox. (It helps if it has a little fun and marketing sizzle to it.) This sounds simple, but it is not easy. What often happens is that everyone agrees to pay attention to both issues, initially. But over time, they tend to lean toward their “favorite” issue. They become advocates or crusaders for “their side” of the paradox. They begin arguing for more resources or attention for their issue. Like the children in the playground, although they agreed to take turns when they first arrived, over time they want more attention paid to their needs.

By definition, there are always two sides to a paradox. That’s why the paradoxical vision statement is the first step to removing the mental blinders and seeing the power of both/and thinking. We’ll discuss the next steps in future blogs.

Is all this paradoxical thinking making sense to you?

Keep eXpanding,
Dave

http://www.DaveJensenOnLeadership.com

P.S. The web-based eXpansive Leadership Method (XLM) Assessment measures paradox in leadership using the “Agility Score.” Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized Profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to: http://xlmassessment.com/ to read about the assessment.

1. http://davejensenonleadership.blogspot.com/2009/07/how-leaders-mismanage-paradox.html

2.http://davejensenonleadership.blogspot.com/2009/07/paradoxical-issues-most-profitable.html

3. http://davejensenonleadership.blogspot.com/2009/08/how-to-leaders-distinguish-paradoxical.html

4. http://davejensenonleadership.blogspot.com/2009/09/how-leaders-manage-paradox-in-work.html

5. Lewis, Marianne; Exploring Paradox: Toward a More Comprehensive Guide, Academy of Management Review, 2000, 35, 4, 760-776.

6. Melanie M. Kan and Ken W. Parry; Identifying paradox: A grounded theory of leadership in overcoming resistance to change, The Leadership Quarterly, 15, 2004, 467–491.

7. Dodd, Dominic and Favaro, Ken, Managing the Right Tension, Harvard Business Review, December, 2006, 73.

8. WorkUSA® 2002 - Weathering the Storm: A Study of Employee Attitudes and Opinions, http://www.watsonwyatt.com/research/resrender.asp?id=W-557&page=1

How Leaders Make eXtraordinary Decisions

If you had all the time and money in the world to make your decisions, do you think you could make accurate decisions? Of course. But that’s the problem with, isn’t it? You don’t have all the time or money in the world to make decisions. Research says that when you decide how to address any issue, you are subconsciously weighing a trade-off between effort and accuracy. (1) This trade-off between effort and accuracy leads to what Professor Hammond and his colleagues call, “the hidden traps in decision-making.” (2) Like sand traps to a golfer, these decision traps can bog you down and keep you from achieving your goal – an excellent decision.

Here's how you can use the eXpansive Leadership Method (XLM) to avoid these traps and make extraordinary decisions in the face of perplexing problems.

The process begins by framing your challenges with four fundamental questions seen below:

The precursor to eXtraordinary decisions is eXpansive thinking.

Management guru Peter Drucker writes that making difficult decisions in the face of ambiguous circumstances is critical for leadership success. Therefore, when your challenges become more difficult, ambiguous or complex, I encourage you to use the XLM as a guide for asking deeper questions. Listed below are several questions, categorized by the leadership style, which can improve your decisions when confronting these confounding challenges.

1. VISIONARY QUESTIONS -- begin by asking, "What would be an eXtraordinary outcome?" Visionary thinking invites contemplation of a broad perspective, strategic implications, and long-term considerations. When dealing with a difficult challenge, probe deeper by answering visionary questions, such as…

How does this challenge relate to the organization’s direction?

Is this a problem worth investing resources to solve?

What might be the downstream negative and positive consequences?

When do I really need to decide?

Shouldn’t I sleep on it?

Imagine that I am looking back on this decision from the future, and it has turned out poorly, what went wrong?

What might I be thinking when I'm sitting in a rocking chair reflecting on this issue during retirement?

Am I too invested in the status quo?

How is my ego affected by this?

2. RATIONAL QUESTIONS – explore how we know what we know. We therefore ask, "What are the facts and expectations of those affected?" Rational thinking helps us monitor our environment and be in touch with the facts. In deciding how to address a complex challenge, this means being aware of the external and internal context of our decision by asking...

Do I have the correct information (quality and quantity) to decide?

What is my backup plan?

What assumptions am I making?

How will I monitor the implementation of this decision?

What transparent process should I use?

3. EMPOWERING QUESTIONS -- concerns themselves with the moral code and values we use. We begin by asking, "What's the right thing to do, especially for others?" This is an empowering question because it focuses our attention on serving those whom we lead. When we’re dealing with thorny issues, consider asking…

If everyone in this organization had to do exactly what I am contemplating doing, what type of organization would we have?

What is the right thing to do for the greatest number of people without violating individual rights?

What is the most honest and fair thing to do?

Is what I am deciding to do consistent with who I aspire to be?

4. COMMANDING QUESTIONS -- remind us that human beings have free will and therefore are responsible for their actions. It leads us to the question, “What are the consequences of our options?" This commanding question compels us to refuse victim thinking and accept responsibility for our choices. Eventually you must choose what to do or not to do. (That is the question!) Here are a few more questions that will help you think expansively as you access your free will responsibly:

Have I solicited the opinions of those with whom I often disagree?

How risky are my alternatives?

Can I test the alternatives on a small scale before I decide?

What are my best options based on the answers to all of these questions?

Peter Drucker reminds us that while leadership used to be about having answers, it is now about asking questions. The best approach to meeting daunting challenges and solving perplexing problems is therefore, to use a consistent methodology that helps you ask expansive questions. This is exactly what the XLM does. It doesn’t tell you what to do, it frames the conversation with questions.

How do you make decisions?

Keep eXpanding,
Dave

http://www.DaveJensenOnLeadership.com

P.S. The web-based eXpansive Leadership Method (XLM) assessment measures 4 fundamental leadership styles, 16 core competencies, and 8 essential leadership skills. Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to http://xlmassessment.com/ to learn more.

1. John W. Payne, James R. Bettman, and, Eric J. Johnson, The Adaptive Decision Maker, Cambridge University Press, New York, New York, 1993, page 2.

2. John S. Hammond, Ralph L. Keeney, and Howard Raiffa; The Hidden Traps in Decision-Making, Harvard Business Review, January 2006, pages 118 -- 126.

How Leaders Make Great Decisions

Several years ago, my company developed a product called Strategy - an interactive CD-ROM that automated medical marketing. I spent two years and a truckload of money creating and marketing this innovative product. It failed miserably. OUCH! (I'm still convinced it would have been a bestseller... if more people bought it! :-)

In previous blogs (http://davejensenonleadership.blogspot.com/2009/03/understanding-leaders-seven-decision.html), I discussed the common decision-making traps leaders fall into. These traps played a major role in my CD-ROM fiasco. As a way of helping you avoid these hazards, a quick recap…

My early profit projections were based on optimistic market penetration, thus subjecting me to the perils of the anchoring trap (#1). The status quo trap reared its ugly head when I refused to kill the project when I realized the project was in deep trouble (#2). Sunk costs almost buried me because my ego encouraged me to throw good money after bad (#3). I fell into the framing trap by comparing my losses to the many Silicon Valley entrepreneurs who were struggling (#4). I also made a number of false assumptions, including the belief that users would spend time entering data and that physicians cared about marketing (#5). Finally, I missed many signals, including hints from colleagues who were not enthusiastic about my product (#6).

Poor decisions flow from poor decision-making processes.

Just like a sand trap in golf, these decision traps are hazards to be avoided. This blog will show you how to use the eXpansive Leadership Method (XLM) to steer clear of these traps and improve your decision making. The XLM is seen below, with the four key questions that can help you make a better decision when confronting relatively simple challenges.

The XLM doesn’t tell you what to do; it shows you how to decide.

When you choose to ask these four key questions, you are actually drawing on the wisdom of the ages. That's because these four questions are offshoots from four branches in the tree of philosophy:

1. Metaphysics -- This branch of philosophy deals with universal truths and ultimate questions -- how it all relates to the big picture. In decision making, the second question we ask ourselves is "What would be an eXtraordinary outcome?" This is a visionary thinking question because it invites contemplation of a broad perspective, strategic implications, and long-term considerations. For example, when you are deciding how to handle an employee who made a mistake, do you take the time put their mistake in the context of their overall, long-term performance?

2. Epistemology -- This is the branch of philosophy that investigates the study of knowledge -- how we know what we know. In decision making, the first question we must ask ourselves is "What are the facts and expectations of those affected?" This is a rational thinking question because it's related to monitoring our environment closely and being in touch with the facts. For example, when confronted by poor performing employees, do you gather all the facts related to their performance prior to a counseling session?

3. Ethics -- This branch of philosophy concerns itself with the moral code and values we use when interacting with others -- how decisions affect others. In decision making, the third question we ask ourselves is "What's the right thing to do, especially for others?" This is an empowering question because it focuses our attention on serving those whom we lead. For example, is your heart's desire to help employees when they make a mistake or do you just want them to follow specific performance standards?

4. Existentialism – The last major branch of our philosophical tree reminds us that human beings have free will and therefore are responsible for their actions. It leads us to the final decision-making question, “What the consequences of our options?" This commanding question compels us to refuse victim thinking and accept responsibility for our choices. For example, where is the first place you look when an employee underperforms for the second time? If you answered, "the mirror," then you're a closet existentialist!

Ask these four key questions to avoid falling into the decision-making traps. One CEO recently e-mailed me the following:

Dear Dave,

Thank you for coaching me to use the XLM as a decision-making tool. This simple and powerful approach clarified our current situation and provided direction in making a decision that resulted in $147,000 to our bottom line. I now use the XLM as I make decisions throughout the day.

The essence of great decision making is effective decision framing. As you go about making your daily decisions, I encourage you to keep the XLM in front of you and ask these four key questions to frame your decisions. Use it at your meetings by asking your team to brainstorm answers to the questions. How surprised will you be when you find yourself making better and more consistent decisions because you are not failing into traps?

Be eXtraordinary,
Dave

http://www.davejensenonleadership.com/

P.S. The web-based eXpansive Leadership Method (XLM) assessment measures 4 fundamental leadership styles, 16 core competencies, and 8 essential leadership skills. Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to: http://xlmassessment.com/ to learn more.

Put Research in YOUR Leadership

I recently commented on a blog, asking the author if he had any research behind his opinions. Here’s his response:

No, it's not a hypothesis, this isn't a classroom, I'm not an academian, and I don't do research. I blog about my experience in the real world; that's really all I'm even marginally qualified to discuss. If it rings true, try it. If not, don't. Some companies even pay me for it. Go figure.

What do you think of his answer? Let me ask you a few other quick questions:

1. How much time, money, effort… do you spend trying other peoples’ ideas in an attempt to improve your situation (i.e., conducting your own "experiments")?
2. How do you know their ideas will work for you?
3. Is there a way to increase the probability that all your time, money, and effort trying new ideas will result in success?
4. If so, how?
5. In 100 years, you’re probably going to be dead. Since you’re going to be dead for a very long time, how many grains of sand (i.e., precious minutes of your life) should you let slip through your hourglass because your tried ideas without any evidence to predict success?
6. Is it my ethical obligation as an educator to teach ideas that research predicts will work, thus honoring your grains of time?

Here are my answers:

1. For most people, organizations, and governments… A LOT.
2. Most of the time, you don’t.
3. Yes, but the approach only increases the probability you get results. There’s no guarantee.
4. Try only those ideas that have some science to back them. The essence of science/research is prediction. And aren’t you really predicting things will get better as a result of trying something?
5. Zero
6. For me, yes.

Thank you.
Be eXtraordinary as you pursue what is true,

Dave Jensen
http://www.DaveJensenOnLeadership.com

P.S. The web-based eXpansive Leadership Method (XLM) Assessment is based on my analysis of research covering 171,000 leaders. Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to: http://xlmassessment.com/ to read about the 360 assessment.

How Leaders Manage the Paradox in Work

In a previous blog, I pointed out that a common approach to addressing any issue or problem that arises at work is to ask, what's the problem? Depending on the complexity of the problem, most of us then go through some problem-solving process to arrive at a solution. We then implement the solution in an attempt to solve the problem. This step-by-step problem-solving process works very well when we have a traditional problem to solve, such as whom to hire, which city to build the new plant in, or which vendor to select for the new IT project. Yet, traditional problem solving does not work when dealing with a paradox. That’s because a paradox has four unique characteristics. A paradox:

1. Consists of two interdependent issues
2. Has issues that recur over time
3. Requires choices be made that consider both issues
4. Is mismanaged when over-focus on one issue creates negative consequences

Listed below are the top ten paradoxes leaders mismanage, usually by addressing only one issue at a time, instead of managing them together:

1. Set uniform/standard procedures and meet customized/individual needs.

2. Cut expenses and maintain productivity.

3. Follow mandates from the central office and address local concerns.

4. Focus on long-term goals and execute short-term objectives.

5. Push for change and provide stability.

6. Maintain customer satisfaction and increase sales.

7. Motivate employees and increase accountability.

8. Stimulate creative innovation and improve existing products.

9. Foster individual initiative and improve teamwork.

10. Excel at work and maintain a fulfilling home life

Do you struggle with any of these? Of course you do. So the real question is not whether you deal with them, it’s how well do you manage them interdependently?

To Strike or Not to Strike

The nurses at the hospital wanted a pay raise, while the administrators wanted to cut costs. Because both parties justified their entrenched positions, neither identified the paradoxical nature of their dilemma. They fought fire with fire, the nurses went on strike, and everybody got burned.

In their two-year study of these New Zealand hospital leaders, Professors Kan and Parry found that legitimizing a paradox was the subconscious process people used to rationalize their biased view of the issues. (1) This tunnel vision led to “divergent realities” – the inability of either party to see any benefits of the opposing position, nor the side effects of over-focusing on their own position at the expense of the other side. This created a negative filter in their mind through which they perceived the changes in the hospital, and eventually a costly strike.

In another hospital 9,000 miles away...

Dan, was having problems getting the nurses union (who wanted to focus on improving overall patient care) and hospital administrators (who were intent on lowering expenses to stay competitive) at one of his hospitals to work out their differences. He invited representatives from both parties to a “negotiation meeting.” He then guided the nurses and administrators to map the quality and expense paradox (using the steps described in this chapter). He told me that mapping the paradox averted a strike, saved his healthcare chain millions of dollars, and may have saved patient lives in the process.

The simple mapping process Dan employed enabled both parties to see the benefits of the opposing position and the possible side effects of over-focusing on their own position at the expense of the other side. This expansive view of the issues created a positive filter through which everyone saw the possibility to achieve the common goal of improving patient care and quality at the same time. Let's see how you can do what he did.

Map the Paradox

Once you have identified your key paradox, you are ready to map the paradox. The simple steps of this process are outlined below:

A. Identify key stakeholders

B. Outline a paradox map

C. Conduct a paradox process meeting

1. Brainstorm the benefits of both issues
2. Brainstorm the negative consequences of over-focusing on either issue
3. Gain buy-in from opposite sides

A. Identify key stakeholders

The process begins when you consider who needs involved. Identify stakeholders who are directly affected by, capable of influencing, or most concerned about the issues involved. The ideal number of attendees is between six and 12. For example, a senior bank executive was in the process of rolling out a new commercial banking strategy (Commercial banking provides services to businesses, such as a accepting deposits and providing loans). She felt that the new strategy might cause her team to lose focus of their existing retail banking goals. (Retail banking consists of those banking services offered to individual customers, such as savings accounts, personal loans, check cashing…). She therefore invited a few bank managers, senior loan officers, lead tellers, customer service representatives to her a meeting.

B. Outline a paradox map

Prior to your meeting, draw a paradox map on a flip chart as seen below. The paradox map is the primary tool that you’ll be using throughout the entire process. It was originally developed by Dr. Johnson.

Paradox Map

C. Conduct a paradox process meeting

After thanking everyone for attending, inform him or her that you have two issues with which you would like their assistance. Show them the paradox map outlined on your flip chart and write the names of the two issues in the left and the right boxes, respectively. For example, the left box could be retail banking, and the right box, commercial banking. Explain to the group that you would like to step through a process to help everyone understand the relationship between these two issues. Do not discuss paradox at this time. It is more effective to step through the process before talking about it.

1. Brainstorm the benefits of both issues

Ask the team to brainstorm all the possible benefits of focusing on the left issue. Explain that whatever they say, you will write it down. Now is NOT the time to process or discuss what they say. Write everything they say in the upper left quadrant using a green magic marker. It is critical to keep the discussion to an absolute minimum. This step is about idea generation not idea evaluation. (A manager ignored this advice and kept trying to process opinions as they created their paradox map. His team completely shut down. When people don’t buy into the process, they won’t buy into the outcome of that process.) So keep them talking by asking open-ended questions, such as What might be all the possible benefits of paying attention to this issue? Continue brainstorming the answers to these questions for five minutes.

At the end of five minutes, do the exact same thing for the right issue. Write their answers in the upper right quadrant using a green magic marker.

2. Brainstorm the negative consequences of over-focusing on either issues

Ask the group to brainstorm possible side effects and negative consequences of paying too much attention to the left issue at the expense of the right issue. Keep the ideas flowing by encouraging them to brainstorm the answers to questions such as What might happen if we paid so much attention to the left issue that the right issue was completely ignored? Write down everything they say in the lower left quadrant of the flip chart using a red magic marker. This brainstorming step also takes five minutes.

At the end of these five minutes, brainstorm all the possible negative consequences of over-focusing on the right issue at the expense of the left issue. Write down everything they say in the lower right quadrant.

3. Gain Buy-in From Opposite Sides

After spending five minutes filling in each of the four quadrants, facilitate a discussion about what they see. Ask them questions such as: What is this map telling you? Is focusing on the right issue or left issue the best way to continue? Do you find yourself feeling more of an advocate for one issue or the other? Do we as a group seem to value the left or the right issue more? How should we proceed?

During the debrief, those who favor one issue begin to see the upside and downside of both sides. This breaks the subconscious process of rationalizing their bias toward their favored issue. For example, imagine that you are a strong advocate for your bank's retail banking strategy, isn't it possible that you'll be more open to the commercial banking strategy when you see all the potential benefits of commercial banking, as well as the possible negative consequences of over-focusing on the retail banking strategy? Of course. That's why this process works. Individuals with an open-mind begin to understand the big picture and appreciate the pluses and minuses of both issues. (A closed mind is a wonderful thing to lose.)

In future blogs will discuss the paradox plot and how to manage the paradoxical tension over time.

Be eXtraordinary,
Dave

P.S. The web-based eXpansive Leadership Method (XLM) Assessment measures paradox in leadership using the “Agility Score.” Within minutes of completing your assessment (which takes less than 20 minutes to fill out), you can download your highly personalized Profile - a comprehensive, 21 + page report and customized action plan in PDF format. Go to: http://xlmassessment.com/ to read about the assessment.

1. Melanie M. Kan and Ken W. Parry; Identifying paradox: A grounded theory of leadership in overcoming resistance to change, The Leadership Quarterly, 15, 2004, 467–491.

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