“Complexity Science and Health Care Organizations:
Leadership in Complex Systems”

In which Jeffrey Goldstein offered a business context for complexity theory.
Jeffrey Goldstein, PhD, Professor, School of Business, Adelphi University

Coming to terms with your confusion

• In dealing with leadership and complexity, are we confronting a blurred picture of a clear situation or, a clear picture of a blurred situation?
  
  
• It’s even more difficult than that. We’re facing a blurred picture of a blurred situation.
  
  
• Goldstein observed: “This conference is building a bridge, but we’re all doing it together. I’m not going to clear up the questions you have from the last presentation. In fact, I may make things more confusing.”
  
  
• Goldstein affirmed that feelings of confusion are natural – even appropriate. Change is so rapid, we can’t deny it anymore. Confusion is an appropriate response.
  

• Consider the true story about the 1949 Mann Gulch fire. A group of “smoke jumper” forrest fire fighters were trapped on the top of a hill with the fire raging up towards them. The leader realized the fire was moving faster than any of them could run. Trapped in a field of high, dry grass, he made a counter-intuitive, seemingly crazy move: he set fire to the grass around them.
  
  Because he’d burnt out the grass around them, the fire burnt around that area. Who would have thought to start a fire in the middle of one? It seemed truly crazy. But it saved three lives.
  
  
• Such escape fires are now in the manuals. But it wasn’t part of the mental model of those smoke jumpers.
  
  
• Health care today is not unlike this fire. Change is burning the market faster than we can run. We must rethink our assumptions about how to lead health care organizations.

• What the hell are we doing here listening to esoteric mathematical constructs?
  
  
• Why should we learn this when there’s a fire coming up the hill?
  
  
• Why are we listening to talk about complexity science?What about
  complexity science makes it so important? Why not gauge theory? Or the human genome? Or superstring theory? Why complexity?

• In Israel several years ago, Goldstein saw copies a book on Chaos, translated into Hebrew on newsstands. In Israel, complexity science, with its emphasis on emerging pattern and order, had entered the national dialogue.
  
  
• Similarly, Goldstein did a search in 1993 on use of the world “self-organization” in Sociology. The search turned up about 35 references. About 25 of those were in Serbo-Croatian literature in the 1980s. Intrigued, Goldstein investigated and discovered a situation similar to that in Israel: the breakdown of an old system was taking place, and Croatians were looking for new ways to think about what was going on.
  

• Like the upheaval that led to a search for new approaches in Israel and Serbo-Croatia, the health care industry needs innovation in the face of upheaval.
  
  
• We need the kind of counter-intuitive innovation displayed by the fire-fighting techniques in the Mann Gulch fire.

• Is self-organization always a good thing? Not necessarily. The events leading to war in Yugoslavia were self-organizing. The ethnic hatred self-organized.
  
  
• It’s not enough just to stand back and let things self-organize. This leads to an important question: To what extent can we guide processes of self-organization to make them more constructive?
  
  
• When do we keep the traditional elements of organizations and when do we let them go? We can explore these questions in the spirit of play.
  

• We’re now living in Complexityland. Imagine a landscape, in which some regions are linear and predictable; others are self-organizing critical states; regions that are unpredictable; and others that we can make more predictable.
  
  
• Thus, there is no one approach, and no one model that works in all situations.
  

• Command and control (lower left quadrant.) Many managers don’t want to admit that most structures are still of this variety. Emergence cannot take place here.
  
  
• Imposed teams (lower right quadrant.) These may seem to be self organizing, but they are not. You can’t say, “I demand that you be participative.”
  
  
• Informal leadership (upper left quadrant.) This is a spontaneous, self-organizing structure... but as soon as there is a crisis, the leader steps in and “commands the troops.” Real emergence can’t take place.
  
  
• Emergent networks (upper right quadrant.) Emergent networks hold potential for real innovation... but they occur only when conditions are right. These networks are a threat to many leaders, and the traditional way they think organizations should be run. Indeed, emergent networks are “out of control.”

Opening the “black box” of emergence

• We now know a lot more about emergent phenomena. We can look inside “the black box” and understand some of its processes.
  
  
• Anacoluthian Processes are a key element in the black box. Anacoluthian refers to a “logical inconsistency.” Order can be found in noise, and noise can be found in order. This pattern creates marvelous possibilities.

• Innovation must be based on allowing random events and violating old rules. Managers traditionally try to eliminate uncontrolled random events. Yet, that’s where innovation comes from, just as the fire fighters realized the need to set fire to the field in which they were standing during a forrest fire.
  
  
• Organizations have to turn themselves inside out to be open to random events.
  
  
• A difficult, rhetorical question: How, Goldstein asked, can we be the kind of “wizard” who can enable people to be open to anacoluthian processes, yet guide emergence in a positive way?

Copyright © 1999, VHA Inc. Permission
to copy for educational purposes only.