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Delivering Health Care in Complex Adaptive Systems I: The Nature of Dynamic Systems

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Central to successful navigation and influence on complex adaptive systems is a full understanding of how to develop high-performance self-organizing local relationships—also known as high-performance frontline teams. Let’s take a moment to explore the current state of understanding of what the most vital context and components are that create the most effective, high-performance teams.

Teams Operating as Complex Adaptive Systems

Many of us have experienced low-performance teams which tend to bias us against teams. That “team” where no one else did anything and we did 90% of the work, yet others took all the credit. That “team” in which a group of people competed with each other to be the leader and nothing else really got done. That team where a dominant character dragged the others on some wild goose chase only to promote his role in the organization.

Let’s face it, most teams are not very effective and don’t perform at a high level. Yet, we have all witnessed and cheered on many great high-performance teams—that rag-tag group of middle-talent USA hockey-players who slayed the mighty Russian team in 1980, the dynasty 49er’s in the 1990’s, 2013 New Zealand Rugby team, the Chicago Bulls in the 90’s, etc.

The Magical Ingredient

These teams inspire and excite us at their amazing abilities. Yes, they include lots of talent, yet there is something else magical about these teams—how they flow and work together, like a flock of birds, dazzling with their fluid dance of victory, often against the odds and against many seemingly insurmountable obstacles. That magic is the magic of teams—the excess energy and effort that comes when simple, self-organizing local relationships are well guided by coaches, experience, and strong relationships within the team. Team peak experiences, though rare, manifest experiences that members of those teams will relish for the rest of their lives and the rest of us yearn for in our workplace and homes.

Thankfully, Google undertook one of the largest and most comprehensive explorations of what makes for the highest performing teams. (Vakil, 2012) While most of us would guess “the team with the most talented members (agents)” or “the teams in the most powerful place with the most powerful people on it”—Google’s Aristotle Project revealed far more impactful influences on team performance. Here is their top 5 with the first being by far the most influential:
#1. Psychological Safety
#2. Dependability
#3. Structure and Clarity
#4. Meaning
#5. Impact

What does it mean that psychological safety is most important and what role does psychological safety play in the successful leadership of a complex adaptive system?

Psychological Safety

First described by Amy Edmonson (2018), psychological safety indicates that all members of a team feel safe with each other and their leaders to express themselves fully and honestly without risk of embarrassment, punishment, ridicule, or reprimand. Errors surface because it is safe to surface them. Opportunities are evaluated because the actual situation is fully understood. All members of the team are actively engaged in solving the challenges they discover together.

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