Similarly, both the Tangy Orange and Verdant Green leader is committed to learning from mistakes that are made. A Verdant Green leader put it this way (McKenna and Pugno,2006, pp. 243-244):
” I don’t chart a course for the next five years, or do formal long range planning. I do, however, reflect on what I’ve accomplished (and what I haven’t) as well as what I’ve learned. For example, reflecting on the email guidelines I’ve disseminated, I appreciate the impact they are having. Reflecting on the website I created about electronic communication in patient care, turned out to be, I believe, a good move. On the other hand, I regret not having spent more time writing.
I learn from my mistakes. I’ve come to realize that I’m not very deferential. I’m frank with people. I say, ‘This isn’t working well, can we talk about how it can be better?’ I make it a habit to be positive.
Some people are sourpusses constitutionally. They have to work especially hard because nobody likes a sourpuss or downer.
You asked about mistakes I’ve made. Years ago, I sent an open letter to our CIO, pointing out that he was a scoundrel and a liar (not my exact words) for diverting promised resources from a patient safety initiative in IT. I later regretted doing that, because it was not politically savvy. I should have said those comments lace to lace (! had, but apparently not strongly enough), or in a private letter; sending the open letter was not the right thing to do. It was a rookie move that came from inexperience.” [Daniel Z. Sands, MD, MPH Internist, Faculty, Harvard Medical School Chief Medical Officer and Vice President, Clinical Strategies, Zix Corporation]
Once again, Verdant Green and Tangy Orange leaders tend to diverge in how they attend to mistakes and the ways in which they learn from the mistakes. The Verdant Green leader will tend to use their own personal history when exploring lessons learned from mistakes. As was the case with Dr. Sands, they usually focus on flawed interpersonal relationships. By contrast, Tangy Orange leaders tend to engage in historical analyses that involve mistaken plans and flawed systems rather than personal foibles.
The Verdant Green and Tangy Orange leaders also share a commitment to reflective practice (McKenna and Pugno, 2006, p.241:
“All of us are ‘brainwashed’ in that we’ve adopted a view of the world that seems true and natural to use. We fail to see our own conditioning and cultural indoctrination. There is a paradox here in that we are most fulfilled when we strive for the truth and reality. However, there is not a single or true reality. Each of us creates our own reality.
We must ask ourselves: ‘What am I doing? Does it work? Do the results reflect my intent? Is it meeting my needs?’ In the end, this is really about asking, ‘What meets the common good? If this doesn’t, then what would?’ We need to be willing to step back, throw out all our assumptions, and take a fresh look. [Randall Oates, MD, Family physician, Founder and President, Docs. Inc.]
Culturally, most physicians have a tremendous victim mentality. That’s what creates a lot of the craziness in medicine. We need leaders to help us get out of that mindset. We are in charge of our well-being and our life’s experience.”
Once again, there are differences in the use of reflective practice among Verdant Green and Tangy Orange leaders in health care. Those with a Tangy Orange orientation are primarily concerned with the outcomes of a specific medical strategy or practice. They engage in “just-in-time-learning” that comes from immediate feedback (“this isn’t working!”) By contrast those, like Dr. Oates, with a Verdant Green orientation are concerned not just with the outcomes but also the level of alignment of these outcomes with the original intentions associated with this strategy or practice.
