Developing a Culture of Innovation

    I’ve been thinking a lot about innovation – the concept has crossed my desk from several different directions recently. I always take notice when I see something several times in short succession from variable sources. It usually means something is moving away from the edges and hitting the mainstream. I like to think of the application to healthcare-which is in need of significant innovation. A few interesting definitions of innovation (which can be a vague over-used term) are emerging from different sources.

    Innovators are people who apply new and original ideas and methods to solve existing and potential issues and problems. Using creative thinking and idea development, innovators are willing and prepared to embark on an initiative that will advance their profession, organization, business, and/or goal. Turning their ideas into action, they play a key role in driving something forward (adapted from Donner and Wheeler).

    An HBR article on Twitter today by Soren Kaplan provided some further insights. Innovation he says can be categorized into 3 different types: incremental (small tweaks that advance the core business), evolutionary (changes that evolve with other changes), and disruptive (defined as an innovation that creates a new market and value network, eventually disrupting an existing market and value network, and often displacing established leading market firms, products, and relationships). A lot has been written in recent years about disruption and disruptive innovations (see Christensen HBS).

    Most organizations today want more innovation. They want employees to be focused on how things could be done more efficiently, smoothly and with more positive outcomes. The highly competitive environment demands this kind of thinking and action. Organizations need people who will find a problem, create an innovative solution, evaluate its functionality and scale it up. Often what stands in the way of more innovation is organizational culture, known to be one of the areas that are hardest to change. Strategies proposed by Kaplan are: embedding innovation in structures and processes across the organization, getting people in all roles and levels involved, training and development in innovative and design thinking, ensuring that good ideas get traction and are widely publicized, and supporting a few key leaders to effectively champion the ideas and keep up the momentum. Many people believe there are no bad ideas; what counts are the early ideas.

Liberating Structures

I have stepped away from this Blog for a while now keeping busy with other things. I am hoping to commit to more writing about things that interest me, and affect the work we do developing health care leaders.

Today I want to talk about Liberating Structures, which, in its simplest form, is a suite of tools that enable people in organizations, teams, communities – groups of all kinds – to engage with each other in meaningful and collaborative dialogue, and work together sharing thoughts, ideas and experiences in order to achieve the outcomes they want. Liberating Structures have the power to alter the way individuals and groups interact with each other, and transform workplace culture.

Henri Lipmanowicz, former President of Merck Intercontinental and a founder of The Plexus Institute, and Keith McCandless, a founder of the Social intervention Group have published their suite of tools in The Surprising Power of Liberating Structures. “So why is it” the authors ask, “that so many organizations of all stripes are filled with disengaged workers, dysfunctional groups and wasted ideas?”

Feeling that improvements could be made in the way people work together, and recognizing that Complexity Science has tremendous potential and practical application to support transformational learning, the authors began to collect ways that people can use to engage everyone, bring out thoughts and ideas, and get people talking and problem solving together. “Gleefully we cut across academic disciplines, tapped spiritual practices, roamed the planet and deepened scientific insights along the way.”

I have been interested in these kinds of practices for 25 years or more. I heard long ago that “the answers are in the room”. I don’t know where I heard it – probably in the Lippitt living room in Ann Arbor, Michigan where I was involved in a Planned Change Internship in the early 90s, working with a small group of diverse others interested in organization and leadership development. This kind of thinking has stayed with me as I navigated the very hierarchical healthcare system working to support transformative change. We know from personal experience that everyone has significant contributions to make, and we know how important engagement in the workplace is to people and outcomes. The question is: How do we engage everyone, provide a safe environment, and enable new ideas to emerge and grow? Liberating Structures effectively support these efforts. Check it out at liberating Communities of practice around liberating structures are popping up around the world. If you’re interested in organization development (OD), developing leadership, engaging people and teams, it’s a movement worth following.

DWHLI 2017

The 2017 DWHLI was held May 23-26 at the BMO Institute for Learning in Toronto. Eighty five participants from across the health professional spectrum of roles and disciplines, and representing several provinces, participated in 4 long days of concentrated leadership development programming. More information about the program, the speakers and facilitators, and the innovative projects that were launched by the attendees can be found at

Exerpts from Longwoods Nursing Leadership, June 2016, Special Focus on the The Dorothy Wylie Health Leaders Institute

Exerpts from Longwoods Nursing Leadership, 29(2) June 2016 Special Focus on the The Dorothy Wylie Health Leaders Institute

DWHLI and CNA celebrate their partnership and plan 2016 events


Earlier this month Judith Skelton Green, Julia Scott and I sat down with Anne Sutherland Boal, CEO of the Canadian Nurses Association, and Carolyn Pullen, Director of Policy, Advocacy and Strategy to put the final touches to our partnership agreement to offer together our 27th Leadership Institute.

Dorothy Wylie, retired Professor of Leadership at University of Toronto Nursing, after whom the Institute is named, and Karima Velji, President of CNA, joined us for dinner and celebratory toasts.

A few collaborative events are scheduled for 2016. In February we will offer a webinar about leadership competencies for health care professionals, and their importance in today’s complex and rapidly transforming environments.

We are hard at work designing a leadership workshop for participants at CNA’s Biennium in June in St John’s NB. In October we will offer our 27th week-long Institute with CNA. We are thoroughly enjoying our collaboration – truly a “meeting of the minds” – as we are very much on the same page about the value and importance of leadership at every level and in every discipline providing healthcare today.

Dorothy Wylie Health Leaders Institute in New Partnership with the Canadian Nurses Association

Dorothy Wylie Health Leaders Institute Canadian Nurses Association

New Partnership with the Canadian Nurses Association
The Dorothy Wylie Health Leadership Institute (DWHLI) is introducing a new and significant partnership with the Canadian Nurses Association (CNA).

The institute is a unique Canadian leadership program that brings together health-care leaders from all disciplines across the country for a concentrated study of leadership principles, models, skills and tools. Established more than 15 years ago, the program offers a refined, highly-specialized and interactive leadership learning experience. A recent survey found that more than 75 per cent of institute alumni said their experience had a positive or profound impact on their personal life and career, and it was described as a “catalyst for change.”

DWHLI has chosen to work with CNA, the national professional association of registered nurses, because its program will be an excellent companion to CNA’s existing suite of professional development offerings, including continuing competencies, advanced practice support and specialty certification. In its 111-year history, CNA has demonstrated a sincere commitment to health-care leadership, and now it will connect more professionals from across Canada to the institute’s innovative work. By working together, the two organizations will extend the reach of the institute’s program, explore new blended learning approaches and integrate advanced technology to enhance participation.

Work is already underway to deliver the 2016 program jointly, with the first offering in October (details to follow). Both organizations look forward to this dynamic collaboration for the advancement of health leadership.

For more information, please visit: Health Leaders Institute or

Thinking about Occam’s Razor

While watching an episode of Madame Secretary the other night, I was interested to hear the main character mention Occam’s Razor as she wrestled with a complex issue and the need to get at the variables, understand them and make decisions about how to proceed. Knowing my interest in complexity and complex adaptive systems (CAS) theory, a friend told me about Occam’s Razor awhile ago. I had never come across it before, despite lots of reading about complexity and complex systems – obviously not reading the right things, Ann! Thanks.

Wikipedia tells us that Occam’s Razor (which is also sometimes written as Ockham’s Razor) is a problem-solving principle devised by William of Ockham in the 13th C – believe it or not. William was a respected English Franciscan friar, philosopher and theologian.

The principle of Occam’s Razor states that among competing hypotheses which predict equally well, the one with the fewest assumptions should be selected. Other, more complicated solutions may ultimately prove to provide better predictions, but—in the absence of major differences – the fewer assumptions that are made, the better – according to the theory.

Called also the Law of Parsimony, it tells us to KISS or keep it simple, and not over-complicate. This of course makes a lot of sense and it also reminds us to quantify, qualify and verify our assumptions. Wikipedia goes on to say “ For each accepted explanation of a phenomenon, there is always an infinite number of possible and more complex alternatives, because one can always burden failing explanations with ad hoc hypothesis to prevent them from being falsified; therefore, simpler theories are preferable to more complex ones because they are better testable and falsifiable.”

The fact that we are still considering William of Ockham’s ideas, 7 centuries later boggles the mind, and makes me question how much more we know or don’t know today than we did centuries ago.

It also makes me wonder about the fit between Occam’s Razor and complex adaptive systems’ theory. This is for another time.

Appreciating a Preference for Introversion

I have had the pleasure of getting to know many people whose preference for introversion is obvious in their interpersonal relationships – including their relationships with me, an avowed extrovert. In her recent excellent bestseller Quiet: The Power of Introverts in a World that Can’t Stop Talking, I was reminded of the many famous and talented introverts who have given the world great things. The contributions of Albert Einstein, Warren Buffet, Barbara Streisand, Bill Gates are unprecedented and undeniable. I realize that with age and experience I am getting better at being a good listener when I am with people whose preference is for Introversion. Even though I still find the silence disconcerting, I am trying to better understand and appreciate it, and, through my own silence, enable both my own reflections about the nature of our conversation, as well as the ability of my introverted colleague to choose where to take the next part of our discussion. It’s hard work though very worthwhile for both of us.

Qualities of Leaders: The Amygdala Hijack

Recently I was driving on a freeway with a friend. We were having a quiet companionable moment together when someone cut in front of our car while changing lanes. My companion, who was driving, immediately went ballistic, swearing and yelling at the other driver. His behaviour seemed to come out of nowhere and I was shocked until I remembered reading about the so-called “Amygdala Hijack”, a term coined by Daniel Goleman in his writings about Emotional Intelligence.

What an interesting phenomenon this is!

Drawing on LeDoux’s work, which uses animal research to understand pathological fear and anxiety in humans, Goleman uses the term Amygdala Hijack to describe immediate and overwhelming emotional responses which are over the top and out of sync with the actual situation. In these cases the stimulus has triggered a more significant emotional threat than would seem reasonable to an observer.

The neuroscience reads like this: From the thalamus, a part of the stimulus goes directly to the amygdala while another part is sent to the neocortex (the rational or thinking brain).

If the amygdala perceives the stimulus as a fight, flight or freeze situation, it triggers the HPA (hypothalmic-pituitary-adrenal) axis and hijacks the rational brain. This emotional brain activity processes information milliseconds earlier than the rational brain, so in case of a match, the amygdala acts before any possible direction from the neocortex can be received, leading to seemingly irrational and possibly destructive behaviour.

If the amygdala does not find any match to the stimulus received with its recorded threatening situations, then it acts according to the directions received from the neocortex.

Now my friend is – most of the time at least – a charming man with a high degree of Emotional Intelligence in his interpersonal relations. He is a leader. As well, he is kind and empathetic, and can often put himself in another person’s shoes and feel deeply for their problems. So when he reacts to a moderate stressor with such an over-the-top response, I find myself getting stressed and wanting to shout at him to settle down and be reasonable, which of course would not be the best choice of my own behaviour!

I wonder if testosterone is involved in some way and if women experience Amygdala Hijacks as often as men may do – and do the trigger circumstances differ with gender differences? or it is more related to temperament and world view thus influencing how different personalties approach and interact with their world?

International Nursing Conference in Jerusalem

Preparing: We’re off to Israel on Monday. We’ll land in Tel Aviv Tuesday morning and have 3 days to explore the city and connect with a few people. Hoping to get to Jaffa and the northern coast as well before boarding a train to Jerusalem.

Monday, May 28 – we are now on our way. The first indication that we are flying to Israel – with its vulnerability to violence and terrorist attacks – is the double security check at the airport, first entering the departure gates and second entering the specific gate for the flight to Tel Aviv.

Tuesday – arrival at Ben Gurion airport and taxi to Park Plaza Orchid after an uneventful overnight flight with no sleep. All the customs agents are young women! Easy process.
Wednesday – fascinating hike to Old City of Jaffa, many good pictures on the way and managing to overcome the jet lag. We want to be fresh when we get to Jerusalem and the conference. View from our hotel is spectacular.
Thursday – City tour of Tel Aviv-Jofa and lots more pictures. Doing well with jet lag. Clocks are set 7 hours ahead of Toronto time – like much of Europe.
Friday – arrival in Jerusalem by car via highway 443 that winds directly through Palestininan land and hillside villages. State of the art highway has been built and is maintained by Israel via an agreement between the 2 countries – and lots of barbed wire and high stone walls! Apparently it’s “very safe”. We weren’t at all concerned. Arrival in Jerusalem was a treat. It is a very beautiful city. Out hiking to see the sights and into the Old City via the Jaffa Gate. It’s very hot in the day and cool at night. Very blue skies most of the day and the search for shade is constant even for sun lovers like me! Today is the holy day in the Muslim tradition but we don’t see much change in the city. We are told there are 1000 synagogues, 500 mosques and 200 Christian churches in this city of 700,000. Population of Israel is said to be 7million although I’m sure it’s very hard to make an accurate count.
Saturday – Its the Sabbath in the Jewish tradition and the city is quiet and we take time to see the important sights in the Old City. This time we enter by the Dung Gate and run into a young Muslim man who wants to guide us for a very large sum. We decline because we’re not sure what we would get ourselves into. There are many people who want to sell you something – maybe it’s a hard scrabble life for many – but what you agree to seems to grow significantly and the stories that emerge change with the telling.
We see King David’s tomb and I am told by a very old woman drinking coke that I can’t go in to the women’s entrance because I’m not a Jewess. Perhaps because it’s the Sabbath. There’s not much to see anyway. We see the room where purportedly the Last Supper was held and it’s a beautiful room but not much evidence that anything happened there – It was destroyed and rebuilt in the 15thC by the Turks – no windows such as the one in Da Vincis Last Supper. We see an older painted replication of The Last Supper. It’s fascinating to be in these thousand++ year old places but hard to tell myth from legend from truth. I am pleased to find delightful colleagues from Montfort Hospital in Ottawa at the Inbal Conference site.

Sunday – The Holy Day in the Christian tradition, and a normal work school day in Jerusalem. We find a city tour bus and take a 3 hour tour some of it very interesting and much of the dialogue either hard to understand or spoken very quickly. Glad we did it though as it was ovall very interesting , informative and included parts of the Muslim section which we wouldn’t otherwise see as its quite a distance from our hotel.

Monday – as well as registering at the conference we spent seveal hours visiting the Israel Museum, which is fantastic and houses the Story of the Book – the Dead Sea Scrolls – beautifully positioned and curated in a climate-controlled building designed to resemble the jars inside which many were found. The gardens are magnificent, full of olive trees, rosemary bushes, lavender and amazingly a beautiful rose garden that is thriving despite the tremendous heat and hot sun all day. We have been resting and swimming at the King David Hotel in the heat of the afternoons. It’s a sister hotel to ours in the Dan chain. Ours is quite basic but comfortable.

Tuesday – Today we toured the Tower of David which was both interesting – with a well curated history of this land going back 4000 years – and a beautiful archeogical site built into the Old City wall between the Jaffa and the Dung gates. Lots of school children visiting as well with energy that if bottled could power the country. I loaded and tested my slides at the conference site and met with a few people.

Wednesday – Back to the Israel Museum to see the things we missed and the presentation at the conference which went well. Interest from Hebrew Unversity in Jerusalem and from the University of Arkansas in pursuing a similar track and I will follow up when I gt back to the office.

Thursday – We’re a little at odds today wanting to tackle something big but also not so energetic. We have 2 more days here n Jerusalem.