“Intellectuals are most valued when the dominant paradigm begins to break down.”
—Paul Yingling, quoted in The Generals by Thomas E. Ricks

The concepts of “organizational thinking” and “organizational learning” have been around for several decades. Peter Senge coined the phrase “learning organization” in his 1990 book The Fifth Discipline, and the more recent influx of business-intelligence solutions has put a big-data spin on the concept.

However, never before have organizations been required to think more rapidly and radically than in the volatile environment of COVID-19, when existing business models are being decimated daily, and organizations need to hit a new target that is hazy at best.

War is an apt metaphor for the situation that organizations—very much including hospitals and health systems—face today. In war, leaders must plan for and react to forces that are volatile and uncertain. That description is fully appropriate for the growing and morphing crisis of COVID-19.

In such situations, organizational thinking is a crucial to both the process and outcomes of leadership. This point is hammered home repeatedly in the book The Generals by Thomas E. Ricks, which is not only a insightful work of military history, but one of the best leadership books you will ever read.
 

Everybody Starts Wrong

“Usually, everyone gets it wrong at the beginning of a war,” Ricks writes, paraphrasing military historian Sir Michael Howard. Faced with a highly complex and unpredictable situation, being right at the outset is, according to Ricks, “an almost impossible task.”

Howard observes, “When everybody starts wrong, the advantage goes to the side which can most quickly adjust itself to the new and unfamiliar environment and learn from its mistakes.” To make those adjustments, Howard goes on, requires an organizational capacity to “get it right quickly when the moment arrives.” And that requires an organizational capability to think, and think quickly.

Which begs the question: how?
 

Intellectuals and Skeptics

This kind of in-the-moment thinking cannot be achieved from a standing start. It is a quality that successful organizations nurture over the long term. And that means nurturing two types of individuals that I fear are a disappearing breed in too many organizations: intellectuals and skeptics.

According to Ricks, based on his study, successful commanders “cultivate and maintain cultures in which their subordinates feel free to exercise initiative and speak their minds freely.” This cultivation includes, writes Ricks, keeping “alive the careers of outliers and innovators.”

This is a tall order for executives who, on any given day, are moving rapidly from meeting to meeting, from tough decision to tough decision. In such an environment, rapid consensus can feel necessary just to make it through the day. The presence of individuals who want to introduce a different context, a contrasting viewpoint, or new data points can certainly slow down progress toward consensus. However, these people are absolutely necessary when a crisis arises.

Paul Yingling was a Lieutenant Colonel in the U.S. Army who had three deployments in Iraq and, toward the end of his career, was highly critical of the conventional wisdom and lack of innovative thinking of military leadership.

Yingling wrote, “Intellectuals are most valued when the dominant paradigm begins to break down. In this moment of crisis, the heretics become the heroes, as they have already constructed alternative paradigms that others haven’t considered.”

From this observation, Yingling draws one of the most important lessons for leadership: “In large organizations, the challenge is to keep the skeptics from becoming extinct.”
 

Leading Through Crisis

After almost a year, daily COVID cases and hospitalizations are spiking. The vaccination rollout so far has been rocky. And even the CEO of Moderna says, “We are going to live with this virus, we think, forever.”

The efforts of hospitals and health systems have been nothing short of heroic. However, the escalating nature of this crisis continues to present the greatest leadership challenge hospitals have ever faced. Every facet of the traditional operating model is being challenged—care models, staffing, facilities, technology, communication, and on and on.

More than ever before, hospital leaders need new ideas. As Yingling said, the old paradigms are breaking down. We need people who are skeptical of the conventional wisdom. We need people who have been thinking for years about new healthcare delivery models. We need people who have new perspectives. We need people with new skill sets. If these people don’t exist within our organizations, we need to bring them into the fold. We need to nurture these people like never before by giving them a platform for testing new ideas and an open channel to share their questions and insights at the highest levels of the organization.

In a crisis, we cannot afford for “organizational thinking” to be just a platitude. It must be a core organizational capability.

Meet the Author
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Kenneth Kaufman

Managing Director, Chair
Kenneth Kaufman offers deep insights on the economic, technological, and competitive forces undermining healthcare’s traditional business model.
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