Detailed Outline for Two Sessions

Session One

Welcome; facilitators’ introductions; review of purpose and intended outcomes
Participants’ introductions and individual expectations
Suggested ground rules for the two sessions
Program overview (how we will spend our time together; mix of individual, team and group activities)
Questions: what does learning mean to you personally?
What are some key leadership qualities for healthcare today?
Review of key characteristics of learning organizations and corresponding shifts in leadership roles and competencies; introduction of vision-current reality-creative tension and of iceberg views of reality; types of structures (drawn from participants).
Current obstacles to learning and functioning as a team between physicians and administrators (in teams, followed by debrief)

Clarification of personal visions and values as context for team work and learning (arm-bending and visioning exercise; sharing in pairs); characteristics of a desired working environment
Surfacing and challenging individual mental models; introduction and left-hand column exercise in pairs; introduction to inquiry vs. advocacy

Key distinctions about advocacy, inquiry and dialogue; strategic dialogue on capitation as current reality
Distinction between events, patterns and structures as foundation for team lunch assignment on systemic view of current reality

Introduction to systems thinking (starting with human body as a system); characteristics of systems; key principles; application of two systems thinking archetypes (vicious loops, shifting the burden) to individual and team cases (in teams); limits of the “problem-solving model”
From personal to shared vision: visionary planning process; vision sharing exercise; distinctions between commitment/enrollment vs. compliance
Team assignment for the morning: explore key commonalities and differences on project outcomes and current reality (clear instructions).

Exploration and sharing of generic perceptions,
mindsets and stereotypes between administrators and physicians; preparation of presentations in 2 groups
Presentations and large group debrief (physicians and administrators)
Illustration of shifts in shared mental models
Exploration and sharing of generic perceptions, mindsets and stereotypes about administrators and physicians; preparation of presentation in 2 group
Presentations and large group debrief (physicians and administrators)
Illustration of shifts in shared mental models.

Reports on team assignments; feedback from group and facilitators; introduction of the organic change model (working with an economy of means); integrating the managerial pyramid and the physicians’ blob?
Exploration of individual and team action steps (in teams)
Insights and questions reported back to the group; feedback from group and facilitators
Evaluation of session (3 questions); verbal and written check-out.

Review intended outcomes of Session II: build on practical experimentation between the two sessions; deepen some of the key dimensions of collaborative leadership development; decide whether and how to stay connected as a learning community
Check-in: individual review of progress made on personal action plan since Session I; insights and questions about personality dynamics; other learnings and questions based on personal reflection and experimentation; points to be addressed in Session II
Creative tension exercise (focus on work situation and structural obstacles): share with neighbor any differences with Session I; option: coaching on “peeling the onion” — “what would it bring you?”; reviewing conditions for learning
Team reports: progress accomplished on project since last session;
insights and questions as a team

Principles and pitfalls in creating a shared vision: participants’ experience; limits to success archetype
Team reflection on next steps in the visionary planning. Application of systems thinking to co-leadership issues, based on Session One assignment (in teams)

Deepening the practice of dialogue: conditions; strategic vs. generative dialogue; collaboration vs. competition; role playing (trading roles in a fish bowl — sculpting)
Complementarity of systems thinking, continuous quality improvement and process redesign; application to organizational change and clinical leadership or administrative/clinical case study.

Principles and practices of change management: phases of change and learning; economy of means (start where you are; work with the forces; build a critical mass; respect the strategic imperatives )
Building/refining an individual and organizational change plan (team work with consultation by facilitators): challenging shared mental models; building momentum; milestones and checkpoints.

Sharing key aspects of plan, insights and questions with large group; co-consulting across teams
Next steps as a learning community; meeting in 9 months
Overall evaluation (written and verbal)