CHAPTER 9
Identification of problem or issue
What problem(s) is the author identifying? Who does the problem relate to?
Kenagy introduces Adaptive Design as an applicable management method for healthcare organizations undergoing a change process. Adaptive design is a management tool that directs managers to learn by committing to change (95-97). This problem relates to hospital heads and nursing managers. The reason for this choice is that they are the individuals tasked with executing organizational changes (96).
For whom is this topic important and why?
This topic is important for patients, management team, and the nursing staff. First, successful changes create new processes resulting in quality and reliable service delivery from the patients’ perspective. Contrarily, the adaptive design approach allows the management and nursing staff to learn new skills and explore new patient management opportunities.
Making connections
How is what I am reading different from what I already know? Why might this difference exist?
I learned that Adaptive management is applicable in almost all organizations, including the healthcare industry. I have always recognized the tool as only applicable in sectors that follow a non-traditional organizational structure.
What new ideas are here for me to consider? Why am I willing or not willing to consider them?
The new ideas I would like to consider are the seven cultural barriers to sustainable improvement as applied to the healthcare industry. These barriers include workarounds, fear of failure, blame, backsliding, lack of accountability, silos, and chronic dysfunctional behavior. The reason is that such elements explain the limitations that can slow down any potential development in the clinical setup.
Interpretation of evidence
What inferences can I make from the evidence given in the assigned chapter(s)?
I determine that the Adaptive Design follows three major elements, namely changing minds, behaviors, and systems.
What relevant evidence or examples does the author give to support his or her justification?
In one instance, the author uses an example of a 36-bed medical unit in the process of a major shake-up. However, through assistance from the new nursing director, the facility effectively applied the principles of Adaptive design to facilitative change (Kenagy 104-106).
Challenging assumptions
What kind of assumptions is the author making? Do you share these assumptions?
Kenagy assumes that all nursing leaders have the same management/leadership styles to help drive transformation. The author also assumes that everyone within the organization is willing to accept the incoming change. I do agree with Kenagy on the second assumption. However, the first assumption might not work in environments where nursing leaders follow passive and non-participatory leadership styles (Kenagy).
What information builds my confidence in the author’s expertise?
Nonetheless, Kenagy’s use of clinical case studies, as well as credible management illustrations, makes me build my confidence in their expertise.
If the opportunity arose, what questions would I pose to the author?
Does the tool work in bureaucratic organization environments?
Making application
What advice could I add to this reading selection? On what basis do I give this advice?
Theoretically, the Adaptive Design is simple, timely, and logical. However, from a practical perspective, an organization can only achieve it using great leadership, data, support, and patience. I offer this advice on the basis that we live in an imperfect world that may not handle the slowness attached to the process.
Looking toward where I want to be in two years, what suggestions from the reading make the most sense to me?
Two years from now, I would rely on the author’s emphasis on a gradual change process applicable to Adaptive Design. I would like to be part of that team that uses this design to bring change to my organization.
What would you point out as important about this topic to others who either question or disagree with my point of view?
Adaptive Design is an exciting new tool that uses evidence to guide clinical practice.
CHAPTER 10
Identification of problem or issue
What problem(s) is the author identifying? Who does the problem relate to?
Kenagy discusses the challenge of leadership and management under Adaptive Design. This problem relates to nursing managers. Like their non-healthcare counterparts, Kenagy calls on to them to copy the likes of Bill Gates in acquiring appropriate leadership skills.
For whom is this topic important and why?
This topic is important for nursing managers and healthcare administrators. These individuals serve as the ultimate organizational heads that help in defining organizational wellbeing.
Making connections
How is what I am reading different from what I already know? Why might this difference exist?
I just discovered that all great world leaders start off as adaptive individuals. This aspect serves as a new lesson because I have always thought that their current styles were present even before the inception of their successful businesses.
What new ideas are here for me to consider? Why am I willing or not willing to consider them?
I also find it rather strange that both managers and leaders in Kenagy’s case share traits. Some of the traits include people-centered development, sense of direction, and trust in development. I am willing to accept these new ideas because, eventually, they are useful in sharing ideas and inspiring change (Kenagy 129-131).
Interpretation of evidence
What inferences can I make from the evidence given in the assigned chapter(s)?
Leadership plays a vital role in helping to drive the adaptive design tool. Also, almost all great leaders start off as adaptive before selecting a clear leadership style. This finding implies that the adaptive design best serves as the benchmark for success.
What relevant evidence or examples does the author give to support his or her justification?
Kenagy uses examples from renowned leaders such as Bill Gates, Herb Keller, and Taichi Ohno. Keller, for instance, focused on the creation of a low cost airline to help ease the resources used to travel across America. Just like these leaders, nursing managers should focus on the ideal patient care as their meaningful direction in practice (129).
Challenging assumptions
What kind of assumptions is the author making? Do you share these assumptions?
First, the direction for nursing managers and the entire organization is toward ideal service delivery. Second, the organization depends on tested, improvable, and validated ways of changing. Third, the senior management supports order, clarity, and consistency (154).
I share the first assumption. However, the other two are wrong because they challenge complex and unpredictability nature of health facilities. Thus, we may not know what kind of leadership fits into the numerous types of systems and organizations existing across the country.
What information builds my confidence in the author’s expertise?
The use of great and dependable leaders as well as a constant review of earlier chapters shows consistency and invites a credibility mark.
If the opportunity arose, what questions would I pose to the author?
Do members of the public understand the research goals of a leader following the adaptive design?
What would you say is the relationship between this process and changes in attitude towards the leaders and their adaptively managed organization?
Making application
What advice could I add to this reading selection? On what basis do I give this advice?
The organizational head is always the right person to implement this plan and lead change. I base this advice on the fact that success is most likely achievable only when the leader is willing to accept adaptive design as a change management tool.
Looking toward where I want to be in two years, what suggestions from the reading make the most sense to me?
This article implies that learning by doing can help nurses in their advocacy roles with patients and policy makers. It shows that adaptive design is one of the most appropriate processes for reaching clear decisions. Two years from now, I should be ready to make such change-oriented decisions for the uttermost benefit of my patients.
What would you point out as important about this topic to others who either question or disagree with my point of view?
Leadership under adaptive design implies a focus on corrections to optimize organizational processes. Given this design, process monitoring offers data and data excite learning. It is this learning that makes organizations effective in producing the desired outcomes.
Works Cited
Kenagy, John. W. Designed to Adapt: Leading Healthcare in Challenging Times. Bozeman, MT: Second River Healthcare Press, 2009. Print.
