Shifting competition to common intention

I have just returned from a three-day workshop with the management teams of five hospitals and other key players in the health system of a large region in Denmark.

The objective was to transform their institutional relationships from their current state (characterized by competition + conflict) to a more co-creative state (of compassion + common intention) that puts the patients in the region first..

Our journey went through several stages. First, all of the participants conducted extensive stakeholder dialogue interviews across the entire region before the workshop that we discussed and reflected on early in the workshop. Then we created a “current reality movie” through role playing (stepping into the shoes of other stakeholders). Later on that day we used Social Presencing Theatre to map both current reality and the emerging future. Current reality featured a largely system-centric structure that was transformed into an emerging future featuring a patient/family/citizen-centric structure.
We spent the remainder of the workshop identifying and exploring the opening of “cracks” that would allow these leaders to move the system from its current reality into a better future.

Something shifted in the collective field of the group when, on the last day, these institutional leaders reflected on their progress. One head of a hospital said to the head of another hospital, with whom they had been in a multi-year structural conflict: “It never occurred to me that I have never asked you ‘How can I help you?’” In the stillness after that sentence I could feel a quiet shift of the heart – theirs and mine.

This group was very serious about putting the well-being of the whole community first and each of their institutional ego-interests second. That is easily said but rarely happens. It’s hard work. They say they succeeded because of the process we went through together in the workshop. But I believe that the Scandinavian culture has something to do with it too. Together with Singapore, Scandinavia has the world’s best system of public administration (schools, health care, government efficiency, absence of corruption).

Why? What’s different there? Well, I think I saw some of their positive qualities in the workshop: they are compassionate with each other, passionate about the well-being of the whole, and willing to relinquish some of their own institutional ego. Two significant turning points that allowed that shift to happen were the sensing interviews and the Social Presencing Theatre exercises – in other words, the left-hand side of the U. On the right-hand side (intuition to action) we used the case clinics as a very helpful tool.

When the participants described their vision for the future, they suggested that instead of all the mechanical productivity measures that today drive health care delivery, the health care system should be driven by direct qualitative feedback from the patients. That’s exactly what Bhutan does in measuring gross national happiness (GNH): it has developed measures that reflect the quality of its citizens’ experience. Reconnecting our systems to the lived experience of its citizens would be a major shift in how we run our key institutions in society today.

Where have you seen examples of that—and what can be learned from it?

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