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Hats and handoffs

The 21C Leader plays several roles simultaneously. It’s a job that involves the whole person. It’s a role most corporations need to fill.

Organizations can no longer afford to restrict making strategy to those in the corner offices. Nor can they artificially separate management from leadership. Nor can they act as if “sole contributors” don’t manage resources to get the work done.

In a turbulent organization buffeted by change, everyone must understand and own the strategy at a gut level, marshall resources, and take action to get the job done. That’s the shift from organizations modeled on machines, where people are interchangeable cogs, to organizations as networked organisms, where everyone is connected to the whole.

Handoffs

Four days ago, an article in the New York Times described how many first-year medical residents are no longer required to work 30-hour shifts. A small, controlled study had compared doctors working 16-hour shifts to doctors working 30-hour shifts. “Interns working the traditional 30-hour shifts made 36 percent more serious medical errors, including ordering drug overdoses, missing a diagnosis of Lyme disease, trying to drain fluid from the wrong lung and administering drugs known to provoke an allergy.”

So far, so good. Less sleep deprivation, better medicine. But when 16-hour shifts started to become the norm, error rates did not go down. “The fact that the policy appeared to have no impact on safety is disappointing,” said David Bates, a professor at the Harvard School of Public Health and a national authority on medical errors.

A plausible explanation points to other factors at work. Shorter shifts means more handoffs. How adept are residents at briefing their peers on patient status? Not very, it turns out. Generally, there’s no structured procedure for handoffs. Interruptions are common. Important information is not passed along. Medical schools offer no training in making good handoffs. The residents were playing the child’s game of telephone, garbling the message as they talked.

The Air Sandwich

In The New How, Nilofer Merchant describes the Air Sandwich, “the empty void in an organization between the high-level strategy conjured up in the stratosphere and the realization of that strategy down on the ground.”

Nilofer says the Air Sandwich is “a symptom of the flawed legacy system of setting direction that may have worked ages ago, but doesn’t any more.”

We need a new system. We need a practical approach that demands that everyone be able to contribute, and let us gather insight from anywhere in the organization. We need an approach that allows us to make decisions that align with the vision, collectively debate, and gather more reliable and insightful information. We need an approach that helps us to use conflict and tension to motivate the creative process, identify the things that matter, and still drie alignment and resolution. And, given the nature of our times, we nee a n approach that lets us move faster, not slower, more practically than theoretically–and it sure better help us tap into the power of the people in our organizations.

We need 21C Leaders because we can no longer afford a diet of air sandwiches and their outcomes of sloppy handoffs.

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