Chaos, Complexity and Leadership in Public Health Systems
Terms such as “chaos” and “complexity” have deep roots in the science of complex adaptive systems, and the recent string of large-scale, catastrophic events have made these concepts disturbingly immediate for most people. In public health organizations, most of your colleagues likely have an innate sense of the larger system that both defines their daily job responsibilities, and the individual and organizational relationships across the public health system. While political stakeholders compel us to maintain “stability” at all costs, effectively dealing with change in light of emerging threats and larger-scale chaotic events is critical.
Crisis events and chaotic situations, from localized political conflicts to natural disasters, require that leaders be credible, and able to command the appropriate level of response to a crisis. This recognizes the nature of crisis as a set of interrelated problems (See Ian Mitroff, PhD). Conceptually related to the ecosocial model of public health, understanding that most problems are part of a larger mess can lead to more effective identification of strategy.
In the recently released second edition of the text, “Public Health Leadership: Putting Principles into Practice,” Dr. Louis Rowitz describes the term “meta leadership” as a methodology for working across organizational boundaries, requiring a systems perspective so that the leader can both promote positive change in the larger system, and serve the interests of the organization and its stakeholders. This implies that leaders need to develop skills for both working within and across organizational boundaries, and to appropriately apply these skills when dealing with crisis events. An article by Henderson, Dorn and Marcus, “Meta Leadership and National Emergency Preparedness,” provides a framework for understanding the leadership implications of large-scale emergencies. An often overlooked component for public health practitioners, whether in routine practice or during a chaotic event, concerns the political component of any crisis. As a problem escalates in its complexity, it inevitably becomes important to external political stakeholders of the organization. The meta leadership framework provides an understanding of the interaction between individual-level emotional intelligence (or lack thereof), organizational effectiveness, and system-wide response. Although many public health practitioners, highly trained in a specialty scientific discipline, tend to resist the political aspects of routine and crisis problem solving, developing these skill would undoubtedly make for more effective implementation of strategy.
The major crises of the last eight years provide many reasons to be pessimistic about the current state of national leadership, and there are as many examples at the state and local level to support a cynical outlook. Despite these seemingly unsurmountable barriers, the ability to overcome our natural inclinations towards judgment, cynicism and fear will help us to become better leaders- and to demand the same in those that would place themselves in such a position.
