Can Public Agencies be Learning Organizations?

Since the publication of Peter Senge’s book, The Fifth Discipline, organizations of all kinds have learned to value systems thinking as a key discipline of success and performance. To create a “learning organization,” leaders must inspire a shared vision, be dedicated to personal mastery (and develop others), promote team learning, and appreciate that each individual has a unique perspective on an issue or problem. At the core of the learning process is reflection-the time to think and discuss issues, and using a shared understanding of the broader system, look for new ways to act. Is this possible in the public health system? There are many examples of innovation in public sector agencies, but the challenges are significant. One of the most frequently cited is “I don’t have time to reflect.” This can also be heard in similar statements, such as “I don’t have time for training.” The pressure of shrinking budgets and doing-more-with-less has lead to a situation where reflection and learning is a luxury that few can afford. But if we don’t take the time (take our time back), we may end up wasting time in the long run by repeating our mistakes. Another way this occurs is when people reject any attempt to understand complexity. Being too busy, or too focused on short-term, bottom line processes, some are simply unprepared to consider mulitple perspectives or define problems as multi-causal. If you ask questions to understand how they see the system (and what change they believe it requires- their “theory of change”), you likely will be met with a blank stare, or marginalized in the organization. The social and environmental forces that make people sick (and some people sicker than others) are complex and multi-causal. To redefine them as anything less, while denying time to public health agencies to become learning organizations, is a design for failure. While I don’t share Senge’s optimism about the altruistic potential of corporate institutions, he does make a compelling case for broader action and leadership in his recent book, The Necessary Revolution. Applied to public health leadership, the lesson here is that our leadership must extend beyond the boundaries of any single organization. We need to understand how problems of population health are connected to the economic system. And we must reclaim our time so that we might find a path forward, and maybe learn in the process.