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Approach to Problem Solving

Approach to problem solving and decision making at Maple City Health Care Center

The purpose of this approach is to model and foster leadership and decision making at Maple City Health Care Center that builds on our values and furthers our mission. Underlying commitments

Mission

The purpose of Maple City Health Care Center is to foster healthy community in our neighborhoods by providing and promoting affordable, accessible, and integrated quality care, and to articulate and promote our experience as a sustainable model.

Values

  1. Long-term relationships
  2. Integration
  3. Empowerment

Agreements

  1. We honor the trust we place in each other when we share together.
  2. We listen with compassion and curiosity and we suspend judgment.
  3. We speak for ourselves with intention, focusing on our shared mission.
  4. We ask for what we need and offer what we can.
  5. From time to time we may take a pause. (This can help us mark a time of emotion, regather our thoughts or our focus, or simply acknowledge that we are uncertain how to proceed.)

In addition, this policy builds on the observation that helping people do effective collaborative work generally requires:

  1. establishing and communicating clear expectations,
  2. offering and using the tools that can sustain the work, and
  3. creating structures and practices of accountability for the work.

Establishing and communicating clear expectations

Making effective, mission-driven, values-based decisions in a context that values consensus and collaboration requires that we use our resources (time, material, skills, energy, attention, relationships, trust) with care, that we not squander them in ineffective and inefficient processes. This will be easier if we follow these principles of efficiency:

  1. We develop a clear shared articulation of the problem or issue before moving to discussions of possible solutions.
  2. We draw on the variety of stakeholder perspectives at points throughout the process.
  3. We use our mission and values as the interpretive framework for identifying the problem and assessing potential solutions.
  4. We do not entertain solutions whose complexity exceeds the complexity of the problem.
  5. Hearing and understanding each other’s stories builds trust, and enhances the quality and efficiency of shared decision-making.

Additional observations

  1. Clarity about the definition of the issue at hand should also lead to clarity about roles: who is taking the lead in the process, who needs to approve, who needs to be consulted, and who needs to be informed? As solutions are contemplated, additional people may need to be brought into the process, and their roles will need to be clarified.
  2. When the framework and the values guiding a solution are clear, we may decide to delegate the drafting of a proposal to one person or a small group. Drafting proposals by committee is often tedious and may lead to inelegant results.
  3. Proposed solutions need to be tested with all those affected before we proceed to implementation.
  4. Implementation requires reevaluation and a willingness to reengage in further change.

Problems of various kinds and complexities may require different processes within the framework outlined above. The strategies described below share these principles, and seek to guide decision making in differing ways, based on the perception of the complexity and type of issues at stake, and the ease of achieving consensus.

In general,

  1. To solve a problem that involves conflict at the level of our values, we will gather all the people who are affected and want to participate.
  2. To solve a problem that is relatively complex (but not at the level of values conflict), we will gather people representing the various parts of the organization and the various processes affected.
  3. To solve a relatively simple problem, we may delegate the process to one person or a few people who are close to the issue and display the necessary capacities for framing the problem and envisioning a solution.

Detailed Outline of Option #1 - Conflict at the level of values

When a problem revolves mostly around issues of clarifying the values that guide us, the process will likely need to involve everyone concerned from the beginning. Finding solutions to these matters cannot easily be delegated. For such decision making to be effective, those involved will ask enough questions to ensure that they understand what is at stake. They will formulate the problem in terms of the mission and the values. They will exercise imagination in arriving at possible solutions. They will evaluate the possibilities in terms of how well they fit with our values and carry out our mission. Along the way, parts of this process may be delegated to a few people who are accountable to the group.

Steps to this process:

  1. Clarify who is participating: Are all the people who need to be here at the table?
  2. Clarify the problem: Do we have consensus around an articulation of the problem in terms of our mission and values?
  3. Repeat steps 1. and 2. until the answer to both is yes.
  4. Clarify roles: Who leads the process? Who needs to approve? Who needs to be consulted? Who needs to be informed?
  5. Make the process accountable to the organization as a whole. Report the process to the administrative team. The designated team member will post it as a decision-making process in the tracking tool, making it available to all staff. (Access to certain decision-making processes—for example, those dealing with personnel issues—may be restricted.) The administrative team will also help ensure that those leading the process have access to coaching and other resources.
  6. Evaluate the problem in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment?
  7. Brainstorm about possible solutions. Anything honoring our mission is considered. We don’t engage in rebuttals or critiques, but instead each option is expanded, making it the best it can be. We discuss dispassionately the possible outcomes, positive and negative, of each option.
  8. Evaluate potential solutions in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment? Narrow your options to a few.
  9. Develop a proposal.
  10. Re-evaluate who is participating: Are there people who need to be at the table who are not present? Draw them in and be prepared to go back as far as you need to in order to allow them to be part of the process.
  11. Make the process accountable to the organization as a whole. Report back to the administrative team. The administrative team will monitor the re-evaluation timeline.
  12. Implement the solution.
  13. Continue re-evaluating and tweaking.

Detailed Outline of Option #2 - Complex problem, but not at the level of values

If a problem is complex but is limited to how we organize our work (that is, not about a conflict at the level of our values), we will not usually gather everyone involved and interested but will delegate responsibility for problem solving to a smaller group of those who represent the parts of our organization affected by the problem. They will talk with their coworkers enough to ensure that the problem-solving group has a full understanding of what is at stake. They will formulate the problem in terms of our mission and values. They will exercise imagination in coming up with possible solutions. They will evaluate the possibilities in terms of how they fit with our values and carry out our mission. And they will hold their proposals lightly until they are fully tested by those affected. Those developing a proposal understand that they are working in the service of the larger group of those affected. They are not exercising power over others, nor are they fixing things for others. The goal is not to please everyone but to arrive at decisions we can own because they align with our values and serve our mission. Parts of this process may be delegated to individuals or smaller groups. This process takes some shortcuts that may expedite finding a solution, but it is essential that proposals be held lightly and tested diligently. (Along the way it may become apparent that what is at stake is at the level of values, in which case the group will need to be broadened and roles redefined.)

Summary of this process:

  1. Clarify who is participating: Do we have people at the table who represent all the perspectives that need to be taken into account?
  2. Clarify the problem: Do we have consensus around an articulation of the problem in terms of the mission and values?
  3. Repeat steps 2. and 3. until the answer to both is yes.
  4. Clarify roles: Who leads the process? Who needs to approve? Who needs to be consulted? Who needs to be informed?
  5. Make the process accountable to the organization as a whole. Report the process to the administrative team. The designated team member will post it as a decision-making process in the tracking tool, making it available to all staff. (Access to certain decision-making processes—for example, those dealing with personnel issues—may be restricted.) The administrative team will also help ensure that those leading the process have access to coaching and other resources.
  6. Evaluate the problem in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment?
  7. Brainstorm about possible solutions. Anything honoring our mission is considered. We don’t engage in rebuttals or critiques, but instead each option is expanded, making it the best it can be. We discuss dispassionately the possible outcomes, positive and negative, of each option.
  8. Evaluate potential solutions in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment? Narrow the options to a few.
  9. Develop a proposal. Hold it lightly.
  10. Re-evaluate who is participating: Are there people who need to be at the table who are not? Draw them in and be prepared to go back as far as necessary in order to include them in the process.
  11. Make the process accountable to the organization as a whole. Report back to the administrative team. The administrative team will monitor the re-evaluation timeline.
  12. Test the proposal with all people who may have a stake. Evaluate any resistance; be prepared to go back as far as necessary.
  13. Implement.
  14. Continue re-evaluating and tweaking.

Detailed Outline of Option #3 - Relatively simple problems

If a problem seems simple—to involve relatively few issues that are principally matters of how to get work organized effectively—the process will often be best served by delegating to one or two people the task of coming up with a proposal for testing. They will talk with their coworkers enough to ensure that the problem-solving group has a full understanding of what is at stake. They will formulate the problem in terms of our mission and values. They will exercise imagination in arriving at possible solutions. They will evaluate the possibilities in terms of how well they fit with our values and carry out our mission. And they will hold their proposals lightly until they are fully tested by those affected. Those developing a proposal understand that they are working in the service of the larger group of those affected. They are not exercising power over others, nor are they fixing things for others. The goal is not to please everyone but to arrive at decisions we can own because they align with our values and serve our mission. Parts of this process may delegated to individuals or smaller groups. This process takes some shortcuts that may expedite the problem solving, but it is essential that proposals be held lightly and tested diligently. (Along the way it may become apparent that what is at stake is a more complex problem, or even one at the level of values, in which case the group will need to be broadened and roles redefined.)

Summary of this process:

  1. Clarify perspectives: Do we understand all the perspectives that need to be taken into account?
  2. Clarify the problem: Do we have a clear articulation of the problem in terms of the mission and values?
  3. Repeat steps 1. and 2. until the answer to both is yes.
  4. Clarify roles: Who leads the process? Who needs to approve? Who needs to be consulted? Who needs to be informed?
  5. Evaluate the problem in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment?
  6. Brainstorm about possible solutions. Anything honoring our mission is considered. We don’t engage in rebuttals or critiques, but instead each option is expanded, making it the best it can be. We discuss dispassionately the possible outcomes, positive and negative, of each option.
  7. Evaluate potential solutions in terms of the values: What contributes to or detracts from long-term relationships? integration? empowerment? Narrow your options to a few.
  8. Develop a proposal. Hold it lightly.
  9. Re-evaluate: Are there other perspectives that need to be taken into account? Bring them in and be prepared to go back as far as necessary in order to include them in the process.
  10. Make the process accountable to the organization as a whole. Report back to the administrative team. The administrative team will monitor the re-evaluation timeline.
  11. Test the proposal with all people who may have a stake. Evaluate any resistance; be prepared to go back as far as necessary.
  12. Implement.
  13. Continue re-evaluating and tweaking.

Tools to help leadership foster this model of decision making

Collaborative decision making is counter-cultural in our society. We have more experience with autocratic leadership, and with leaders who try to fix things for others. Implementing this model of decision making will require that we keep growing in sensitivity and skill; it will take time to develop the necessary habits and practices, but the process will shape us as individuals and transform our organization in ways that bring greater alignment with our values. It will also allow decision-making processes to emerge throughout the organization, not just from designated leaders. Some peer coaching will be indispensable in this learning process.

Reflections on resistance

In providing leadership, whenever we encounter resistance we have more work to do. How we experience resistance can help us decide where to focus.

When resistance takes the form of raising issues and concerns that we neglected to take into account in the process or the proposed solution,

  1. it suggests that we have not adequately listened to all the perspectives that need to considered. If this is the case, go back as far as necessary to create a more inclusive process.

  2. Or perhaps those providing leadership may not have the gifts or skills needed to address the problem. If this is the case, get coaching or let someone else do the job.

  3. Or the problem is sufficiently complex that a more inclusive process is needed. If this is the case, go back as far as necessary to create a more inclusive process. When resistance seems out of proportion or unconnected to the articulated issues, perhaps there is more going on than meets the eye.

  4. Are cross-cultural dynamics confusing the process? Try listening with imagination and in an effort to identify and relativize your cultural preconceptions. Consider getting coaching from somebody attuned to these dynamics.

  5. Are personal issues or resistance to change showing themselves as sabotage? Are discussions about the matter occurring in contexts that do not contribute to problem solving? The possibility of dismissing substantive concerns as sabotage and attributable to others’ problems is dangerous. When considering this, get a coach not directly involved in the process to test leadership impulses. Consider how your reactivity may be contributing to the sabotage. Consider one-on-one clarification with the resisting party or parties so that if dysfunctional personal dynamics are at play they can be dealt with in a way that does not make them the problem of the whole group. Get help early.

In a leadership role, when you find yourself feeling like a victim, or being resentful, consider the possibility that you are over-functioning. Are you trying to fix things for others instead of empowering them? When you find yourself in a fix-it rather than a problem-solving mode, consider focusing more on the process instead of the content, and involve others in defining the problem and solving it.

When in a leadership role you find yourself getting anxious, reflect on what that anxiety is telling you about your role and your engagement Pay attention to it—but as information that can inform your response, not as something driving you to react.

We need to set up a system for peer coaching to help each other reflect on the processes we are trying to model and teach, and more fully live out the commitments we share.

Creating structures and practices that support effective leading

For leaders to function sanely and effectively, the responsibility they carry needs to be matched by authority to carry out their duties, in the context of appropriate accountability. Leadership that exercises authority in the absence of a commensurate level of responsibility becomes autocratic and self-serving. Leaders who feel responsible to fulfill duties without being given authority adequate to see that those responsibilities are met tend to overfunction, become frustrated and resentful, and eventually burn out. Adequate provision for structures of accountability creates conditions in which people exercise authority transparently and follow through on commitments, with the result that trust (in their leadership and throughout the organization) grows. For this decision-making process to work well, we need to maintain structures and processes that are clear about roles (in terms of authority and responsibility) and that make us accountable for how we are working as leaders.

A key role of leadership in decision making is evaluating changes we propose and initiate in terms of how they serve our mission and mesh with our values. We also seek to model transparency and graciousness with each other about how we are moving through processes of decision making, so that we can learn from our failures as well as our successes and keep growing, personally and organizationally. In the context of healthy relationships, with clear expectations and good coaching, we can do this integrative work with imagination, courage, and joy.

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