Outcomes of Complexity Leadership

By Beth Boynton

The butterfly effect is a property of Complex Adaptive Systems and refers to a small thing happening in one place, like a butterfly flapping it’s wings, contributing to a large thing happening someplace far away, like a hurricane on the opposite side of the world.

There are all sorts of communication-related skills that contribute to positive or adverse events in healthcare that can be explained at least in part by this property.

How We Interact Matters

Human Factors, Leadership, and Communication involve human interactions.  They are also long-standing root causes of sentinel events.

As these examples illustrate, respectful and effective communication contribute to desirable or adverse outcomes.

• A nurse overhears a colleague talking about her in a negative way and interrupts the conversation.  “I’d appreciate it if you have concerns about my work that you discuss them with me directly and professionally.”  The gossiping nurse apologized and later offered to help the nurse.  The help enabled the nurse to get her pain medication to her post-op patient quickly and the patient and his wife felt cared for.  The patient experience scores increase.

• A doctor yells at a nurse on Tuesday.  Saturday she hesitates to call her to report a subtle change in a patient’s condition and since it is close to the end of the shift, reports her concern to the oncoming nurse.  The oncoming nurse, makes it a priority to check this patient, but the telemetry alarm beats him to it.  The patient does not survive.

The concept can be elusive, yet understanding the connection between soft skills and outcomes is an important aspect of leadership in complex human systems such as healthcare. In short,  leaders who build trust and promote positive communication and respectful behavior will be empowering staff to be their best selves.

Individuals then bring their best selves into therapeutic and inter-professional relationships including teamwork and leadership. All of which who in turn will influence the culture in the most positive ways. 

Everyday healthcare professionals are presented with opportunities speak up, listen, lead, follow, delegate, set limits, honor others’ boundaries,  give and receive constructive feedback.  All of which, for better or worse are influencing outcomes such as patient safety, patient experience, and workforce health.
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As a leader, influencing the butterfly effect in a direction of positive outcomes requires providing effective communication training, clear expectations and modeling of behavior,  and ensuring a supportive culture where these skills can be practiced.

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