Reflective Practices: Rethinking Leadership to Improve Global Quality Healthcare

Continuing issues of global healthcare quality in nearly every country continue to confound efforts for safe high quality patient outcomes. Progress is slow despite concentrated efforts, in part because efforts are not coordinated but often in isolated projects. Achieving global health quality requires investment in reflective practices using systems thinking skills while activating polarity and paradoxical leadership strategies that enable leaders to connect, collaborate and catalyze to rethink nursing care quality. To improve global healthcare quality we need leaders who move beyond traditional leadership to balance evidence and innovation to catalyze a new workforce of collaborative teams. Across the three presentations we will describe reflective practices as evidence based improvement strategies both for individuals and applied to learning organizations focused on systems design.

Healthcare systems sometimes appear to be volatile, uncertain, and complex yet we know that achieving healthcare quality depends on creating high reliability organizations. To move towards reliability in healthcare requires leaders who can think and manage systems. The need for new models of leadership are increasingly evident as nursing curricula and practice setting look for ways to foster cultures of quality and safety. Nurses are at the front lines of these efforts, as the information nurses have from their care giving and leadership roles are key to the ability to connect, collaborate and catalyze systems improvement.

Nurses, like most healthcare providers have typically worked in silos, rather than through connections with other members of the healthcare team. We will begin the session with a group activity that requires working together to achieve agoal: building a tower with materials provided. As we debrief the activity we will move into discussion of the role of leadership in improving healthcare quality, particularly focused on the necessity for system thinking and collaborating in teams across the healthcare system.

Reflective practice is an evidence based approach for examining one’s own leadership and contributions to increase self-awareness, consider our impact on others, and expand horizons to consider the context of environmental factors. Reflective practice, then helps promote emotional intelligence and can help propel us towards the next steps of change and growth. As an essential tool for lifelong learning, reflective practice is the foundation for innovative leadership models that will be described and practiced in sessions 2 and 3 of the symposium.

To alleviate preventable harm across our countries, several recommendations are called for. First is to transform leadership education to focus on preparing leaders from a systems thinking perspective across all education levels. While we have embedded the need for evidence based practices as an essential aspect of quality improvement, evidence must be balanced with an appreciation for innovation to catalyze the workforce to move outside silos to practice and lead team based care, build reflective organizations focused on learning, and develop models for connecting, collaborating and mobilizing to catalyze change. We will end this first session by examining a brief case study to help participants identify and discuss the major points of the presentation.