Description/Overview: The Adaptive Leadership (AL) framework supports nurses and managers’ ability to mobilize patients/families and staff to confront, adapt, and thrive, when facing difficult challenges of chronic illness and care systems. AL can be applied at the individual or group level and thus can address the need for leadership at the point-of-care and care-system levels. In chronic illness, AL is a perspective for studying trajectories of symptoms and developing better tools for patient-centered care. Patient-centered care aims to give patients a voice in care decisions, shaped by their preferences and values. However, discussions of patient-centered care rarely extend the work that occurs after treatment decisions are set and how to keep patients/families at the center, and help them to develop capacity to adapt to difficult challenges and new behaviors needed to manage their health situation over the illness trajectory. The AL framework guides researchers to develop the evidence base for extending patient-centered care through and beyond treatment decisions. Similarly, at the care-system level, managers who give directions and expect them to be followed will not develop a workforce capable of meeting the multi-dimensional care needs of patients with chronic illnesses. The AL helps to reframe leading as a verb which allows leadership to spring up where it is needed at all care-system levels. We will describe AL and our model which applies AL to chronic illness and care systems. Two papers will report finding of studies using AL; a study of self-management of patients undergoing treatment for chronic hepatitis C and a study of culture change in nursing homes. This AL perspective calls for methods in trajectory science that can help us understanding how patients/families/organizational navigate through disequilibrium, confront challenges, engage in problem-defining and problem-solving work, and share responsibility for their future. Thus, third paper will address these methods.

Learner Objective #1: Use the Adaptive Leadership framework to conceptualize studies of trajectories of chronic illness and care systems

Learner Objective #2: Develop familiarity with a range of trajectory design methods used to study health challenges of patient/families/and providers