Unsolvable Probems in Healthcare: An Introduction to Polarities

Sunday, 28 July 2019: 8:00 AM

Luanne M. Shaw, DNP, MA (Interdisciplinary), RN, CEN
Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA

Purpose: This session will provide participants with an introduction to polarities, the recurring unsolvable problems experienced by healthcare teams. Often times, leadership and educational teams get stuck around issues, which creep into discussions repeatedly over time. These issues tend to polarize team members, leaving leaders seemingly left with an either/or answer, alienating some members and affecting the optimum function and performance of individual team members. Each side or pole of the issue has merit, or an upside, but how can leaders and teams achieve the greater purpose that neither side can reach alone (The Bonnie Wesorick Center for Health Care Transformation, 2017)?

Methods: This session will define the difference between problems to solve and polarities to manage. Arnold (2017) describes this concept of polarization as a “healthy tension,” which when effectively managed, can be a positive tool to move past ongoing, unsolvable problems. This concept may also be known as a dilemma, paradox or wicked problem. Wesorick (2016) calls polarity thinking “the missing link or logic, ” which she described in her struggle to understand why so many issues reoccur in health care despite numerous paradigm shifts, intelligent and capable thinkers, and advances in research and technology. Change efforts which attempt to “fix” problems in health care, such as cost and quality, have not been able to produce sustainable gains (Wesorick & Shaha, 2015).

Results: Polarities help us see the big picture, or whole of reality, each pole of an issue together produces something more complete (Wesorick, 2016). It does not have to be an either/or choice sometimes, rather it can be a both/and pursuit of improving the situation, moving towards sustainable improvements.

Conclusion: Health care problems are complex, especially when considering issues such as individual performance and team performance, patient satisfaction and staff satisfaction, mission and margin; These are not simple problems that can be fixed with a single solution. Understanding the nature of polarities may help healthcare teams and practitioners improve practice outcomes.