Strengthening African health systems through outreach and support and values-driven leadership.

Louis S Jenkins,Zilla North,Gideon Van Tonder,Klaus B Von Pressentin

doi:10.4102/phcfm.v13i1.3043

Abstract

Healthcare systems are complex adaptive systems, requiring a change in leadership style, from the traditional model to collaborative, values-driven leadership (VDL). Family physicians are well positioned to facilitate integration and coordination between levels of care, across specialties and within teams, in partnership with local and district management team members. This short report describes a leadership innovation experience in a rural South African district, where a VDL course was introduced in a district health context to build on a strong tradition of relationship-centred outreach and support aimed at creating a learning health system. The authors reflect on the contribution of family physicians to strengthen team-based capacity building, care coordination and a learning culture aimed at quality improvement from the perspectives of the regional and district hospital environments. A values-based leadership style will enable family physicians to strengthen team-relationships and create organisational environments, which support shared learning and quality improvement approaches. Ultimately this approach should lead to improved health systems.

Highlights

Healthcare organisations have been recognised as complex adaptive systems where traditional leadership models of command and control thinking have shifted towards a collaborative approach.[1]
Through the values-driven leadership (VDL) programme family medicine (FM) is playing an active role to help create a culture of learning and reflection in the health system
It is within these roles of the Family physicians (FPs) where good communication skills and collaborative teamwork within the complexity of the health system create a different experience of patient care, which reflects in patient satisfaction and community trust in the health service

Summary

Introduction

Healthcare organisations have been recognised as complex adaptive systems where traditional leadership models of command and control thinking have shifted towards a collaborative approach.[1]. The workshop facilitators and fellow attendees, as well as the VDL template, allowed me to explore the dilemma and unlock the situation, by rescripting my response to the dilemma (e.g. by acknowledging that I as the family physician am not solely responsible for creating a structured learning environment, and that I should allow the clinical team to share this responsibility) This ‘rescripting’ approach was useful to develop a fresh approach to the dilemma. Research, measuring the impact of the VDL initiative is ongoing, with initial results 1 year later showing the value of understanding the ‘me-we-all of us’ perspective.[7,12] In other words, participants began to understand how individual actions are determined by underlying values and how these values drive professional practice within their team and influence the health system This happened through processes of active, respectful listening and relationship building. Box 1 provides an example of a weekend workshop participant’s reflection

Findings

Discussion

Conclusion