Tuesday, March 8, 2016

A632.8.3.RB_PALUGODCAROLYN



Problem solving within multiple contexts requires good critical thinking skills and good perspective.  To be able to move between a simple, complex, complicated and chaotic context takes skill and good-decision making skills. “Effective leaders learn to shift their decision-making styles to match changing business environments” (Snowden & Boone, 2007).   

 One great example of moving and responding within multiple contexts is when I worked for a nonprofit called International Hospital for Children.  Those of us working on these medical missions, found ourselves bouncing around in different contexts, depending on the situation.  First there was the simple context.  This was the routine interviews with  patients and their families, collecting information and categorizing each child depending on their degree of severity.  This is how we decided who got surgery now and who had to wait until our next mission.  Once all the data was collected we moved into the complicated context.  The data needed to be analyzed.  Here is where the expertise of the surgeons and nurses came in.  There were several options and surgeries available.  Based on the interviews and data we decided what kind of surgery, when and what resources were needed.  The situation many times slipped into the complex context.  Children with multiple problems, or serious illnesses or unidentifiable symptoms required further analysis and interpretation.  Their health history was probed, backgrounds were researched and other entities needed to be brought into the decision-making process such as our partnering clinic, government officials and sometimes even other specialist.  All parties needed to communicate well and a well thought out response to the issue needed to be made.  When surgeries went bad or there were complications, the situation could go from complex or complicated to chaotic.  This was the “life or death” decision-making process that needed to be made in the moment and with a top-down control.  Our surgeons being the ones with the expertise in these situations had the last say and the rest of us just followed suit.

When looking back at this experience, I can see how we reached a decision in each context.  During the initial assessment of the patients, it was easy to make decisions since everything was based on straight-forward medical records and data.  When it came time to choose the best candidates for surgery, the complicated context, we used a general assessment process based on a list of questions and standard criteria for each type of surgery.  When and if there were complications during the surgery, the complex context, our surgeons had to become creative.  For example, prior to a brain surgery, the electric drill they were using stopped working, we had limited resources, so we sent someone out to secure an orthodontist hand drill that could drill through bone and the surgeons were able to conduct the surgery.  They needed to use their creative skills.  Lastly, when the situation went chaotic, we had to consider the fastest course of action which was to leave it to the experts, our surgeons.  They had to make decisions on the spot without consulting anyone and only basing it on their life experiences and training.

I feel that the Cynefin Framework provides an improved context for decision-making because it provides guidelines and boundaries for different situations.  First, knowing which context you are in will also alert you to the danger signs attributed to that context.  Second, we have some clear guidelines on how to respond depending on the context.  Third, seeing problems through the Cynefin Framework provides a better visual of the problem at hand and how it can deescalate or escalate, allowing us to prepare for change.  Fourth, the framework provides structure to the decision-making process which can assist in situations of doubt. Lastly, the framework is a reminder of how easily things can spiral out of control and how we need to be prepared for anything.  We cannot remain complacent because we live in an ever changing dynamic environment. As Snowden and Boone tell us "good leadership is not a one-size-fits-all proposition" (Snowden & Boone, 2007).

References

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