1. Leader as Change Agent in a Time of Complexity
NURS 560 Fall 2015
Dr. Mileva Saulo Lewis
Professor Emerita
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2. At the completion of this session, learners will be able to:
Compare and contrast theories of change
Differentiate among models as appropriate for health behavior change and organizational change
Analyze a situation for readiness to change

3. Samuel Merritt University, School of Nursing
Dr. Lewis All rights reserved
NURS 560 FA 2015 Dr. Mileva Saulo Lewis All rights reserved.

4. “You can’t solve a problem from the same level of
consciousness that created it.” Albert Einstein
Courtesy Dr. Phyllis Kritek
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5. Martha Rogers, PhD, RN Science of Unitary Beings New York University 1967
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6. Thomas Kuhn Paradigm Shift
From Newtonian Physics – linear, predictable
Quantum Physics – interrelatedness, action/reaction, constant movement
Kuhn, T.S. (1962). The structure of scientific revolutions. (2nd ed.). Chicago: The University of Chicago Press.

7. Science of Unitary Human Beings Chinn, P. L. & Jacobs, M. K. (1987)
Science of Unitary Human Beings Chinn, P. L. & Jacobs, M.K. (1987). Theory and nursing: a systematic approach. St. Louis, MO: Mosby.
Individual
Nursing
Society
Environment
“Man” is an energy field
Endless boundaries
Characterized by:
Unified wholeness
Openness
Unidirectionality
Pattern and organization
Sentience
Science of humanity
Synergistic wholeness
Life processes are the core of nursing
Principles of homeodynamics:
Reciprocity
Synchrony
Helicy
Resonancy
Environment and man are energy fields coexisting with the environment

8. Dr. Mileva Saulo Lewis, All rights reserved

9. Complexity Science
Paradigm shift from mechanistic dualism to quantum physics
Cause and effect only is an incomplete theory
Quantum physics – subatomic particles are synchronized, cooperative, and interlinked
Essential Ingredients – Interconnected Universal Web of Energy
Impact of awareness
Relationship between observer and observed
Koerner, J. (2009). Insight: The application of complexity science in decision making. Creative Nursing, 15(4),
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10. “Change agents continue to struggle with outmoded models, tools, and techniques---ones that were sufficient in slower and simpler times, but that are counterproductive when complex adaptation is the only viable survival strategy”. Edwin Olson and Glenda Eoyang Facilitation Organizational Change (Courtesy Dr. Phyllis Kritek)
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11. Insanity is doing the same thing, over and over again, but expecting
different results.
Albert Einstein
Courtesy Dr. Phyllis Kritek
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12. Complexity Science and Adaptive Systems The Butterfly Effect
Seemingly small changes large effect on the results
Groundwork for the mapping of chaos mathematically.
Small changes in the initial characteristics of an active system can dramatically affect the long-term behaviour of that system.
Referred to as the ‘butterfly effect’.
If a butterfly flaps its wings somewhere in the world today, there will be a hurricane somewhere else at some future point
Holden, L.M. (2005). Complex adaptive systems: concept analysis. Journal of Advanced Nursing, 52(6),
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13. Change Agents Understand Systems
Motivation Change Complexity Science
Change Agents Understand Systems
Open systems – flows and constraints
Bertlanfy researching international postal system – WW II
Inputs
Throughputs
Outputs
Social Systems – Seeing the world through interactions - Social groups
Perceptions that shape social interactions
Purpose and goals of the system
Process Systems - Seeing the world from information flow
Living systems – Seeing the world through the interactions of self-creating entities
Senge,P. (1991). The fifth discipline: The art & practice of the learning organization. New York: Doubleday Currency.
Dr. Mileva S. Lewis, All rights reserved
Mileva S Lewis, All rights reserved

14. Small Groups Relevance and Application of Gerardi to Nursing Practice

15. Complexity Science and Healthcare Organizations
Complex Adaptive Systems
Dynamic, interdependent activities occurring simultaneously
Qualities:
Self-organizing
Patterns emerge over time
Non-linear (future is unpredictable)
Patterns result from personal interactions and relationships
Organizational effectiveness, quality, clinical outcomes depend on quality of relationships
Gerardi, D. (2015). Conflict engagement: a new model for nurses. American Journal Of Nursing, 115(3),

16. High Performing Primary Care Practices (Emotional & Social Intelligence)
Individual Traits & Interpersonal relationships characterized by:
Trust
Mindfulness
Heedfulness
Respect
Social and task relatedness
Diversity
Communication
Gerardi, 2015

17. How about a Break
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