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What's your agility ability?

Orski, Kiki MBA, RN

Nursing Management (Springhouse): April 2017 - Volume 48 - Issue 4 - p 44–51
doi: 10.1097/01.NUMA.0000511922.75269.6a

The AGILE Leader Approach presents a change in mindset, methods, and metrics needed by every nurse leader for success in today's turbulent healthcare environment.

Kiki Orski is president of Peak Performance Consulting in Bayville, N.Y. She's held previous clinical roles as the director of Curative Wound Care Centers, Great Neck, and South Nassau Community Hospital, Oceanside.

The author has disclosed no financial relationships related to this article.



Change at the speed of light...I witness it every day from healthcare executives. The solid ground of our environment is shifting so rapidly that even the most successful and tenured leaders must evaluate how they've achieved results in the past to ensure these ways still prove most effective. “Change is the only constant” is trite, but it's the absolute truth, and unless you have the skills necessary to handle these changes, you won't succeed. It's no longer enough to “have experience.” The simultaneous changes in technology, reimbursement, best practices, and competition are unprecedented, leaving us unprepared and unsuccessful if we rely on our old ways.

Yet, for decades, other industries have experienced this same type of volatility and still flourished. For us in healthcare, the challenge isn't solely change, but also our way of thinking. It's a new leadership mentality that welcomes change, sees possibility, embraces the potential for outstanding outcomes, and isn't afraid to be uncomfortable while achieving these outcomes—an AGILE Leader mindset.

First used in the 1990s regarding manufacturing and customer demand, the concept of agility became wildly successful in software companies looking to bring products and services to market more quickly, efficiently, and successfully. Steve Jobs at Apple is a prime example of paving the way for improvement before customers even knew they wanted it. That's the attitude of an AGILE Leader: the ability to anticipate the need for change and take effective action in conditions never before witnessed. Not surprisingly, leadership agility is the most desired trait of 130 interviewed CEOs.1

According to new research from the Center for Creative Leadership and Columbia University, truly AGILE Leaders face each day with an open mindset, coupled with a collection of specific leadership actions.2 These actions and behaviors include challenging assumptions, practicing self-reflection, and taking risks while remaining calm in the face of difficulty. This combination allows a leader to continually develop personally, and use new effective strategies professionally to navigate the ever-increasing complexities we face daily in every healthcare organization.

The goal of every healthcare organization should be to have AGILE Leaders who are visionaries—individuals who can lead transformative change at every level. An AGILE Leader commits to self-development; builds high-performance teams and strategic partnerships throughout the organization; and constantly strives to develop creative, high-leverage, high-impact solutions—all while continuing to deliver sustainable positive outcomes.

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The matrix

So, how do you develop an organizational culture in which AGILE Leaders can flourish? Start with the AGILE Leader Matrix™ as a pathway to the four essential components every leader must master: personal development; strategic partnerships; efficient and consistent processes; and sustainable, measured progress. (See AGILE Leader Matrix™.)

1. Personal/professional: AGILE Leaders understand the realities of their industry and what's required of them personally. Some leaders may have been promoted simply because of their technical or clinical excellence. Although many have started this way and went on to achieve unparalleled success, most aren't so lucky. The skills needed to be an exceptional individual contributor are no longer enough when striving to be an AGILE Leader.



Leaders low on the agility scale have achieved their success by being the expert, the go-to person with all the answers. They've been relied upon by their staff to help get things done and will often use a hands-on approach. They're usually very proud of their own personal accomplishments, but don't always take full responsibility for team output. They strive to improve the environment and their results by continuing to rely on the normal daily behaviors and skills used to get them where they are now. Their leadership style hasn't been assessed, and their ability to deal with conflict and have effective difficult conversations is usually limited. Leaders low on the agility scale are reluctant to innovate and experiment with new ideas.

Leaders high on the agility scale know that they'll have to continue learning new skills, perfect the ones they have, and repeatedly adapt to constantly changing conditions in every area of their business. They embrace these changes, knowing that to stand still or, worse, rely on past practices as their only method of coping will lead to disaster for them professionally.

In contrast to the less successful leaders we coach, AGILE Leaders take on an intentional, proactive approach to change. They anticipate change in practice, new patient expectations, and emerging opportunities, as well as threats to their norm, by continually scanning inside and outside the healthcare industry for new developments and the associated necessary skills. They view the challenges they face with a fresh perspective and a willingness to challenge every past assumption. They understand that to embrace the visionary role, they must be the model for adapting to change with a high level of emotional intelligence, a relentless pursuit of excellence, and a keen awareness of their strengths and weaknesses. To begin, they do a thorough self-assessment and invite others to weigh in on their present state. A 360-degree feedback tool is most helpful here to ensure that they have an accurate picture of their level of knowledge, interpersonal skills, coping abilities, and future focus.

2. Partnerships: AGILE Leaders understand the importance of people in their lives. They know that they can't traverse the volatile landscape without the help of strategic and trusted partnerships, which come in many forms, including, but not limited to, employees, peers, superiors, interdisciplinary colleagues, patients, and physicians. Without strategic and trusting relationships with all of these people, it's impossible to create the type of organization where quality is key, speed is essential, and outcomes determine viability. This is a basic concept, but one that's often overlooked by a leader low on the agility scale.

Cultural perspectives, language barriers, different educational backgrounds, personality traits, and varying value systems with which individuals come preconditioned greatly affect how information is processed and interpreted and, therefore, can impact the leader's success. To optimize effectiveness, AGILE Leaders have an awareness and ability to flex their approach on a person-by-person basis to match the situation at hand. The willingness and capacity to execute this concept plays a huge role in the ability to get the best work from any team or strategic partner.

AGILE Leaders seek alignment with these strategic partners and determine from whom they need agreement, buy in, and commitment to get desired results. Then, the AGILE Leader actively pursues it. Those lower on the agility scale unfortunately believe that they can get results on their own with sheer will power. But as every successful leader we talk to tells us, partnerships are mandatory. The level of agility improves when the leader progresses from a position of “the buck stops here” to one that understands how the motivations and expectations of others can (and will) have a major impact on any initiative's effectiveness. These strategic partnerships involve relationships, and relationships start with trust.

Trusting strategic partnerships can usually negotiate the alignment process quite smoothly. AGILE Leaders aren't afraid to ask the clear and concise questions to gain agreement and commitment from all stakeholders, whether it's a supervisor for the go-ahead on a project, a corrective course of discipline with an employee, or a contract with a preferred provider.

3. Process: Highly AGILE Leaders are acutely aware of how the plans, policies, and procedures of the past may not work in this complex and uncertain environment. They actively seek new information and answers to the ever-present question of “how do we need to do this now to get the best results going forward?” They aren't afraid to journey along new avenues, try innovative ways, or start from scratch. They wholeheartedly buy into the concept of trying small and failing fast to be the first to market, improve outcomes, delight a patient, or increase revenue. In addition, they're willing to learn from outside their industry to understand best in class from the most successful AGILE organizations.

An unrelenting pursuit of excellence must cascade throughout the organization, with a solid understanding of what excellence means to everyone. An AGILE Leader has a crystal clear vision of where he or she wants the unit, department, or organization to go, and has made that abundantly clear to all involved strategic partners. Leaders high on the agility scale get employees involved in improvement plans and are open to suggestions and ideas from those doing the work, ensuring that no one roadblocks necessary changes.

4. Progress: Highly AGILE Leaders know how to measure their successes, regardless of how big or small. Attention to this component determines if initiatives will be given the praise they deserve for improving the organization or allowed to languish for years, even if the change was unsuccessful. Performance metrics are a leader's secret weapon when trying to move an initiative forward and make any substantial change. The metrics before and after an initiative is introduced can be what saves the organization thousands of dollars and hours of lost productivity. We find many healthcare organizations to be data rich, but information poor.

This component of the AGILE Leader Matrix also addresses the need for leader accountability. Without a source of measurement, accountability falls by the wayside. Clear markers of what constitutes success, and failure, are utilized here.

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Guiding principles

How do you specifically develop these AGILE Leaders in your workplace? The most efficient way is to apply the principles of intention, focus, follow through, and follow up to every change, initiative, idea, project, and need for improvement. These four principles, when applied consistently, are the keys to developing an AGILE Leader growth mindset, while incorporating sound business principles. It's this rigor that helps nurse leaders see beyond present state situations and imagine the possibilities while moving forward with strategies and actions. It also helps aspiring nurse leaders look beyond what they can see and imagine what can be.

The first principle of declaring intention, or visionary thinking, leads to transformational change on a system level. Stating one's intention answers the very important question of “why” we should move forward. Intention provides clarity and ensures that we aren't constantly wrestling with old ideas and solutions, and presenting them as new. It takes courage and discipline to look beyond the current daily challenges to see the potential for the future. AGILE Leaders seek new and diverse opportunities for themselves and their organization. They embrace complex problems and challenges that take them out of their comfort zone and push them to new possibilities. They understand that they're no longer measured by past accomplishments, but instead by future results. As some experts say, it's the quality of being able to create a “vision for the future that most differentiates people who are seen as leaders from those who aren't.”3

The second principle is focus. AGILE Leaders have a clear strategic focus on who and what needs their undivided attention. They identify resources, processes, performance strategies, and partnerships that need to be forged, developed, or strengthened to achieve the desired intention. AGILE Leaders seek to determine where their efforts and the efforts of their team members reap the greatest return on investment, as well as positively impact patient and employee satisfaction levels.

The third principle is follow through, which addresses what specific steps will be taken to achieve the intended outcomes. It answers the where, when, how, and how much questions. Follow through is about creating specific measurable goals and a targeted action plan that's employee generated and agreed upon by all. The consistency by which the follow through step is implemented will directly correlate to the positive outcomes you achieve.

The fourth principle is follow up. AGILE Leaders have clear metrics for success. Relentless attention to metrics leads to sustainable results. AGILE Leaders know checkpoints are needed and strictly conduct them. This is the step where AGILE Leaders make the biggest difference. Intention without attention leads to repeated failures. AGILE Leaders know that where they place their attention matters to their employees.

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Advancing the scale

So, how do you proceed up the AGILE Leader scale? Through self-reflection, practice, and a growth mindset, accompanied by clarity of intention, strategic focus, consistent follow through, and relentless follow up, anyone can become a more AGILE Leader.

As a review, ask yourself the following questions related to each matrix category:

  • INTENTION: What do you hope to accomplish? What's your vision for yourself; your team; and your unit, department, or organization? What new and innovative way can you approach this challenge?
  • FOCUS: What's your overall strategic plan. How, where, and on what will you focus your energies to accomplish what you need to? What large resources do you need (time, money, supplies)? Your focus should be on the major components needed for any change, innovation, project, idea, or initiative to flourish.
  • FOLLOW THROUGH: What specific action plan will be used to generate improvement in any change, innovation, project, idea, or initiative you begin? Is the action plan employee generated? Can it be tested in a short amount of time, in a limited scope? Inaction is the biggest challenge to innovation in any organization. AGILE Leaders simply make the decision to act.
  • FOLLOW UP: How will you ensure that this project, if it provides positive outcomes, is sustainable and the gains are enough? How will you ensure accountability? How do you know it's happening when you aren't present? Change of any magnitude typically isn't welcome, but it's usually desperately needed. Older inefficiencies have a way of resurfacing if the AGILE Leader isn't strong with follow up. Constant reinforcement demonstrates the level of strategic priority and importance placed on the potential outcomes.
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Is it in you?

AGILE Leaders welcome new ideas, try different things, understand that old ways aren't enough, and encourage the people around them to do the same. AGILE Leaders absolutely and actively seek novel and diverse experiences from both inside and outside of their own industry. They foster strategic partnerships, create uniform and efficient processes, and measure progress every step of the way. Cultivating an AGILE Leader mindset and the associated skills takes persistence and consistent work. AGILE Leaders recognize this and purposefully challenge themselves to be the very best that they can be.

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1. Joiner Bill, Josephs S. Leadership Agility: Five Levels of Mastery for Anticipating and Initiating Change. San Francisco, CA: Jossey-Bass; 2006.
2. Mitchinson A, Morris R. Learning About Learning Agility. Greensboro, NC: Center for Creative Leadership; 2014.
3. Kouzes J, Posner B. The Leadership Challenge. San Francisco, CA: Jossey Bass; 2012:105.
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