Leadership in healthcare as a solution-oriented practice

Abstract

The paper re-theorizes leadership in healthcare as a solution-oriented practice (Bate, Mendel & Robert 2008) aimed at improving decision making in healthcare contexts. The first part draws on relational leadership theory (RLT) and in particular, the idea of 'skillful leadership processes' that is theorized as complex political decision-making. Two constructs are identified - intelligent social actions and flexible social order (Hosking & Fineman 1990) - that are used to link RLT to the Cynefin framework (Kurtz & Snowden 2003. The latter approach draws on a multi-ontology sense-making perspective to identify five domains of decision making. The paper discusses the use of this framework in healthcare and its practical relevance to reform and change.