Minnesota Rural Health Conference
OPENING SESSION
Brock Slabach, FACHE
Senior Vice President for Member Services
National Rural Health Association
NRHA Mission
The National Rural Health Association is a
national membership organization with more
than 21,000 members whose mission is to
provide leadership on rural issues through
advocacy, communications, education
and research.
Improving the health of the
62 million who call
rural America home.
NRHA is non-profit and non-partisan.
2011 Meetings
 Quality/Clinical Conf., July 20-22
Rapid City, SD
 RHC/CAH Conf., Sept. 27-30
Kansas City, MO
 Multi-Racial/Cultural Conf., Dec. 7-9
Daytona Beach, FL
NRHA’s Principles
To resolve the health care crisis in rural America, the
rural health care safety net must be prevented from
crumbling. Four reforms are crucial:
 The workforce shortage crisis must be abated;
 Equity in reimbursement must occur;
 Decaying rural health care infrastructure must be
repaired and non-existent infrastructure must be
created; and
 Health disparities among vulnerable populations must
be corrected.
Value of rural lifestyle
Researchers have found two areas of brain function
directly affected by city living, leading to a higher risk
of anxiety and mood disorders:
 21% greater risk for anxiety disorders
 39% greater risk for mood disorders
 Incidence for schizophrenia is almost double for
people born and raised in cities
 Almost 70% of the world’s population is expected to
live in a city by 2050
Our Grassroots Effort
NRHA doesn’t have a PAC
Website: ruralhealthweb.org
Depends solely on grassroots advocacy
Members have access to:
 Periodic Washington Updates (webinars):
[email protected]
 Rural Health Blog
http://blog.ruralhealthweb.org
 Join NRHA today at ruralhealthweb.org
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Generous Leadership
for an Era of Austerity
“We live in an era
of massive
institutional
failure.”
--Dee Hock, founding CEO of Visa
“When the
infrastructure
shifts, everything
rumbles.”
--Stan Davis, Author and Management Consultant
An Era of Austerity?
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Federal Budget Deficits
State Budget Deficits
Unemployment
Low Economic Growth
Healthcare Environment
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Healthcare Reform
HIT and Meaningful Use
Reimbursement
Quality and Safety
Workforce
Technology
In a word……
CHAOS
Chaos Theory for…..
Have you ever thought?
 Why so many organizations feel lifeless?
 Why does progress, when it appears, often come
from unexpected places?
 Why does change itself, that event we’re all
supposed to be “managing,” keep drowning us,
making us feel less capable and more confused
Chaos Theory for…..
Have you ever thought?
 Why have our expectations for
success diminished to the point that
often the best we can hope for is
endurance and patience to survive the
frequent disruptive forces our
organizations and lives?
Chaos Theory
Chaos theory describes the complex motion and the
dynamics of a system. A system can descend into
chaos and unpredictably, yet within that state of
chaos, the system is held within boundaries that are
well ordered and predictable.
 Chaos and order are complementary partners,
not polarities
 Chaos is a necessary process for the creation
of a new order
Chaos Theory
 Why do we seek equilibrium and live in fear
of change?
 At equilibrium, there is nothing left for the
system to do. It is at this point the system
has exhausted all of its capacity for change
 We have treated organizations as closed
systems, like machines
 Disturbances create disequilibrium.
Disequilibrium leads to growth.
Organizations as Systems
Generous leaders inquire into three domains:
Identity
Information
Relationships
Identity
 Disruption initiates self-organization
 More freedom in self-organization, the
more order
 Each individual maintains clear sense
of individual identity
 Each individual shapes a system’s
identity … nothing is wasted
“I go every place in my organization and talk to
people about our vision; about our commitment to
distribute power and authority so that people can
genuinely feel they have real impact on the business
from wherever they are; about trust; about
openness; about eliminating political game-playing
and confronting difficult issues publicly rather than
in back rooms.”
--William J. O’Brien, CEO, Property/Liability Insurance Company
Information
 Employ information the same way life does.
Information feeding back on itself and changing in
the process
 Freedom evokes trust that people can make sense of
the information because they know their job and
organizational purpose
 Allow information to flow freely through systems,
disturbing the peace
 Develop new approaches to information
Information
 Possible benefits of free flowing
information in organizations:
Higher the ability to process the
information, the greater the level
of intelligence
Information-rich, ambiguous environments
are the source of surprising new births
Relationships
• The potential that becomes reality,
depends on the relationships between
multiple elements:
People
Events
The moment
Relationships
 None of us exists independent of our
relationships with others
 Power is the capacity generated by our
organizational relationships
 Assessing an organization’s capacity for
healthy relationships … a prime role for
generous leaders
“There has to be
something at the soul of
an organization that does
not change but that will
enable people to live
with change.”
--Stephen Covey
A Generous Leader Should
 Learn how to facilitate process
 Become savvy about how to foster
relationships
 Learn how to nurture growth and
development
 Become better at listening, conversing and
respecting one another’s uniqueness
A Generous Leader Should
• Help develop a clear identity that lights the dark in
moments of confusion
• Support employees as they learn to incorporate
values into their organizational lives
• Understand that we are controlled by concepts that
invite our participation, not policies and procedures
that curtail our contribution
• Create space where people, ideas and information
circulate freely
A Generous Leader Should
 Understand complexity
“For every great problem, there is a simple
solution—and it’s wrong.” --Oscar Wilde
 Realizes that aspiration drives all
fundamental learning
 Know that ends and means are inseparable.
7 Things That Will Destroy Us
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Wealth without work
Pleasure without conscience
Knowledge without character
Commerce without morality
Science without humanity
Worship without sacrifice
Politics without principle
--Mahatma Ghandi
Most Important…
“The servant-leader is
servant first. It begins
with a natural feeling
that one wants to serve,
to serve first, as
opposed to wanting
power, influence, fame
or wealth” –Robert K. Greenleaf
In Summary
 Era of Austerity is here
 Austerity is a disturbance that is, and will,
create disequilibrium
 Generous leaders understand organizations as
living systems:
 Identity
 Information
 Relationships
In Summary
 Change should be the normal
 A generous leader is a servant at heart
 Islands of Excellence in a sea of
mediocrity
 We are all leaders!
“We are the leaders we have been
waiting for”
Paradox of
Generous Leadership
“Genuine leadership is deeply
and inherently
personal
collective .”
--Peter Senge, Author, The Fifth Discipline
Resources
• Wheatley, Margaret, Leadership and the New Science:
Discovering Order in a Chaotic World. San Francisco, 1999
http://www.margaretwheatley.com
• Greenleaf, Robert K, Servant Leadership: a Journey into the
Nation of Legitimate Power and Greatness. New York, 2002
http://www.scottlondon.com/interviews/wheatley.html
THANK YOU
Brock Slabach, FACHE
Senior Vice President for Member Services
National Rural Health Association