Collaborative Leadership Can Rubberize the Hierarchy!

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We need the hierarchy in healthcare yet in many places it is a very destructive force.  If we are going to have safe care, healthy workplaces and rewarding careers we need to ask ourselves and each other;  What makes the hierarchy healthy?  What are your thoughts about making the hierarchy a healthy one?

240px-Quadrate_auf_dem_Geobrett_SchrägsichtIn my opinion we need the hierarchy for clinical decision-making and related use of expertise, but not for egos, power,  status or dare I say, even money. We need to work collaboratively so that everyone’s expertise and best efforts are supported and brought forth for every patient.   Think of it as the hierarchy being the structure and the collaboration as the process.  The former requires knowledge and skills where the latter requires respectful communication and emotional intelligence.   Healthcare professionals must be adept at both.  Yes, physicians may lead more often than not and yes the nurses’s assistant will follow more often than not, and nurses will be leading and following almost all the time, but we must all be able to do both! And with respect and grace.

This is the combination of the art and science of safety.  We don’t get rid of the hierarchy, we rubberize it!

Collaborative leaders who understand this dance of being in charge while listening and following as necessary AND supporting staff to bring their best to the table will be making a huge contribution to creating the ideal healthcare organization!

There are many activities from improv, applied improv, or medical improv that can be used to practice the leadership and followership necessary to jump into either role and switch between the two in the dynamic unfolding of providing care!




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10 Responses to Collaborative Leadership Can Rubberize the Hierarchy!

  1. Improved patient safety and outcomes is our ultimate goal. To be successful, we need clear communication among collaborative team members. Your post highlights the essential need of every team member’s collaborative efforts in shared governance for a successful healthcare delivery system.

  2. Nurse Beth says:

    Great post and something all wise leaders know..and practice! How do we sing to the non-choir members? Maybe we just be the best we can be and model the behavior.

    • Beth Boynton, RN, MS says:

      Thanks, Beth. Thanks for mentioning role modeling. I think it is very powerful. Teaches, gives permission, and even takes a stand…I also like making it visible by talking and writing about it! 🙂

  3. Donna Carol Maheady says:

    Rubberize it….love it Beth! I also think a rubber eraser is needed….to erase “hard lines” in the healthcare hierarchy to facilitate more collaboration.

  4. Elizabeth Scala says:

    Great post, Beth. I love how you highlighted the complementary articles as well. I remember the one where the doctor introduced himself and asked that he be called by his first name; great article!

    I believe that leadership is about getting into the spaces and places that the people we are leading are in. It’s about collaborating, allowing others to show up as their best selves and keep pulse with what’s what in the group.

    I recently wrote a post myself ( which received some discussion when I asked what leadership qualities allow for work-life balance.

    Great article, Beth. Thank you for sharing!

    • Beth Boynton, RN, MS says:

      Thanks, Elizabeth. Your points highlight the relationship parts of leadership which are key for complex adaptive systems. And helping/encouraging/creating opportunities for people to do their best is vital. Collaborative leaders really collaborative leaders find joy in helping others be successful.

      I just read your article and think you did a great job explaining transformative leadership as well as how helpful it can be in terms of role-modeling a healthy work-life balance! I highly recommend it to readers.

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