Are you leading through continuous change? Is the change unpredictable and moving at such a fast pace that it is difficult to keep up and has you wondering what it looks like to lead effectively and with the space to think? Not just for yourself, but also with your leadership team and for your teams across your system?

These are very common questions we hear from our clients, and frankly, what a multitude of articles and books are being written about in the leadership development space. The fundamental principle involved in all of them is similar to the metaphor of the Oxygen mask on the plane: in order to navigate the changing situation (e.g. cabin pressure dropping), we must slow down and put the oxygen mask on ourselves, before we can effectively serve others and take further actions. 

What is that metaphorical oxygen mask for you, your leadership team, and your system as you look to navigate unpredictable and complex situations? One vital tool to answer that question is to create increased awareness through feedback systems – internal and external – focusing on the way we are interacting and taking action with others.

Image by David Emerald,

If you read that sentence and felt an added weight or wanted to dismiss that because it’s just “another thing to do,” you may be interested to learn that Peter Senge, known as the father of organizational learning, has long advanced the framework that focusing on thinking about how we think, interact and take action is the critical 3rd dimension of work within every organization.1  This is not extra work, nor soft work – it is the vital groundwork that when incorporated, can support you and your teams to navigate complexity and ambiguity effectively over time.

So back to that oxygen mask metaphor: having systems and structures in place to get feedback on how you are interacting and taking action, the impact it is having to yourself and others – is your way of assessing what the cabin pressure is in your environment.

Internal feedback systems include administering “self check-ins” and establishing a “self care plan” that puts you as a priority on your to-do list, among all the other priorities that your role and organization are asking of you. As leaders, you have this strength developed around planning for implementations, for budget cycles, for change initiatives – you must apply that same skill to yourself before any of those others. In healthcare, the troubling reality – and sad irony – is the increasing evidence that those providing care, administering and leading the health care system are doing a poor job of modeling that care for themselves.  No system – and no person – can sustain over time with that kind of discordance within.  What is your “self care plan?” On a scale of 1-10, how do you rate yourself in implementing your plan successfully? What works for you, and what gets in the way?

External feedback systems include informal, formal, ongoing and easeful ways of giving and receiving information to each other that increases your collective awareness, for the sake of learning and evolving amidst the ongoing change around us. When done effectively, this can raise the learning cycles from single loop, to double loop and even triple loop learning.2,3 What systems do you have in place to learn about the ways you – individually and collectively – are interacting and the impact you are having with respect to your intended results?

In healthcare, most often the external feedback loop stops with processes like HCAHPS and performance reviews. While both provide important information, it is at best partial and incomplete for an overall effective external feedback system. While it is beneficial and important to look backward to review what has been achieved, having only that focus orientation has an inherent trap in its design. Namely, the underlying intention and processes typically do not include two-way communication, nor have the intention of generating growth and development in a forward direction. Effective external feedback systems require a “growth mindset” and a focus on “scaling leadership.”

These two components are your metaphorical oxygen being delivered in the oxygen mask.  Stay tuned for additional articles to expound on these topics.

For now, take a moment to ask yourself – and your leadership teams – the questions posed in this article.  So that our readers can learn and grow together, tell us your story of what you find is working for you. If you recognize any gaps or areas you could improve in, we invite you to share that too.


  1. Senge P. (1992) Building Learning Organization Journal for Quality and Participation. 15(2): 30-39.
  2. Argyris C. (1991) Teaching smart people how to learn. Harvard Business Review. 69(3): 99‐109.
  3. Tosey P., Visser M., & Saunders M. N. (2012) The origins and conceptualizations of ‘triple-loop’ learning: A critical review. Management Learning. 43(3): 291–307.


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