Due to weather, Duke Integrative Medicine will be closed on Monday, December 10.
Publisher: Penguin Publishing Group, Penguin Random House, New York, NY. 2015.
By General Stanley McChrystal (with Tantum Collins, David Silerman, and Chris Fussell)
Review by Lori Knutson, RN, BSN, HNB-BC
If you Google “books on leadership” the result is 394,000,000 pages. Apparently we have not figured out the secret sauce to effective and sustainable leadership that is resilient to the dynamics of a global environment. However, General Stanley McCrystal’ s recently released book titled, Team of Teams: New Rules of Engagement for a Complex World, certainly comes close.
General McChrystal retired from the U.S. Army as a four-star general after more than thirty-four years of service. His last assignment was as the commander of all American and coalition forces in Afghanistan. He took command of Joint Special Operations Task Force in 2004. Al-Qaeda was a new kind of enemy, and this was a different kind of war. Although the U.S. had large ground forces, state of the art equipment, and highly specialized training, it was not effective. The U.S. was losing ground. This new enemy was agile and moved quickly through its decentralized network.
In some ways this mirrors our current state of healthcare. The new enemy is the epidemic of chronic disease, pervasive and decentralized; and the healthcare system is too bureaucratic and slow to fight the war.
In Team of Teams, General McChrystal shares his vulnerability as a leader during a time of extraordinary complexity, turmoil, and real-time constant change. He states, “the necessity of real-time innovation and problem-solving requires integrative and transparent leadership that empowers individual team members”. His message is clear, that leadership today requires “trust, common purpose, shared awareness, and the empowerment of individual team members to act”. If this is the premise for success in the military environment where control and command has been the historical edict then I believe leaders in a civilian environment may want to take notice and read this book.
The title, Team of Teams, is simply defined by General McChrystal as, “a large command that captured at scale the traits of agility normally limited to small teams”. He further describes an imperative to the rules of engagement — shared consciousness and empowered execution. Shared consciousness, defined here, is a “carefully maintained set of centralized forums for bringing people together”, and “empowered execution is a radically decentralized system for pushing authority to the edges of the organization”. General McChrystal submits that the union of these two rules creates an environment of high adaptability in dynamic and complex organizations. I suggest this is quite applicable to the current complexity of our health care system.
This book demonstrates, on a guttural level, what happens when a leader transforms their inner state of being from a place of power over to power with.
Through this profound insight McChrystal transformed the Special Forces simply by engaging the knowledge and wisdom of those in the field to guide his decision-making. By intertwining frontline teams through newly designed communication technology and empowering these interconnected teams to receive and make lateral decisions they now matched the new enemy’s agility and decentralized networking but with much greater power.
So what is the leader’s role? According to General McChrystal, it is no longer about being the “heroic decision maker”, but rather “an empathetic crafter of culture”. Any leader in health care will admit that there are times when they feel the desire to adorn a suit of armor for a day on the battlefield. But I assure you that in Team of Teams you will see that being a brave and effective leader is much less about being in front and making all the decisions, and much more about having the courage to be vulnerable, trust others and yourself, and embrace the power of collective wisdom.