Strategy lessons from a hui

Kia ora. Last week, I was privileged to attend a hui in Aotearoa New Zealand. I was there to draw on Māori healthcare to feed into the strategy work I am doing for the Australasian College for Emergency Medicine, and I learnt some things that leaders, strategists and facilitatators might value.

The Manaaki Mana strategy, (tr: to ensure that conscious and persistent effort maintains or enhances the mana [honour, agency, power] of all people and environments) is six years old, and is working to embed deep cultural change into emergency healthcare in Aotearoa. Over three days, delegates from across the system discussed the why, how, what and who of making change.

We spent two hours on introductions

In a white colonial system, the speakers at the front of the room do bio and brio, and with authority established they tell the room what to think and do. Or they may be a facilitator, in which case they’ll do some sort of groupwork introduction of neighbours but then down to business. Ten minutes, then the rest of the hour on ‘the task’.

At the hui, connection and trust was a task. It was given time – as long as it needed. Every person in the room spoke for a couple of minutes: Background, hopes, role, skills, needs – no structure, just time to speak. The room listened. Deeply.

I have never seen a gathering treat every attendee with such respect, to consciously grant everyone agency in the proceedings. I was an outsider, the only non-healthcare professional in the room. I was no less welcome. The gathering is its own purpose.

The values are the point

The strategy is built around the expression of Māori values. Any actions that are in accordance with these values are by definition strategic. This is almost anti-strategy: values and context lead to conversations and actions, and because all those will be 'right', there is no need for anything else.

Discussions explicitly focused on what we could do, not on what wasn’t in place. Deficit thinking was explicitly called out as not being the path.

Also, note there is no ‘best practice’. The foundations are clear, actions lead to good practice, and this leads to excellence. I love this resistance to the notion of ‘best practice’, which is so often an unsubtle code for ‘what the professors say is the only way’.

This challenges Change Management orthodoxy. It suggests that

→ Strategy

  → Define changes required

    → Manage change

      → Achieve outcomes

Could be better thought of as

→ Set purpose

  → Articulate guiding values

    → Begin, all helping each other

      → Continue, continue, continue

        → Achieve outcomes

Many 1% changes over a Long Now

I recall my incredulity, as a naïve young student, when I encountered the idea of the Clock of the Long Now. The founder said ‘Such a clock, if sufficiently impressive and well-engineered, would embody deep time for people…’. I can now see, as a less naïve parent, that a long term lens leads to greater valuing of cumulative impact.

At the hui, many spoke of 1% actions: tiny concrete, real things whose impact accumulates over time: Putting up a sign. Teaching a colleague protocols. Greeting people in Te Reo (Māori language).

This was all with confidence of the benefit that would be achieved across the Long Now.

Anti-sequential thinking

Traditional strategy leads to plans, which set out tasks to be done in order. Q1, design; Q2, build. But manaaki mana does not have sequence baked in: rather, you do what you can, when you can, where you can. Because the 1% adds up over time, it is all useful. Do not hesitate to do something because no-one has done the preceding step. Would this offend a Prince2 practitioner? Maybe. But it’s getting lots done.

Anti-force thinking – let things ‘seep’

Change isn’t ‘pushed’ and there no particular sense of ‘pull’. The verb used was ‘seep’. As an individual, do something. It will be good. That practice will seep into neighbouring places, people, practices. That seep is how the change takes hold.

Call it like it is

I participated in museum conferences for two decades. Speakers would articulate the racism in the sector, and delegates would agree and make exhortations that ‘the sector should change’. Next conference? Rinse and repeat.

At the hui, a speaker said ‘stop asking if there is racism in our communities. There is. Let’s ask what next from here’. And another said ‘there is a lot of power in the room – what concrete actions can they take?’ It was a direct call to action, in a place that was action-oriented. There was no appetite for feelgood agreements that ‘this is the sort of thing we should do’ and ‘the sector must change’. There was just an explicit call to tell the powerful what to do.

Why was that possible? Because we were at a hui, with cultural protocols in place to sanctify the room as a safe space, one delegate said 'I am saying these things in front of big scary doctors, but we are in [I did not understand the te reo, but from context ‘Māori space’] so I feel safe and supported to speak up.'

Cultural safety + time spent on introductions + respect = agency.

And the powerful responded with ‘yes we will do that’. And the trust exists because last time these ‘powerfuls’ were asked to do something they actually did it. As I wrote in my notebook: ‘this gathering has the largest call to action and then actually do it that I have ever seen'.

Safety is excellence

Cultural safety is not an add on, it’s not a side project. The outcomes experienced by patients are a direct result of the excellence of staff. And staff can only be excellent if the environment is fully safe. So there is an explicit direct line drawn between inclusion and outcomes. Would that all organisations were so clear.

The same goes for burnout. Any workforce that is not thriving will not be able to achieve excellence. So being ‘anti-burnout’ – resting after a shift, not trying to do just one more thing – is actually doing your prime purpose of achieving excellence.

Building communities of change at the scale that change happens

Most gatherings about putting strategy into practice that I’ve seen or run have put people into clusters by department – implicitly, by skills and cultural alignment (sameness).

At the manaaki mana, breakout groups were clustered by geography. Because a group of nurses, doctors and administrators from a single place are the unit that will achieve. It isn’t about skills and roles, it is about acting where you are, with the people around you.

Summary: lessons for strategy applications:

• Create and maintain safety – without it, nothing is achieved
• Spend (so much) more time on introductions
• Build from values
• Tiny actions over time, not big hairy audacious grandstanding projects
• Speak the truth to power. Tell them directly what to do
• Do what less powerful people tell you to do. Just do it
• Create gatherings based on what will effect change (by geography might be better than by skills)
• Values are the foundation, not just one of the things you take into account when implementing

 An apology

I have not done justice to the sophistication of either Māori culture or the medical profession, and I was not an adept enough notetaker to capture everyone’s names. So I haven’t mentioned any individuals, and I credit the entire collective for the learning I have been fortunate enough to gain, in the process of working on the College’s strategy.

 Fin

I hope you find some inspiration here for your work. If you did, please hit the ‘like’ button or leave me a comment. I’ll see in a bi-week.

Paul.