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Policy & Practice February 201920 Policy & Practice February 201920

February 2019 Policy & Practice 21

By Natalie Williams

ADAPTIVE LEADERSHIP The Evolution of APHSA’s Organizational Effectiveness Practice

On January 9, 2019, I sat down with Phil Basso, the architect of APHSA’s Organizational Eff ectiveness (OE) practice. Phil joined APHSA in 2003 as a leadership training specialist and soon after realized that APHSA’s existing technical assistance (TA) practice, which was designed to help health and human services leaders build organizational capacity and eff ectiveness, could provide an enhanced suite of training services that addressed multiple challenges that member agencies were facing. In 2004, Phil, in concert with APHSA’s leadership, expanded the scope of the initiative and created what is known today as APHSA’s OE practice. Phil has personally worked more than 1,200 days in the fi eld with member agencies and has overseen more than 120 projects in 30 states and localities. APHSA’s OE practice is founded on this premise: “Eff ective organizations are foundational to building healthier and stronger communi- ties,” and bases its training principles on assisting health and human services (H/HS) agencies to progress through the stages of the Human Services Value Curve1 and achieve the desired future state of the H/HS system: “Thriving Communities BUILT on Human Potential.” The features of APHSA’s OE practice, as well as its own evolution, provide useful examples of adaptive leadership principles in action.

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Policy & Practice February 201922

Phil Basso is the Director of Organizational Effectiveness at APHSA.

Natalie Williams is an OE Consultant at APHSA.

NATALIE: If adaptive leadership is an approach to change where the solutions are not known, how does this relate to APHSA’s OE practice?

PHIL: In 2004, when the OE practice was created, we didn’t know what adaptive leadership was. It turns out that the essence of what we do is adaptive system change. The OE practice does not come in with solutions to the problems agencies are facing. Rather, it helps leaders fi nd those solutions through what we have termed the DAPIM process. The DAPIM™ (Defi ne, Assess, Plan, Implement, and Monitor) model is a process of discovery that facilitates groups to defi ne their desired state, assess related strengths and gaps, identify the root causes that suggest solutions deep beneath any symptom fi xes, and then establishes planning, implementation, and monitoring methods to help these groups learn and adjust their thinking and solu- tions. Through DAPIM and other tools we employ, the OE practice helps to establish the makings of a learning organization that generates evidence, versus looking for solutions in evidence and just plugging them into their systems, which we fi nd results in lower adaptability, sustainability, and buy-in.

we did things in the past, and how imperfect and fl awed we were.” This mentality has driven the evolution of OE practice over the years. We used to joke among ourselves that our practice was bad, and that’s what kept us going, using each practice innovation as the baseline to make OE even better.

NATALIE: So how has OE itself adapted throughout its existence?

PHIL: From 2004–2006, our practice was literally a pile of papers consisting of tools and templates we were developing for actual clients to meet their needs. While drawing deeply from existing research on organizational development, we were strengthening what worked and changing what didn’t work in a “learning by doing” mode. Then in late 2006, a state’s local direc- tors’ association asked us to create a virtual consulting tool that would be accessible without our literal involve- ment. That eff ort didn’t succeed, but it yielded the DAPIM model and method. In 2007, a state’s SNAP program asked us to teach OE to 20 or so internal managers to be ongoing facilitators, and that’s when we created our fi rst OE Handbook. From 2007–2012 we “re-versioned” that handbook four more times, developing new tools and strengthening the practice through each iteration. Along the way and since then, we’ve linked OE to broadly adopted eff orts for logic modeling, practice models, and more recently, Value Curve progression.

NATALIE: Phil you mentioned the Value Curve (VC). How do adaptive leadership principles and Value Curve progression link together, or do they?

PHIL: We fi nd, when working with agencies on VC progression, that it's easier for them to improve themselves through stages 1 and 2 because the means for doing so are more technical in nature. Stages 3 and 4 require adaptive leadership and system change because at these stages, agencies are working with families to solve problems at the root-cause level, and with partners at the community level to solve problems that are bigger than the family. These eff orts are more adaptive in nature.

NATALIE: Why did APHSA embark on this adaptive journey to create the OE practice?

PHIL: First and foremost, we believe that our member organiza- tions and the workforce within them are the driving force behind achieving desired outcomes, so it’s important to help them reach their potential to best help the people and communi- ties they serve. When OE was created, we already had respected leader- ship training in place, but we knew the transfer from training to actual practice was low. We also knew that traditional classroom training, outside of more routine skill-building eff orts, is not very eff ective in building up orga- nizational capacity and performance. In addition, this shift represents a parallel process for the way we aspire to engage the families and communi- ties we serve. Instead of delivering fi xed benefi ts and supports, we work with families and communities to discover the root causes between them and what they see as the desired state, and customize from there.

NATALIE: What would you say are the primary leadership qualities that have moved OE from an idea to a practice that has been used for more than 120 projects in more than 30 states?

PHIL: Four qualities come to mind … and these are the adaptive leadership qualities we seek to embed within agencies. The fi rst is humility. Leaders tend to be conditioned that to be a good leader you have to know the answers. But opening up to people and saying “I don’t know the answers” is actually more important when searching for solutions that aren’t known. The second is the capacity for critical thinking—even if I don’t know the answers, I know how to think and work my way to them systematically. OE helps people do this. The third quality is an “empowerment mind- sight.” I don’t know the answers, but I know how to mobilize people who will help me discover those answers. The fourth is a drive for continuous quality improvement. This mindset says, “we’re never done with growing, learning, and improving what we do, and we’ll always look back on how

February 2019 Policy & Practice 23

NATALIE: How does OE contribute to the culture of the agencies with which you work, helping them to be more adaptive?

PHIL: Three things come to mind when answering this question. First off, let’s define culture by how an organization and system does business, how it gets things done. Second, it’s clearer to recognize that critical thinking methods, methods of staff empowerment, and using lenses like the Value Curve are ways to assess where you are and where you want to go—all cultural phenomena. Third, when we facilitate groups, we aspire to be “good doctors,” meaning we embed the capacity to do all these things for one’s self, just like we try to do with families.

NATALIE: So how do we know that OE matters, that it has the desired impact on organizations and the people they serve?

PHIL: Great question! OE has been evaluated twice, and we are in the midst of a third evaluation. The first external evaluation in 2013 was a look back, surveying and interviewing about 30 past client organizations. The data showed our tools continued to be used long after our projects were completed; the objectives set out in the projects were, for the most part, achieved; and the impact on those served in achieving those objectives was also apparent. With the second external evaluation, we used goal attainment scaling within one state to compare counties that worked with OE to those who had not worked with OE. The data showed that the OE counties were achieving higher levels on the goal attainment scale than the counties that had not yet employed it. Our current evaluation, being conducted by the National Opinion Research Center through 2021, is studying the impact of our OE work within a related theory of impact at the ecosystem level for seven different cities or counties. We hope to substantiate connections between OE, ecosystem network development, service innovations across multiple partner entities, social and economic mobility, and improved structural equity by race and place. Now that’s a lot to evaluate!

NATALIE: Who has been mainly responsible for sustaining this effort over such a long time and in so many places?

PHIL: A ton of people and organiza- tions! I’m sure some will be left out but here are the ones that come to mind most readily. In delivering 4,600 days of consulting through 123 projects in 33 states, we’ve had 12 on-staff OE consul- tants over the years, most of whom have moved on to bigger responsibilities in the field. The University of Pittsburgh was an early adopter and collaborator. Casey Family Programs supported us for many years in child welfare projects. Now the Kresge Foundation is a key strategic partner. On the private- sector side of things, Public Consulting Group, Accenture, and most recently, Optum, deserve mentions. For the Value Curve, Harvard has been a great leader and supporter. Finally, as this is a “learning by doing” practice, we devel- oped and sustained our practice with and through our members, who wanted it to be better and better over time. OE belongs to them.

NATALIE: How have you been per- sonally and professionally enriched by taking this journey yourself?

PHIL: My professional journey now consists of 30 years of work focused on increasing outcomes for organiza- tions, 15 of these years for Fortune 500 companies, and 15 years at APHSA. Because of the 15 years at APHSA, I sleep well at night because I know the cause we’re about is true north. APHSA has been uniquely open to the work we’ve done around OE, and at this stage in its own strategic path, sees OE as a core asset and driver. Here, what we do is not about money, not about compliance, not about pleasing the boss or even the stakeholder. It’s about helping the people we all col- lectively serve reach their potential.

In that adaptive spirit, even though we didn’t know the destination of OE, and in some ways, we still don’t, we’ve always known we were using the right compass setting. This has enriched me more than I can easily express.

NATALIE: What’s next for OE, what do you see in your crystal ball?

PHIL: Looking out 5 to 15 years, I see OE being more connected to advancing our field’s approach to data and ana- lytics, linking social determinants of health to equitable outcomes, cracking the code on social and economic mobility, and moving from waking to really working through racial inequi- ties2 inherent in community structures. I also see us having turned the corner on workforce well-being and health; it’s always been important, but we haven’t really cracked the code on it yet. Finally, through that crystal ball, (with tears in his eyes), I know that someone is going to give this interview 10 years from now and it won’t be me. It will be someone else from the team, and I am excited and inspired because our current team is great, and I am excited about what they will be doing well into the future. Not sad tears…this is gratitude and appreciation.

NATALIE: Thank you, Phil, for your visionary leadership and your commitment to making the world a better place!

Reference Notes 1. The Human Services Value Curve can

be viewed at https://aphsa.org /APHSA/ Value_Curve_Toolkit/Toolkit__ Moving_ through_the_Value_Curve_ Stage.aspx

2. Awake to Woke to Work: Building a Race Equity Culture—Nonprofit Leadership Alliance. https://www. nonprofitleadershipalliance.org /resource/ awake-to-woke-to-work-building-a-race- equity-culture/

Instead of delivering fixed benefits and supports, we work with families and communities to discover the root causes between them and what they see as the desired state, and customize from there.

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