Kenan Distinguished Professor and Associate Dean for Research Ruth Anderson, RN, PhD, FAAN, has co-authored research showing that the Adaptive Leadership for Chronic Illness Framework can be helpful when treating patients with chronic hepatitis C (CHC) – a population which faces particularly difficult challenges in terms of adherence to medications and management of symptoms.
“Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness” was published online January 17, 2019 in SAGE Open.
Adaptive leadership is a well-known problem-solving framework and set of leadership principles developed by Dr. Ron Heifetz at Harvard University to help individuals or institutions adapt to change and approach problems for which there appear to be no solutions by identifying technical and adaptive challenges. The research team analyzed treatment encounters between providers and patients to explore how this framework could help providers encourage behavioral changes in CHC patients who face problems with adhering to medication and side effects.
The team engaged 11 CHC patients in one-hour clinical encounters with a provider, where the provider discussed medication and treatment and patients shared concerns. Patient interviews collected patients’ concerns about treatment and recorded how the provider responded to those concerns. The providers’ interviews collected their descriptions of the interaction, including their goals for the encounter and approaches used to meet these goals. From this information, the team identified provider behaviors that were consistent with adaptive leadership (such as the ability to mobilize resources), as well as multiple ‘missed opportunities’ – instances when a patient described what could be an adaptive challenge, but the provider addressed it with a technical solution or overlooked the concern.
Anderson says their study illustrates the important contributions of adaptive leadership behaviors by health care providers and how the absence of these behaviors poses potential risks for patients.
“When providers approach patient issues by exploring adaptive and technical challenges, it will guide them to the patient’s strengths on which to build behavior change,” she says.