HLTH 6031 Week 1 Leadership Analysis Paper Example

Leading a Coalition Nobody Reports To: Adaptive Leadership Tested Against a Campaign to Extend a Bus Route to a Clinic Corridor, Move by Move, With What Survives Without a Title

Student Name

Walden University

HLTH 6031: Leadership and Advocacy in Health Education

Instructor Name

Month Day, Year

Leading a Coalition Nobody Reports To: Adaptive Leadership Tested Against a Campaign to Extend a Bus Route to a Clinic Corridor, Move by Move, With What Survives Without a Title

The Model

Adaptive leadership, developed by Heifetz and colleagues, claims that a leader is effective when they mobilize people to tackle adaptive challenges, problems that cannot be solved by expertise or authority alone because the people with the problem must change their own values, habits or priorities to solve it (Heifetz et al., 2009). The model distinguishes these from technical problems, which have known solutions that an expert can apply. It also separates leadership from authority: a person can exercise leadership without holding a position from which to give orders, and a person in authority can fail to lead at all (Heifetz & Laurie, 1997).

That separation is why the model fits this analysis. The question is which of its moves still work when the person using them has no positional power over anyone involved.

The Situation

I am a health educator at a composite federally qualified health center, Eastgate Community Health Center, in Harbor County. Eastgate shares its corridor with three other services, a dialysis unit, the county's WIC office and a senior center, and transit reaches none of them; the nearest stop on the county's Route 22 is 1.4 miles away along a road without sidewalks. Over the past year our front desk recorded 312 appointments missed because patients said they had no ride. I coordinate an informal coalition of seven organizations asking the Harbor County Transit District board to extend Route 22 into the corridor in its next annual service plan.

No one in the coalition reports to me. The dialysis unit's social worker answers to a national dialysis company, the WIC coordinator to the county health department, the senior center director to a nonprofit board, the tenants' association president to her members, and two pastors to their congregations. My own supervisor supports the effort but has given it no budget. The decision belongs to a transit board on which none of us sits.

Transportation barriers are common. National survey data put the scale of the problem at 5.8 million Americans who put off care in 2017 for want of a ride, a burden heavier for people in poverty, Medicaid enrollees and people with functional limitations (Wolfe et al., 2020).

Testing the Model, Move by Move

Diagnosing the Challenge as Adaptive or Technical

Heifetz et al. (2009) argue that a common leadership failure is treating an adaptive challenge as technical. Our challenge has a technical part: a route extension is a planning problem with known solutions. But the adaptive part is larger. Each coalition member must give something up: the dialysis company must accept being named publicly as a site patients cannot reach, the senior center must spend its one board testimony slot on our issue rather than its own, and the transit district must reconsider a service standard that favors high-ridership corridors. This move needs no authority. Diagnosis is analytical work anyone can do, and doing it changed how I ran our first meeting: I stopped presenting the route map as the answer and asked each member what the extension would cost their organization.

Survives without a title: fully.

Getting on the Balcony

The model asks leaders to step back from the action to see patterns, including their own role in them. In the second meeting I noticed that I was doing most of the talking and that the members with the most at stake, the tenants' association and the dialysis social worker, spoke least. This observation required only attention.

Survives without a title: fully.

Regulating Distress

Heifetz and Laurie (1997) describe the leader's job as keeping the level of distress high enough to motivate work but not so high that people disengage, which they call maintaining a holding environment. A manager can regulate distress by setting deadlines and assigning work. I cannot. When the WIC coordinator said her department would not let her sign a public letter, I had no way to raise or lower pressure except through the group itself. I could pace the agenda and choose when to raise hard questions, but I could not compel anyone to stay at the table.

Survives without a title: partly. The pacing of meetings works; the backstop of authority does not exist.

Giving the Work Back to the People

The model holds that leaders should resist solving adaptive problems themselves and instead return the work to those who must change. This move fits a coalition without positional power, because I could not do the work for others even if I tried. At the third meeting each organization took one task matched to what only it could provide: the tenants' association gathered rider stories, the dialysis social worker counted missed treatments attributed to transport, and the pastors asked their congregations to attend the transit board's public hearing.

Survives without a title: fully, and arguably works better without one, because no one expects me to do it for them.

Protecting Voices of Leadership From Below

Heifetz and Laurie (1997) urge leaders to protect people who raise difficult questions. When the tenants' association president said publicly that the clinic itself had moved its evening hours without asking riders, I could have defended my employer. Instead I recorded the point and asked how the coalition's request should address it. Protection here meant not silencing her, which needs no authority, but I could not shield her from consequences outside the meeting.

Survives without a title: partly.

What the Test Shows

The moves that rely on perception and framing survive intact. The moves that rely on controlling conditions, pressure and protection, survive only within the room. That finding fits the model's own claim that leadership and authority are distinct, but it also shows the cost of leading without authority: when distress rises past what the group can hold, nothing stops members from leaving. Roussos and Fawcett (2000) note that collaborative partnerships depend on conditions such as shared vision and leadership that are hard to sustain, which is consistent with the fragility seen here.

Table 1

Adaptive Leadership Moves Without Positional Power

Assessment based on the coalition's first three meetings.

Limits

The situation is composite and covers only the coalition's first three meetings. Adaptive leadership is one of several models the course assigns; a distributed leadership lens might see the tasks assigned in the third meeting as leadership spreading across members rather than as one person giving work back.

References

Heifetz, R. A., Grashow, A., & Linsky, M. (2009). The practice of adaptive leadership: Tools and tactics for changing your organization and the world. Harvard Business Press.

Heifetz, R. A., & Laurie, D. L. (1997). The work of leadership. Harvard Business Review, 75(1), 124-134.

Roussos, S. T., & Fawcett, S. B. (2000). A review of collaborative partnerships as a strategy for improving community health. Annual Review of Public Health, 21, 369-402. https://doi.org/10.1146/annurev.publhealth.21.1.369

Wolfe, M. K., McDonald, N. C., & Holmes, G. M. (2020). Transportation barriers to health care in the United States: Findings from the National Health Interview Survey, 1997-2017. American Journal of Public Health, 110(6), 815-822. https://doi.org/10.2105/AJPH.2020.305579