our work

Working In Complexity

Engaging residents in the problem-solving process created a shift from a belief system with predetermined results to recognizing the value of social change under conditions of complexity.  Shifting power dynamics and adopting the Cynefin® framework helped us navigate this unpredictable new terrain where there are no right answers and “safe-to-fail” is the new norm.

Power Dynamics: Grounding Our Work

Palm Health Foundation learned over time that we had to be exceptionally mindful of real and perceived power dynamics that were influencing the very behaviors that needed to change for community change work to take hold.  We realized early on that the most challenging power differential was our hold on the purse strings.  But how to navigate around it?  How could we shift an entire traditional foundation mindset from “our grant dollars” to “your grant dollars” and from “we know best” to “you know best?” 

FSG’s “The Water of Systems Change” became the foundation’s North Star, guiding leadership to change their own ways of thinking and acting and advancing equity throughout the initiative.

Leadership was very comfortable working in the explicit space of structural change from a history of funding grants that directed resources toward improving nonprofit programs and services and affecting policy.  Working within semi-explicit conditions, where power dynamics reside, and implicit conditions that affect power dynamics, was where the learning needed to happen.  These are defined by FSG as:

  • Relationships & Connections: Quality of connections and communication occurring among actors in the system, especially among those with differing histories and viewpoints.
  • Power Dynamics: The distribution of decision-making power, authority, and both formal and informal influence among individuals and organizations.
  • Mental Models: Habits of thought—deeply held beliefs and assumptions and taken-for-granted ways of operating that influence how we think, what we do, and how we talk.

Three factors emerged as critical to shifting power dynamics and breaking down the barriers to create relational and transformative change:

  1. Authentic community participation
  2. Embracing emergence
  3. Setting the table for difficult equity conversations

They were the three factors that aided in embracing the Cyenfin Framework.

The Cynefin® Framework

Created by Dave Snowden in 1999, the Cynefin Framework is a conceptual framework used to aid decision-making.  Pronounced “kuh-nev-in,” it is a Welsh word that signifies the multiple factors in our environment and our experience that influence us in ways we can never understand.

The foundation migrated from the “chaotic” to the “complex” category and adopted a “probe-sense-respond” methodology to discovering health issues from the residents’ frame of reference.  Consultants working with the foundation introduced a sensemaking framework for community meetings that relied heavily on drawing the voices of the community to the table and exploring their health challenges in an open dialogue. Pre-determined notions were abandoned and eye-opening interpretations of how health issues were defined by residents emerged.

The Cynefin Framework

Embracing Emergence

Complexity requires abandoning the constraints of best practices as a baked-in solution and accepting that there are myriad ways of looking at root causes, symptoms and what a good outcome might look like.  The process is instinctual and gives everyone involved the ability to share perspectives from their points of view and accept that there is no one way to solve a problem. 

Embracing emergence put everyone on the same baseline.  The residents saw that the foundation did not have the answers and they weren’t there to impose a solution on the community. It was difficult for the foundation to let go of the known and move into the unknown in the early stages, but as the work progressed, leadership shared their vulnerabilities with the residents, allowing the residents to see that this was not an “us vs. them” initiative, it was “we.”

As one example, when Healthier Lake Worth Beach’s project director first probed residents for which of the three foundation health priority issues they wanted to adopt—diabetes, behavioral health or family caregiving—she was dumbfounded by what she heard.

“Having worked with the community’s families and children for eight years, I was so sure that Lake Worth would choose diabetes.  I see so many kids who are overweight, residents who are diagnosed with high sugar levels and so many people taking medication for diabetes. But they chose behavioral health.  When we probed for the issues they saw as behavioral health, they cited homelessness. Prostitution. The SWAT teams in certain neighborhoods two or three times a week. The dirtiness and the trash, the drug deals, the gangs, the crime. I never saw these things as affecting behavioral health and social/emotional welfare. But they were right there, right in my face. It was a lesson learned for me that social determinants can be common ground.”

     — Project Director, Healthier Lake Worth Beach

The Healthier Lake Worth Beach experience was just one that guided the foundation toward the social determinants of health— health-related behaviors, socioeconomic factors and environmental factors that are estimated to account for 80-90 percent of healthy outcomes for a population.

Everyone—from the foundation to the residents—we were all learning at the same time. We saw Palm Health Foundation working hard, struggling, but we were doing it together and it was OK. It was messy work, but we were doing it together.

Ten Flexible Rules to Challenge Mainstream Organizational Approaches

The Healthier Together initiative is grounded in Complex Adaptive Systems Thinking and has adapted the following flexible rules that challenge mainstream organizational approaches. As each Healthier Together community evolves and develops its own localized resident-led networks, these rules of engagement are beneficial to achieving the changes we want to see:

  1. Unintended consequences are not bugs, they are features.
  2. Follow the community’s energy and help manage flows and patterns of projects and activities. It’s impossible to engineer your way to an idealized future state.
  3. Patterns of behavior cannot be predicted, nor can they forecast what will happen next. However, by better understanding the present, what may be likely to happen can be inferred.
  4. Expectations can be undermined at any time by circumstances beyond our control.
  5. Seemingly small changes – a new person, a new idea, events that impact the mood of a community – can have significant consequences.
  6. New ideas, insights and opinions will generate constantly. Many emergent ideas or activities will present as unexpected opportunities. Others may create unforeseen challenges to ongoing work.
  7. View evaluation with Goodhart’s Law in mind: “When a measure becomes a target, it ceases to be a good measure.”  He observes that high-stake targets stifle innovation while promoting potential for fraud.
  1. Embrace “fail fast, fail forward,” – a requirement for working in the complex adaptive system’s “probe-sense-respond” decision-making process. As stated by Seth Godin, “Anyone who says failure is not an option has also ruled out innovation.”
  2. When an approach, project or idea has gained positive energy and proved successful, it has potential to test the waters of the complicated domain. More structure, predictability and process can create greater impact and move toward being replicable.
  3. Look at capital inputs from multiple perspectives and define different types of capital.  Don’t attempt arbitrary calculations of “ROI” by assigning monetary value to different types of capital. There are many successes to celebrate that can’t be easily assigned a monetary value.