226 Chapter 6 ture and culture during this time. COVID-19 was the external pressure that put Sanquin’s system into disequilibrium, forcing the organization to cope to find solutions.21 Here, the elements of adaptive process, adaptive spaces and enabling leadership occurred. The resulting collaborations were examples of adaptive spaces where Sanquin’s entrepreneurial (innovative) persons were forced to work together with operational (stability and efficiency) persons to achieve their aims. Within these spaces, respondents experienced how to conflict and connect well (defined as finding ways to bridge differences to create adaptive solutions, or linking up ideas, information, resources in beneficial ways or a beneficial new order.22 Overall, these spaces enthused respondents because it was the first time that many of them experienced its fruitfulness. Additionally, the strong support and wide freedom from top management were novel and significant as it gave room for these adaptive spaces to continue. Furthermore, enabling leadership occurred through the presence of key persons (not necessarily managerial) who led these collaborations and/or fostered the adaptive process by using skill and creativity to unite people together.22 Lastly, the adaptive process was completed when the solutions within the adaptive spaces became incorporated into the operating system in the form of new order21 (e.g., new processes, new blood product, digitalization of the donor registration form). However, as found by our respondents, and described in CLT, after a certain time, the opportunity window for adaptation closes and it becomes more difficult for adaptive spaces to occur unless CLT elements are built into the system.21 22 With regard to leadership, the collective COVID-19 experiences have shown that for organizations to thrive in turbulent times, it is not and cannot be one person who is the sole driving force for survival and success, but an entire system composed of meaningful and effective interactions.7 8 22–26 Put simply, as CLT states, leadership is co-creation.21 Leadership studies from the pandemic period have similar overtones that leadership needs to be a sustainable, collaborative, changing mentality,20 27 28 focusing more on purpose and relationships than outputs and/ or outcomes20 21 27 so that there is a shift away from “planned” to “playful” change.29 Complexity leaders are described as having attributes of deep conviction to take risks in creating adaptive spaces for others but humble enough so others can take the lead. They are willing to engage with tension and ambiguity and use it to propel forward action. They possess skillsets of brokering, connecting, facilitating and energizing learning and growth. Complexity leaders share credit and work collaboratively as seeing people engaged and systems changing gives them deep fulfilment and fun.3 9 Uhl-Bien describes how healthcare systems, when faced with complexity, usually respond with traditional bureaucratic approaches. She advocates that instead of adding complexity leadership on top of traditional leadership, it is more effective to replace the latter
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