The really big systemic changes play out over decades and can require sustained leadership through three distinct horizons of awareness and action.
In the first horizon, leaders identify the strategic issue and work to create collective awareness of the need to change. They challenge the assumptions defining the system now, point out the shortcomings, and invoke a vision for a preferred future. They may encourage and sponsor pilot initiatives to probe the potential for this new direction.
In the second horizon, leaders have created some momentum for change and they have the results from their pilot initiatives to guide significant investments in new capabilities and systems infrastructure. For individuals and organizations, this is an intense time of unlearning and relearning to move in this new direction. This is a time for identifying and inculcating best practices.
In the third horizon, leaders have achieved the transformation. They are now engaging in continued learning either to improve the new system or to address the unintended consequences that inevitably emerge when a different reality replaces the status quo. They are working to align the culture to sustain this change.
If we can understand systemic change as a slow and sustained process, it can give us the patience and reassurance to keep working for the really big and important changes. Rather than asking, why are we still talking about this change a decade later, we can instead ask, where are we now in this change?
For example, in healthcare we have been talking for several decades about the importance of prevention and the need to replace an acute care and chronic disease medical model with a health promotion and prevention model. We have navigated the first horizon and have collective awareness that this is where we need to go. We even have proof of many concepts from a multitude of pilot initiatives. The healthcare reform law is a second horizon move to instill this priority into the system. Major employers and insurers and public health organizations are doing their part to move more resources into prevention. Prevention is a good example to illustrate the challenges of the third horizon. Without a cultural shift of profound significance and breadth, this will be a difficult transformation.
In the long arc of significant systemic change, leaders have to understand and accept where they are in the horizons of systemic change. This can be part of the story they tell to inspire individuals and organizations not to give up even when the change is decades in the making.