People want to know: How will needed social change come? By creating good-paying sustainable jobs for everyone? Through universal, affordable, high quality health care? Through education? A greener environment?

Myles Horton, the great educator and social theorist, lived and taught by the phrase, “You cannot achieve what you cannot imagine.”

Horton was also a great realist, someone who devoted his life to social change, largely achieved at the grass-roots level. But his visionary mantra drove his students, organizers and activists to great achievements during the civil rights movement, union organizing campaigns, and community land use and environmental projects in Appalachia.

I suggest that “you cannot achieve what you cannot imagine” is a call for systems thinking.

What is systems thinking?

Lisa Schilling, Kaiser Permanente’s vice president for Healthcare Performance Improvement, sent me and others an article titled “Get the Whole Picture.” (Follow the link to quickly register and view the article.) It’s a great primer in systems thinking for health care professionals:

“…systems thinking means focusing on the organization as a whole – and transforming it as a whole – rather than merely paying attention to its individual parts or departments. By focusing on the entire system, you can identify solutions that address as many problems as possible.”

For us in the unions at Kaiser Permanente, we have a mission (“what we can imagine” in Horton vernacular). Our mission is to empower working people to have a secure stake in the society, to have the right to have their life experience at work contribute to the best outcomes for the community as a whole, and to build a secure future for the generations to come. We have refined this vision into a legacy statement: that unionized health care workers advance Kaiser Permanente’s model of care as the foundation for universal health care, while preserving and enhancing the best wages, benefits and working conditions in the industry.

For me, the engagement in systems thinking that is foundational for the collaborative efforts of every unit-based team enables frontline workers to think in ways that go beyond the workplace and beyond health care. If we can truly become effective systems thinkers on the job, we, as union members, can contribute enormously to the larger social and economic challenges of the nation.

Role of unit-based teams

We know that in health care, there are errors, waste and other failures that drive up the cost of care. Paul O’Neill, former U.S. treasury secretary, has said, “It is possible for our society to reduce the cost of health and medical care by 50 percent and simultaneously improve the outcomes for individual human beings.”

The work of unit-based teams is designed to do just that: create improvement methods and outcomes placing the patient at the center of everything we do. This systemic approach to change can be applied to any endeavor and in every workplace that envisions sustainable, affordable and competitive products.

I believe that the day-to-day engagement of frontline workers in systems thinking and patient-focused care enables us to think more broadly. Systems thinking in the workplace will lead to achieving what we can imagine. We must support systemic outcomes, not just improved project outcomes. As we do, we will empower the kind of thinking and action that can overcome the waste and errors in the way many decisions are currently made.

In so doing, we are contributing enormously to both the improvement of the whole of Kaiser Permanente and the security of our workforce. We are also contributing to a broader social consciousness, necessary for new thinking to improve our nation as a whole.