Leading in VUCA

In this episode of the "Stand in the &" podcast, Heather Gates and Lisa Macon Harrison discuss the complexities of public health leadership in a VUCA (Volatility, Uncertainty, Complexity, Ambiguity) world. They explore the importance of communication, trust, and connection in navigating challenges, emphasizing the need for active hope and collaboration. The conversation highlights the significance of understanding both the external environment and internal team dynamics to foster effective leadership and community engagement.

Host: Heather Gates, MPH, Owner & Strategy Partner of Human-Centered Strategy, LLC
Guest: Lisa Macon Harrison, MPH, Health Director, Granville Vance Public Health

Takeaways
•Public health professionals are navigating increased complexity & uncertainty
•Active hope is essential for effective leadership in public health
•Communication must be clear & frequent to build trust
•Understanding team dynamics enhances collaboration & decision-making
•Trust takes time & is built through consistent engagement
•“VUCA Prime” offers a framework for addressing challenges (Vision, Understanding, Clarity, & Agility)
•Leaders must balance processing & doing in their roles
•Human connection is vital in an increasingly technological world

Chapters
•00:00 Introduction & Background
•08:50 Navigating Complexity & Uncertainty in Public Health
•17:43 VUCA: Understanding & Responding to Challenges
•26:29 Collaboration & Leadership in Public Health
•26:54 The Gift of Collaboration in Public Health
•29:41 Self-Awareness & Team Dynamics
•34:59 The Importance of Communication
•49:08 Navigating Human Connection in a Tech-Driven World

Quoted Resources & Tools in this Episode
Moments of Impact by Chris Ertel & Lisa Kay Solomon
VUCA Prime Framework by Robert Johansson

Hymn for the Hurting by Amanda Gorman
Everything hurts,
Our hearts shadowed and strange,
Minds made muddied and mute.
We carry tragedy, terrifying and true.
And yet none of it is new;
We knew it as home,
As horror,
As heritage.
Even our children
Cannot be children,
Cannot be.

Everything hurts.
It’s a hard time to be alive,
And even harder to stay that way.
We’re burdened to live out these days,
While at the same time, blessed to outlive them.

This alarm is how we know
We must be altered —
That we must differ or die,
That we must triumph or try.
Thus while hate cannot be terminated,
It can be transformed
Into a love that lets us live.

May we not just grieve, but give:
May we not just ache, but act;
May our signed right to bear arms
Never blind our sight from shared harm;
May we choose our children over chaos.
May another innocent never be lost.

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Transcript

Transcript:
Heather Gates (00:01.673)
Good morning and welcome back to the Stand in the & podcast, y'all. I'm so excited. Today I'm joined by a dear friend and colleague, Lisa Macon-Harrison. Lisa, thank you for being here today.

Lisa Macon Harrison (00:18.346)
what a joy. I've been looking forward to this. And I have to, know people who are listening can't see, but I have a visual for you to be in my background with you today.

Heather Gates (00:25.021)
Nice for the y'all are missing this, but it looks like an and sign lit up with lights and everything. So.

Lisa Macon Harrison (00:36.204)
it up with lights. It's not as pretty as the one you've painted, but is always behind your visual when we get to see you. But I'm gonna channel the and today.

Heather Gates (00:46.987)
I love that commitment to the brand. The way to go. I know you obviously and I'll say a little bit more about that, but tell listeners what you want them to know about Lisa Macon-Harrison before we jump in.

Lisa Macon Harrison (01:03.87)
goodness, to know about me. Let's see. I think it's important to know that I am a very tired, eager, and proud local public health workforce. I guess what would you call me?

cheerleader, a little bit of a cheerleader for the public health workforce. Yeah, yeah, Love some public health workforce, all the work that they do, all of the incredible complexity that the public health workforce manages now and earlier and into the future. And then I would also say I'm a similarly tired and eager and very proud mama of a high school senior. And that takes a lot of similar energy.

Heather Gates (01:25.897)
Yeah. I was thinking advocate. Yeah.

Heather Gates (01:53.963)
Mm.

Lisa Macon Harrison (01:54.19)
So we're busy in all the ways these days. Work and home have lots of fun and lots of complexity like we like to talk about.

Heather Gates (01:57.771)
Mm-hmm.

Heather Gates (02:04.555)
And I think we're going to probably talk right on about that today. And I was actually thinking about how our paths crossed originally. So you're going to have to help fact check this with me. But I think the math is 20 plus years ago. So think I was in graduate school and did my practicum at the Institute for North Carolina Institute for Public Health with the Center for Genomics. So that would have been around like 2004. And I think you were there at that time with the Center for Public Health Preparedness. Does that sound right? Okay.

Lisa Macon Harrison (02:38.924)
Yeah, yeah, absolutely. Yeah, and that little intersection of research and practice is that sweet spot that we've had in common since then. So I love that 20 plus year history. After that, we'll just round up to the plus sign and not worry about the details. But 20 plus years of research practice policy and fun stuff.

Heather Gates (03:04.946)
Yeah, just always and when I think about you, I think of somebody in my life who's always, I think of you as a visionary. know, when we think about how we're similar or different, like you're imagining it and then I can kind of help put the blocks together on how to get there. But I have loved crossing paths with you in that way, in so many ways on different projects and different organizations over the years since then. So I'm just, I'm grateful for Yeah, not only what you do for the state of North Carolina, but how you have intersected with my life professionally and then certainly been a dear friend for me over the years. So I'm glad to see you. I'm glad to have you here. I love your headphones. Y'all are again missing the visual. We look like that we could be directing air traffic control right now with our headsets. We'll see. Ashley will let us know whether we've done a good job choosing the headgear that suits us.

But I do, Lisa, you mentioned complexity and I do want to come back to that. But before we do, kind of per our tradition here, I'm curious, you mentioned a little bit this already what and you're standing in, right? This sort of tired, eager. I don't know if there's more to that you want to say about kind of today, the and that you're showing up in particularly, or if that covers it for you.

Lisa Macon Harrison (04:25.752)
Well, I think we've been as public health professionals, we've been thinking a lot in recent months about present and future. So I think that would be the and that I'm I'm trying to wrestle with is, you know, how do we lead in public health in local communities with strapped resources that continue to fall away instead of come in the door. And so I think that that present and future is gonna be a different gear, right? We're gonna have to have one gear for now and one gear for later. That's usually the case. That's not something terribly new to us, but it feels more intense to understand the difference between now and later. I, know, yesterday, I did write this down in preparation because... I ran across a new Amanda Gorman poem that I had not read before. And in it, there is a stanza that says, “we're burdened to live out these days while at the same time blessed to outlive them.”

Heather Gates (05:44.533)
Mmm.

Lisa Macon Harrison (05:45.536)
And that's my end right now. Amanda named it.

Heather Gates (05:47.723)
I feel like my body just felt that before my brain registered it. Yeah.

Lisa Macon Harrison (05:55.309)
Yeah, Amanda can do that for you. She is quite the light with her words and I just love that. And so that is how I can explain my and with her words better than with mine.

Heather Gates (06:11.347)
No, yeah, love honoring the and with, and once you, one of the things I think that is curious is once you kind of dialed into thinking about things in this and frame, you hear a lot of people talking about it, right? You hear a lot of language around part of me feels this way, part of me feels this way. You hear people talk about paradox and the things that we're navigating. It is a bizarre sort of meta thing that we're doing by naming the and in this way, but I think it's fascinating. One of the things that's surprising to me today, clearly I know that we're gonna do this, what and are we standing in thing. So, morning of podcasts, I'm like, what's my answer gonna be? What am I standing in today? And it was interesting that as I asked myself that question even, like the question as a tool, as a mindfulness tool to go, what and am I stand again? And something would come up and then I was like, well, what else also? You know, I'm feeling frustrated and grateful that that teenager even still lives here to be playing that loud music, right? It's so it's, it's an interesting thing just to ask the question, what and am I standing in? I think where I land right now, is I'm pretty sunny side up today and I'll explain that in I think the weather so it's I don't know it fits as cool where you are but it is feeling very fall vibe here in the mountains. It's apple picking season like I just I think my I can take a deeper breath when the air clears like this so I feel I'm feeling uplifted just by the energy of outside right now and I'm yes yes and I have a whisper I think it's a baby whisper of overwhelm

Lisa Macon Harrison (08:03.576)
especially in the mountains fall is the best.

Heather Gates (08:14.079)
that I'm noticing. And it's helpful just to notice, because already this morning I was like, I feel you. It's like sunny side up with overwhelm rising. How does one want to notice this before it becomes the dominant narrative of my present? I have a lot of moving parts right now. with client work and podcasts and other creative projects and I've had family in town and just, right, birthdays and things. So I'm just noticing that I'm like whisper of overwhelm. Yeah.

Lisa Macon Harrison (08:51.506)
I sense a hike in the woods in your near future.

Heather Gates (08:56.317)
I love that for me, future self. So, yeah.

Lisa Macon Harrison (08:59.374)
Enjoy the fall air and calm the whisper. Yeah, I like it.

Heather Gates (09:03.047)
Yes, exactly. And you know, I think we could do a, I know we could, and we will just put a pin in this, a whole episode on overwhelm and what it really is or what it isn't and how we navigate that and how we get stuck in all those things. So that's not, we're not here to talk about overwhelm necessarily, but it is not, unconnected from what we are going to talk about, which I think is really leading in VUCA.

Lisa Macon Harrison (09:33.71)
Indeed.

Heather Gates (09:35.5)
So maybe I'll frame it up and then you actually have an update per usual you have an updated model of the one that I've been talking about that I'd love to invite folks into and for us to understand a little bit more. So VUCA for those folks who've not heard this acronym it's an acronym VUCA stands for volatility uncertainty complexity and ambiguity.

I did not invent it. actually, and I dug this book out again, maybe we really do need to make this podcast have visuals because it doesn't help for me to show it to y'all like I'm showing it to Lisa. But this book, Moments of Impact, How to Design Strategic Conversations that Accelerate Change by Chris Ertel and Lisa K. Solomon is the first place that I read about VUCA. And it's probably been, I don't know the math on that, 10 at least years ago.

And it felt very resonant at the time. Kind of, I was working with primarily hospital systems and health departments at the time. It was in a post ACA sort of landscape, lots of change. And it just felt helpful to name the change and the experience that we were all sort of feeling and navigating. You know, I continue to feel grounded by just giving experiences words that are hard to talk about.

So since then, and Lisa, you and I have talked about it. Certainly we talked about VUCA quite a bit in the COVID context as you led through that. And we find ourselves in, you know, continuing to be in times of uncertainty and complexity in particular. Before we talk about the flip side of that, I'm curious for you when we really break that apart, when you think about those words separately, is there a piece of VUCA for you that feels trickier than the other? Like, is it the volatility, the uncertainty, complexity?

Heather Gates (11:42.123)
Or is it all kind of the mush together is the same?

Lisa Macon Harrison (11:46.137)
right now in this moment in the present for public health, think uncertainty is the biggest one that is just hard to help others with. I mean, we can get a little bit more comfortable based on our own experiences or our own personality types, but to really coach and help and lead and inspire others through uncertainty is a real, it's a, it's a real hard thing to do. Well, I've decided it's just,

Heather Gates (12:08.811)
Okay.

Heather Gates (12:13.619)
It's official. It's official. Yeah. And it's interesting how often I feel like uncertainty comes up, even in the podcast. mean, Ashley and I, in episode two, we're talking about navigating the not yet and just the sense of this, what you do in the meantime or in the not yet. I, I, I'm the same. just from how I navigate, not even talking about team, but of them all, because truly complexity, I love it.

Lisa Macon Harrison (12:15.296)
It's just tough. 
We're used to that. We've got that down.

Heather Gates (12:43.285)
So the complexity part, yeah, I'm like, yes, let's cover a dry erase board with it. My brain likes to kind of get curious about all those parts and how they fit together and how to optimize those things. I think it's probably quite common that uncertainty is just hard. You know, we've talked about this sort of.

Heather Gates (13:07.955)
or natural inclination in uncertainty to go worst case scenario too with it. Like I'm having to train myself, especially as we launched this podcast. And I've talked about that is like, what, what else, what might be interesting? What might be helpful? And I don't know. So we need somebody, I need some neuroscientist on this podcast. If y'all haven't seen my request for that.

I need some nerdery deeper in here about some of these things, because it just feels true that we're wired more for the threat side of uncertainty. yeah, I feel the same. And in working with teams, you know, I think you're right. So.

Lisa Macon Harrison (13:48.62)
Absolutely.

Lisa Macon Harrison (13:53.865)
I think it's just human brains don't like the open loops. We want to close all the loops. We want to put all the things away. We want to feel like we're organized. We want to feel like the chaos we can control. And we can't always. And so that is a hard thing to sit with and then to lead with.

Heather Gates (14:18.98)
Yeah, definitely a tough and a stand in. was interested lately, you and I had a session with one of your teams and you had an alternate VUCA definition that I think is, Im curious about. So will you tell us a little bit more about that?

Lisa Macon Harrison (14:34.53)
Yeah, yeah, and I sort of found it by accident as one does on the Google. Just getting ready and getting ready for the meeting and trying to find the right visual and make sure the agenda was like you and I like them. And this visual popped up in a new framework and at least the Google tells me that Robert or Bob Johansson is the gentleman who came up with VUCA Prime, which sort of serves as this strategic response to the challenges of how you address VUCA and have more positive actions around it because the solution to some of that uncertainty and some of the things we can't figure out is at least to act, right? To have active hope and to get in there and to do some stuff. And so...

The V that has meant volatility in traditional VUCA, you should as a leader work on turning into vision or just figuring out the focus, the purpose, the goal into the future. And I think most of us who've had a work life are used to trying that exercise. And so that feels like the action that is the response to volatility.

And then under uncertainty, Bob has understanding, getting the feedback and perspective to sort of refine your plan and at least do some PDSA cycles in there while you're not certain about where the budget's gonna land in the future of local health department in the next six months. Let's at least try some things and some scenarios and figure out how you get feedback and perspectives from others on solving that uncertainty.

And that feels like forward, as you say. And then with the complexity, VUCA prime says, get to clarity, create the plan, stick with it, turn it into those actionable tactics. And again, that's the way forward is to find clarity. Even if it's not exacting, find the two things that I think.

during COVID, you helped us so much saying, all right, we don't know what the future holds and it's really complex to figure out your staffing model, but let's least look at the next two weeks and two months. We might not yet know the next two years, but let's see what we can figure out with two weeks and two months. And that clarity of the, at least a timeline that we knew we were gonna live in could help, that helped with.

Lisa Macon Harrison (17:13.166)
chunking down the complexity into these bits and parts that were easier to figure out. And then last is what has been in the VUCA world, ambiguity. You should as a leader seek agility. So just being flexible. we do, had a nursing director at one point early on here at Granville Vance Public Health who sort of coined the term for our team that we are public health flexible. We know things are going to change. We know that it's not going to look the same in two weeks or two months than it does today, but let's just be flexible with what we need to do to respond to that. And so I think turning ambiguity into agility feels like a natural exercise for most in public health.

Heather Gates (18:03.327)
Yeah, and I want to circle back, I think, to one of the things you first said before even you got into the acronym. Use the language active hope.

Right. That kind of having that model. And so in particular, thinking about active, cause I was thinking about uncertainty yesterday as one just ponders, right. Everybody sits around pondering complexity and uncertainty. Right. I'm sure they do. Or they, these are our people that are listening to this podcast. Right. For everybody else who sits around and ponders such things, it occurred to me.

Lisa Macon Harrison (18:33.546)
At least we find each other, right?

Heather Gates (18:43.563)
You know, I mentioned a minute ago that we were thinking about uncertainty and even as we launch podcasts, how's it going to go? that uncertainty that is something that I am choosing feels very different than navigating context that feels like it is happening. Cause just when I think about VUCA, I don't think, Oh, I'm, I'm launching all these creative pursuits.

Right? I think of it as I am navigating this in an environment that I do not control. And so I was, it just felt like an important insight even for me for like the tools that we're going to use in the frameworks, because it's, it's often too, hang with me. I'm, I'm, I'm quite sure when I was pondering that this thought went somewhere, I'm not sure if I can reclaim it or not, but why that matter? It's like, it's so that's one piece of it.

that it's this external thing that's happening. And also as you and I have talked about this before, it's a situation where you said act of hope, but where action is required of us at some level, right? That doing nothing does not really feel like an option. So I think about you, like I was thinking about your team and COVID, VUCA context, a lot happening.

And as a leader in a public health agency, there's no, we're going to just sit here and see what happens, right? It's ready or not. We're going to send an email at five o'clock ready or not. We're going to give the press conference ready or not. So it just, strikes me as a specific kind of piece of this where I think, but I'm interested in your reflection back where it feels like VUCA is happening and we to stand in our integrity in our role.

Heather Gates (20:35.923)
must find forward. Whereas you hear me say, yep, I just stood back afraid for seven years and didn't do the podcast until finally I was ready and the scales tipped in that direction and they can move that way. Right there, we're talking about context where there's no waiting. There's not, we're going to wait till Heather feels ready. It's today this is happening.

Lisa Macon Harrison (20:59.47)
Yeah, I think that's an essential way of combining the right personality types and the right community members in the work of public health because this work does take processing and uncertainty and pondering and some frameworks and some theory and some research to roll up into the doing and the... know, plan, study, act cycles that you do in quality improvement and the things that it takes to move projects forward, to move coalitions of people forward, to take the energy to use influence rather than, you know, authority in your leadership. And so it's just, it's an important thing to harness. I guess that's a the way I think about it, the combination of those energies of processing and doing. And we all have different affinities or are on the spectrum somewhere between process and doing in most days. Some days I'm more of a doer, some days I'm definitely more thoughtful about what's coming next and plan for next. And that's a gift to have a job that allows for that, right?

Lisa Macon Harrison (22:24.342)
that gives you the thinking time and the self-actualization to study how others have done it before and get it right, or at least get it closer to right for your community than you might have if you didn't look and see whatever else has been done before. So I just have that respect of harnessing, I guess I'll go to the past before we get to the present, before we get to the future.

Heather Gates (22:51.05)
Yeah.

Lisa Macon Harrison (22:52.246)
And I feel like that's what we're putting together as leaders in public health and really what led to a lot of the work of the academic health department model to make sure that we were pulling those things together before we were doing.

Heather Gates (23:09.183)
And you said that we're always on some, I remember your exact language, but on this kind of dancing in the end of planning and doing, right, process and doing. I guess it just strikes me that in the whole range of the work that you may be tasked with, the urgency of that, right, it looks a little different when we have space and time for more versus when we're in crisis. And we've talked about kind of routine complexity.

Lisa Macon Harrison (23:38.018)
Yeah.

Heather Gates (23:38.804)
The day to day, we take it in, we can engage. And then in crisis, how different it looks and feels where, yeah, I mean, I see you head nodding. So I don't know what's resonating with you about that, but I just, see that those same things juggle differently.

Lisa Macon Harrison (23:56.936)
So.

Lisa Macon Harrison (24:01.016)
So you know, since I'm back and forth in this district with two counties and a local health department in Granville and in Vance counties, I have two offices and I'm in my Tuesday office today, which is Vance. But in my Monday, Wednesday office in Granville, I have a post-it note that I wrote down after one of our conversations where you actually taught me crisis equals clarity. And the rest of the time, we have a lot more of the ambiguity, a lot more of the complexity.

Heather Gates (24:25.525)
Mm.

Lisa Macon Harrison (24:30.818)
but there is something somewhat satisfying and even driving adrenaline to decision-making in the brain back to the neuroscience that if you're in a crisis, you know you've got now, you've got that five o'clock email to tell the community what's going on and you've got that sense of urgency that drives the things that you do and it might not be as perfect as you'd like it. You might not get to do three drafts and ensure that it has no mistakes before that email goes out, but you've got to get the message going and make sure that people know what's happening and there's something satisfying about that mode when you can do it well. When you have the tools to do it well, I think public health sometimes lacks the funding, the tools and the technology advancements to get it done as well as we would like sometimes, but we're going to get there.

Heather Gates (25:09.856)
Yeah.

Lisa Macon Harrison (25:21.026)
That's the future. The future is ours and we're going to figure that one out.

Heather Gates (25:25.193)
Well, it strikes back to the VUCA prime model, right? If the C now is clarity, this sort of how we get to clarity, how much time we have to get to clarity, who's involved in getting us to clarity. You know, we do a lot of strategic planning work. and I talk about strategy being, you know, kind of focus and clarity grounded in reality and results. I mean, that's all we're trying to do is in your example , what's now next and later, whatever the time period is, if that's in a crisis context, it's like now is in the hour and next is the next hour, you know, and later is tomorrow versus something spread out over time. but yeah, and you mentioned working with teams and working across folks. I'm curious for you in that, in that dance from sort of planning to doing, getting to clarity, all of that leading in this sort of VUCA environment. What gets sticky for you? Where do you get stuck?

Lisa Macon Harrison (26:35.64)
You know, I think over the 20 plus years, I have been trying to navigate where I get stuck. I've learned a lot about the power of collaboration with others who have different personality types or different ways of looking at problems and how critically important it is to have a leadership team, to have people... with you on the journey of getting to clarity, of getting to understanding, of sharing the vision with you and being flexible with you. That's the gift that we have and why I said early on I'm such a public health workforce advocate and cheerleader is that the people who are attracted to the work of public health and want to make their communities better, want to make people live longer and have higher quality of life as they are in this world with other humans is just a gift. You know, the people who do this work are amazing people. I get to work with cool humans all the time who have other people's best interest in mind. And I do not take that for granted. So when you can learn to respect different viewpoints, different affinities for the focus and the details. It feels like magic. And so I had just gotten off of a meeting prior to our meeting and it was our Thrive team meeting. And you know, my project manager on that is just such a great detail person.

Heather Gates (28:07.816)
yeah, nice.

Lisa Macon Harrison (28:13.838)
So I these amazing public health nurses, as I have always bragged, can do one of everything and then figure out 17 other things that they have never even been trained in or tried before and they do it all with a plomb. And I just am so fortunate that the nurses I work with in particular can do everything from patch plaster walls that have a crack in them to write up some wonderful grant to do a new project in between the time that they're taking care of individual patients. They're just incredible humans and I love them. And they have skills that I definitely don't on the detail front and they see things I don't see and they know things I don't know. And we walk into this office every day understanding that about each other. They know I'm the one who has the big picture thinking and the new ideas and I'm so excited about next week's meeting with this partner or that grant mission. And then they remind me what needs to go on the agenda or make sure that the details I might not be seeing that they can communicate so that I'm also thinking about those things. And it's.

You when you find the people who understand how you show up every day and the things that you bring in your brain to the job and that they bring their things to the job that are very different, you know, it sounds like a duh moment. Of course, Lisa, everybody knows that and shows up to work that way. Well, it actually takes a little time to really figure that out.

And it takes a lot of self-reflection to know what you're good at and what you're not and to remain confident in your decision-making when you know how to, you know, tap into the gifts that others bring you. And I just think that's a real key cornerstone to good leadership.

Heather Gates (30:12.681)
Well, and I think I'm glad you mentioned the self-awareness piece of that, because I think we can, speaking of where we get stuck, think on collaborative teams, we can see, strengthen others and feel like I should also be that way. Like, my gosh, this is, I need to be this. I am inadequate because I am this. And what I hear you saying is that clarity about where I am strong.

And right, we know that we all have, can, we can flex and bend beyond our natural tendencies and do things, but this sort of lean into here's where I'm naturally strong and I will then trust others to be in their strength also.

I think is, yeah, is a lot on the growth side. is, go ahead.

Lisa Macon Harrison (31:04.494)
Well, and we, we got good at that as a team when we did the assessment called Strengths Finder, you know. So we've, we've done some exploratory assessments and, and, yeah, I've been here 14 years now. So we've really gotten to know each other well over those years and also understand and talk through what our strengths are. But I think that's part of, that's part of the processing. That's part of, you know, some people might,

Heather Gates (31:10.921)
Yep, right.

Lisa Macon Harrison (31:30.862)
push back on that a little, especially people that I work with to say, hey, I don't have time for these, you know, fun leadership meetings where you and Heather kind of coach us through how to think about what we're doing. Let me go out and deal with the septic system that's failing and get this stuff done. And you can have your processing over there. one of the best conversations I had about people's strengths was from my Environmental Health supervisor a few years ago who came in and said, you know, that he never knew it was called winning over others that he knew how to, he said, I just know how to talk to people and I know how to make sure they understand the rules and the regulations that, you know, help them not get sick. But, but we learned with StrengthsFinder that that was his, one of his strong superpowers is winning over others and communicating and teaching them what they needed to know. And I mean, yeah, that's what we do in public health.

Heather Gates (32:28.361)
Well, and what's standing out to me about this, as I keep looking back to this VUCA acronym and how you describe VUCA Prime, understanding was piece of it. And I think when we talked about it earlier, it was more about understanding kind of our strategic context, but this piece about understanding ourselves and the team, again, all of this, y'all, is like, there's VUCA, which feels

Heather Gates (32:55.945)
like it sounds. That's why I think I like it. just, it, it, yeah, it feels like what it, what it sounds like it is. Volatility, uncertainty, complexity, ambiguity. And we're like, what are the tools that help us lead into and through that? And if understanding is a piece of it, what you're saying for me now really resonates with this sort of understanding the relational strengths.

Heather Gates (33:21.117)
and assets and our own strengths and assets. Like what a foundation that is for how to move forward. So as we're figuring out, you know, now next and later and this and that and what are we going to do? All of this doing because everybody working in an organization, whether your business model includes collaborative models or not, has a team. So you are in the business of collaborative advantage at some level because of that, the nature of team.

And so the understanding within the team that helps things move more smoothly, more robustly, if we can really piece together like, okay, Lisa helped set the vision and we're gonna, we just know that we're gonna need somebody else. It's probably not you to help map all the details out and that's okay. But that we don't waste a lot of energy. I'm always very curious and part of my fascination with the and is trying to capture, like use all of our energy toward the vision that we have. So anytime we're not wasting energy, feeling like we should be a different way or trying to understand each other and we keep missing each other like that. And not efficient. don't, I don't say, I get itchy about the word efficiency because I feel like sometimes it squeezes out humanity from process. So I think I'll say effective relationship effectiveness as part of understanding that feels to me like the leading forward side of VUCA is what's resonating for me as you talk about kind of understanding across the team and where we can get stuck in that if we, you know, I think maybe don't honor kind of honor the strengths to use your language about what we are and how that pieces together. 

What are some other places when you think about this, especially this notion of action?

I feel like before maybe we talked some about communication in this context. I don't know if this is, if that feels like a trail to get curious about, or if there's something else coming up for you want to dig into.

Lisa Macon Harrison (35:33.081)
Yeah, communication is definitely one of those things that can get in the way if it's not done well enough, often enough, and clearly enough. And one of those things that I'm always working on, you know, we have performance reviews annually, most everybody in the working world does. And every single year I have been in public health, I have always reflected.

gosh, I sure could improve on my communication approach and style and frequency. It never goes away. It's always an improvement opportunity because there's so much more and so many more ways and modes to communicate through. It's just this never ending matrix of opportunity and challenge.

And so I'm grateful that it's a foundational capability of public health that we're now recognizing and trying to at least build our skill set around in public health in a different way before it's been sort of like piled onto the health educator's role and the nurses role in different job descriptions and always been present, but it's never been separately tended to for training or funding in the same way since the last three.

Lisa Macon Harrison (36:49.55)
three to five years when we're like, clearly we need to be using technology in new and different ways in all of its forms to make sure that the public knows and understands, you know, different behavior interventions, different information around preparedness and response, or in more simple terms, just we as a public health workforce have to communicate those effective things that we're doing.

Lisa Macon Harrison (37:15.842)
to contribute to community positively. And that's just a responsibility we all have and new ways of figuring it out are just always around the corner.

Heather Gates (37:25.607)
Yeah, I mean, and so it does strike me. as again, somebody who works with leaders, teams and multi-agency partnerships, consistently communication is the thing that comes up no matter what is right. Whatever, wherever the conversation starts, kind of all roads will lead eventually to communication on a sticky note.

Lisa Macon Harrison (37:26.572)
It's hard. It's hard to get it right.

Heather Gates (37:48.97)
And it means a lot of things. think we have to be careful. Sometimes we get lost in ourselves because we use that word to represent a lot of things. So I'm always asking groups, so like peel the onion layer back for me one more time. Communication to whom, about what, for what intended result. Because I think sometimes with communicate, well, two things I'll say first is,

in the public health context at least separating, do we mean communication to the community outward, right? In service to behavior change, in service to, right, making sure folks have the information that they need to pursue health in that way. Are we talking about how our team communicates, right? The culture of the leadership team, that sort of stuff. All is still words.

result is different, intended result is different. Either way, we know that communication is how human beings interact, right? It is the currency with which we engage. And I agree with you, it consistently is hard and we're not the best at it. In this context, I would divide it again into primarily what comes up is communication that is the relational side and communication that is to coordinate.

Right, so when we talk about communication sometimes to teams, it's the right hand needs to know what the left hand is doing. So we put the thing out in a way that the pieces make sense and it all goes together. There's that. And then there's the Lisa, need to give you some tricky, you know, I want to give you some reflection about your communication as a leader.

and how that impacts the team, right? It's that more emotional relational peopling side of it. So there's a lot in communication. you know, even as we think about this sort of VUCA and VUCA Prime context, if we're thinking about vision, right? Almost you can lay it across all this. When you're thinking about vision, you could see where communication fits in there. Understanding, clarity.

Heather Gates (40:07.581)
agility. Is there a place for you as somebody in particular? Because you and I, if it's not been clear to everyone so far, Lisa and I are in different pieces of the spectrum when it comes to this big picture detail situation. I'm probably more on the detail side. And I do think can build a bridge. I think part of why you and I connect so well is I can help sort of build the bridge between your vision and more detail side of it.

So I'm somewhere kind of maybe across, but as somebody who's geared in vision and operates in leadership, would say like tenacious, bold, visionary leadership. When it comes to, because you've talked about the importance of communication and collaboration, what gets sticky in there? Where do you find yourself getting stuck there and how do you...

I don't know if mediates the right word, how do you, what are the ways that you navigate or so to manage that stuff?

Lisa Macon Harrison (41:14.294)
Well, I think you've taught me, know, connection before content. And so those are two really good categories to put your communication efforts into because I've had to learn just the general effectiveness of meetings over time. Because we have, you know, we have leadership team meetings, have collaboration meetings, we have task force meetings, we have a lot of meetings in our lives as public health leaders.

There are people who show up and want a really good use of their time to be respected to different types of meetings. And so I've really had to learn to be really clear at the beginning of every meeting. Is this more of a connection meeting? And we're really going to get to know the assets of community people who are in the room and what they have to offer for this particular project or mission that we have before us.

Or is this a leadership team meeting where really we're sharing information and knowledge and we're letting people know what's happening in the dental clinic versus the child health clinic versus the WIC clinic and we're giving people updates on what to expect from each other when they see each other. That's also an important meeting. But you know what that's not? And some people can get frustrated. That's not a decision-making problem-solving meeting.

That's not a meeting that takes data and uses it to come up with a solution. And some of the doctors and finance officers and people who love those details and are so good at managing them at a fast pace really kind of want to get together and use good time to make a decision. so, you know, if I don't have like...

Heather Gates (42:38.635)
Mm-hmm.

Lisa Macon Harrison (43:03.49)
the birthday strawberry shortcake to connect with first, I'm not gonna be as good at making that decision with those data points. I've gotta have the connection, I've gotta make sure that we've built trust so that we can share the data and information we need to share to make the best decision. And I've had to learn over time that I have to explain that to some of the docs in the room, right? Like this is not a bad use of time, this is actually gonna get us to a better decision and

Heather Gates (43:09.131)
You're like, need my peopling and my pondering first.

Heather Gates (43:26.603)
Mm-hmm.

Lisa Macon Harrison (43:32.313)
thank you for bringing the amazing revenue cycle data that will get us the decision that we need to make this week. Great. It's not gonna be in the next 10 minutes. you know, those are the kinds of things that you're constantly in different gears, but you're having to, and again, this probably took me a good 12 of the 20 plus years to learn. You have to say that at the beginning. Say, okay,

Heather Gates (43:39.561)
Yeah.

Heather Gates (43:57.211)
Hahaha!

Right.

Lisa Macon Harrison (44:00.729)
This hour and a half time together has these three components and this is why these three components are important to everybody in the room. And you might not like one of those three things that we're gonna have to spend some time on and let's get to it so we can get to your favorite thing. I mean, really, it takes that.

Heather Gates (44:15.711)
Yeah.

Heather Gates (44:19.019)
Well, and I mean, I keep coming back to this list. So clarity being one of the things that, I mean, there's a lot in what you just said related to clarity, clarity and the purpose of the meeting, which if y'all never worked with me, you know, I'm a big fan of what are we here for? I, yeah, right. And I think it's actually,

Lisa Macon Harrison (44:38.156)
And are we making decisions or not? And what decisions are we making?

Heather Gates (44:44.607)
I'll have to look back, but I think it's in this moments of impact book that I mentioned in the beginning as they talk about these phases of building common understanding in my language. So I'm not, I don't have the reference so y'all can look it up, but generally building shared understanding, shaping options and making decisions. And that we're always working through that, right? Especially when we're in a VUCA context. So it's not quick and easy, right? There's not an easy.

Lisa Macon Harrison (45:05.261)
love that.

Heather Gates (45:11.667)
A to B C and we just need to get together to figure it out. There's a lot in there. And if we are going to operate in this collaborative model like you talked about, and we always are at some level if we're on a team, we have to make sure that folks have shared understanding. And I think that people get stuck a lot assuming that they do when they don't. And so taking the time to say, here are the facts as I see them, do you also see this is true?

Well, how do you see it? What do you see as different? then, cause it does take some time and that is an itchy place. So back to what you said before, like we're just ready. We have to take action and we know that. And so to take the time in the beginning to like pull time apart and to sit there and really settle into building shared understanding across the team.

which again, when you say strengths, people are gonna see reality in a different way. So we need to make time to understand how everybody sees it, which then shapes the options that we have to work with. You're gonna have different options depending on the reality that you're working in. And then from let's understand all the options, we can together make a decision. And again, we may not all love it and agree, but we understand where it came from and why we are the way we are.

Back to thinking about crisis and sort of routine complexity. Sometimes you're having to run that track fast. Here's the situation, right? It's more like, here's where we are, here's what we could do, what are we going to decide? Boom. And you have to run that whole thing through in a meeting. Sometimes we get the grace of space and we can spread it out. We can have a big community gathering where we're sharing things and creating, right, common understanding.

bringing folks in with lots of different experiences to then shape options and the other. So yeah, I feel like I just went down a rabbit hole with that, but it felt to me like clarity in meetings, what are we here to do? And then clarity about why it matters. I do, yeah, all of that communication. And for you, my guess is,

Heather Gates (47:26.205)
A piece of that is clarity about what other people need in the meeting too and making sure that we protect time for that, right? Like, we have some folks that think this way. So we do need to push all the way to that third, third piece. Cause you're like, I'm good with the connection. And I got to say Chad Littlefield, here's a shout out to you again. Everybody that I know can that credits me for connection before content. And I'm going to keep saying that I took that from Chad. So there's another shout out for Chad Littlefield.

Buy all of his things, everybody. He's awesome.

Lisa Macon Harrison (47:58.247)
The other thing it brings up for me in this moment that we're navigating today and into the future is this, you say also a lot at the beginning of meetings that we're humans, not robots. And what that brings to the table for a leader is also connection, empathy, making space for trust to be built as we look at.

Lisa Macon Harrison (48:24.332)
data and information and make decisions. And you have to have both of those. in healthcare, providers of healthcare know that they have to have that connection with the patient and we have to have connection with community and you have to build trust and connection through story, through trust, through empathy, through being present. And those things take a lot of time.

And I think it's frustrating in public health world to see how much public health leaders at national levels have been criticized or also, thankfully, we've had really good ones who are super at communication. Mandy Cohen has come into mind. She was really good during a time of crisis in sort of laying out the facts and telling people the real story, but also having that connection piece.

that cannot be underestimated. And if you have the gift of being able to translate connection with humans as you're giving hard information or uncertain information or ambiguous and complex information, that is the work of what's before us. And here's the dot dot dot part. We're getting to the place where so much technology is being over.

laid on top of all of this that we're talking about. And so the we're humans, not robots is like, but maybe not for long. Like this trust and empathy. Humans with robot assistance and humanoid robots will be here soon. And we've got to learn to make space and time for that human connection and human peace.

Lisa Macon Harrison (50:11.486)
It's so important. And if we don't name it now as an essential part of communication, we'll just be stuck in data and graphs that thankfully I know a whole lot of wonderful friends who are good at visualizing data now and helping us understand it and tell stories around it. I love it so much. I do get wonky with my details when it comes to...

Heather Gates (50:26.56)
Yeah.

Lisa Macon Harrison (50:35.244)
data, but I also love the translation of that. So I guess that's my other word that we haven't talked a lot about that we can go down another rabbit hole in is like this translation between, you know, what we do and how we do it and how important it is and how fast we're going to be expected to do it into the future and how we've got to translate the human side of all this all the time.

Heather Gates (50:41.127)
Yeah, I know.

Heather Gates (50:58.731)
Yeah, mean, both y'all were already, I feel like we're at time and now I want to go down this. Now that we've said hello, let's really get into it. Yeah, just as, as we wrap it up, I do, I think we can't under emphasize this trust takes time.

Lisa Macon Harrison (51:03.766)
Welcome to Lisa and Heather Conversations.

Lisa Macon Harrison (51:12.076)
Yeah.

Heather Gates (51:21.737)
I mentioned before that efficiency makes me itchy. All these things that it feels like we're trying to squeeze time out of. I'm hopeful. Maybe we do make a lot of things more efficient so that we have more time for thoughtful dialogue that's trust building, for deep understanding across people and teams and in community. What feels true to me is the

The cultural wave and energy feels fast. And I think trust is built in slow. And I don't know how we stand it. I mean, I'm all the time. mean, even just to have a strategy session with your leadership team, like it takes a lot to slow. I you know, I've had pause buttons made for a reason that sometimes the most important action we can take

isn't a forward, it's a stillness in some way. And I don't mean to stop, we have to do things. And I hope we can remember to cultivate what you're saying in these relational things. And not even in, yes, in service to what we're trying to get done, but so much of this is just, this is the humaning.

Like we are having a human experience that happens through connection with others. It is where we cultivate joy. It's how we feel seen. It's where we find belonging. So all of that has value of its own, not to mention it is the foundation with which we can take risk, with which we can have difficult conversations, with which we can do all of these things that we've talked about previously on this call today that are not easy to do and are going to

right, are going to be tricky with the strongest connection, but for sure, just the resilience and connection and support that we need in team, I hope we'll continue to make time to, yeah, whatever that looks like. And I'm not saying it needs to be, you know, strawberry shortcake every day, every meeting, but just the space to know each other and that we expand that, right? I think

Heather Gates (53:42.9)
And I'm hopeful that this podcast, even in the way we're talking about the, and can make space for conversation that really is fueled by curiosity. I think so much of it, right? That's, that's to me, that's how we get there. it's I'm curious about you. I'm curious about your perspective. I want to better understand. And that's just stuff that isn't like a quick chat, GPT scan of things. And I'm not anti-tech or AI. I'm just in follow up to your point.

Lisa Macon Harrison (54:08.6)
Mm-hmm.

Lisa Macon Harrison (54:12.652)
Yeah, no, but that's what we're getting ready to navigate. That is absolutely the finding the way forward with all of that together.

Heather Gates (54:13.163)
about trust and time.

Heather Gates (54:23.019)
I have to tie it up. Lisa will be back. We have infinite things. Yes, she's showing us her and sign. I feel like we need to post it. Send me a picture of you with your and sign so I can stick it on Instagram for everybody. Because y'all know now I've been convinced that we should be all the places. So you can follow Stand in the And on Instagram where we share kind of fun photos and other things behind the scenes and the show notes.

So we'll link Lisa, if you'll send me your information about VUCA Prime, we'll stick that in the show notes. I'll make sure I connect you all to this moments of impact book. It's great resource. Because we like, let's continue to share with each other what we're learning about, yeah, showing up in the messiness so that we can continue to do so with connection and trust and clarity. There's big work ahead.

I look forward to hearing from folks that are listening. It has been so lovely. People are starting to send us, you know, whether through Instagram or text or emails, sort of what's standing out to them, what resonates with them in the podcast. So I hope y'all continue to do that. I hope that you'll share podcasts that resonates, you know, let your team.

Like, hey, let's maybe some of the framework that Lisa shared feels helpful. Or maybe we said a little snippet of something that helps you have a different conversation and get curious with your team and your collaborators so that we can all keep. We have big work to do, Lisa. And we love it and are humbled by it and all the and things that keep us showing up.

Lisa Macon Harrison (55:58.542)
Always, always. We love it.

Heather Gates (56:09.193)
Glad to know that folks like you and your team and partners are out there doing the big hard work of public health in a real tricky time. So thank you to you and your team for what y'all do and what you're up for on everybody's behalf, in service to the public's health. So appreciate you and everybody else. And Lisa, I'll see you soon. And until next time, stay curious.
Bye!
Lisa Macon Harrison (56:38.328)
Likewise. Take care.