Hierarchy: Let Form Follow Function (2 of 3)

If we want more diverse and creative organizations that can adapt to this quickly changing world, and if we want more sustainable jobs and happier teams, we have to open up to what is possible. We have to reorient around what we’re trying to achieve and then design our resources, practices, and decision-making and communication channels so that people have agency to do their jobs well, without gatekeepers. Most importantly, we have to be willing to check what we know about organizational management at the door because management is historically built on an assumption that status and power over others is a necessary part of effective organizations. 

What’s right for your organization is going to depend on your context, but there are examples to learn from. 

My favorite case study from Frederic Laloux’s Reinventing Organizations (2014) is a revolutionary nursing organization, Buurtzorg, in the Netherlands that centers the patient experience by ensuring that decision-making power is decentralized to autonomous teams and tied to function, not status. That means that frontline nurses have complete agency over their day, work, and relationships. Each nurse is part of a 12-nurse self-managed team that serves a neighborhood of about 5,000-10,000 residents. The company resources their nurses for collective intelligence through an online platform for sharing ideas and trouble-shooting patient needs. Instead of regional managers or directors, teams have regional coaches who have no decision-making power over the teams and no goals tied to profit or performance of the teams in their region. Their job is to serve as a thought partner, help connect nurse teams to one another, and share how other teams have resolved issues. In other words, they are network weavers.

In Buurtzorg, the nurse teams themselves don’t have formal hierarchy. Rather, the unique talents and interests of the individual nurses inform the roles they take on for the team. Laloux writes, “In Buurtzorg’s teams, there is no boss-subordinate hierarchy, but the idea is not to make all nurses on a team ‘equal.’ Whatever the topic, some nurses will naturally have a larger contribution to make or more to say, based on their expertise, interest, or willingness to step in. […] Because there is no hierarchy of bosses over subordinates, space becomes available for other natural and spontaneous hierarchies to spring up–fluid hierarchies of recognition, influence, and skill (sometimes referred to as ‘actualization hierarchies’ in place of traditional ‘dominator hierarchies’),” (p. 69). 

Once dominator hierarchy is removed from the environment, there is no longer a ladder to climb. Individuals within the organization can’t increase their influence by supervising or making decisions for other people. They have to grow and achieve advancement through learning, through relationships, and through continuous improvement. With full agency over their work, the human development opportunities are vast. Buurtzorg relies completely on self-management, and it’s really paid off. Their workforce is highly engaged, and even the limited administrative staff functions (like finance, communications, and human resources) are clear that the purpose of their work and their organization is to center patients and trust frontline nurses. Laloux doesn’t shy away from admitting that self-management is hard work and that power dynamics surface. That’s where the regional coaches come in, to ensure teams are resourced to work through it and manage themselves effectively. 

I love this case study because it’s an example of how one very specific industry looked at its own context and asked what form would best serve their work, instead of assuming that traditional organizational structure is the best way to achieve their mission. As Laloux emphasizes, a characteristic of next level organizations is that form follows function. We have to ask ourselves: what organizational structure centers the organization’s mission and clients? 

I have a lot of questions for Buurtzorg, as I’m sure you do, too. But, one thing is clear: they demonstrate that it is possible to break away from traditional hierarchy and have a highly functioning (wildly successful, actually) organization. It’s easy to think that this kind of revolutionary reorientation is not possible in your line of work, whatever it is, but I encourage us all not to just take the easy way out. In your organization or in your industry, it will probably look different than at Buurtzorg, but surely, there is a better way that doesn’t rely on maintaining control by perpetuating power scarcity.

Cited Work:

Laloux, F. (2014). Reinventing Organizations: A guide to creating Organizations Inspired by the Next Stage of Human Consciousness. Nelson Parker.

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