trained to avoid or suppress their emotions, in relation towards patient’s circumstances, or their disease progression and healing processes. As a result, this conservative biomedical model often fails to offer a health system that embraces immense potentials for integral communication, wholistic healing and the opportunity for wholistic human growth and development (Schlitz, 2005).
Consequently, ethical enactment by health officials and HR practitioners requires expansion of their knowledge base and experiential learning, regarding the interconnections and integral relationships between spirituality, awakened integral leadership, and organisational development. According to Morecroft (2015), the psychosocial and spiritual organisational environment are the intangible traits that influence individuals to take decisions and act. These traits define organisational beliefs and attitudes which consequently form the prerequisites to their ethical enactment and responsiveness. An example of inspiring psychosocial and spiritual organisational beliefs and attitudes is the culture of technological excellence at Massachusetts Institute of Technology, that permeates all sections comprising the humanities and management, who determine collective decisions on faculty recruitment, the curriculum and choice of students (Morecroft, 2015).
With this expanded consciousness integral team performance, as well as participating fully in imminent tasks, there are emerging possibilities to share insights, observe, and experience diverse perspectives in which team members consolidate their learning. Consistently strengthening awakened consciousness and presencing from the Source, and enacting integral team practices, overcome these disconnects between egocentric attitudes, mental models, systemic and structural disconnects and Self (Scharmer, 2007). Integral health teams interact with substantial structural disconnects for example, disconnect between institutional leadership and co-workers, disconnect between immeasurable growth domineering service demands within finite resources and disconnect between technological
advancements and essential societal needs. Moreover, these gaps or systemic disconnects result in complexities at several organisational layers such as the invisible elemental level, the physical layer, the environmental, community, mental, emotional and perceptual layers, the financial, political, and technical layers as well as the spiritual layer. This disconnects result in systemic imbalances that lead to poor organisational performance (Scharmer, 2007).
To recognize the cause for poor organisational performance, awakened integral leaders explore causative variables with the intention of understanding how service delivery may lack quality, how the systems/processes oscillate, how organisational culture may be contributing, and how leadership consciousness might be limiting performance. Awakened integral leaders’ constant integrated awareness of these systemic disconnects are able to facilitate shifts from egocentric to worldcentric consciousness or as Wilber (2006) stated to in his AQAL model, as We space. This collective
consciousness resonates and creates the space in attaining abundant trust among integral health teams to influence work performance, enhance their professional role, and integral practices, resulting in the systemic balance and well-being of local and global citizens (Senge, 2008).
Since health ecosystems are dynamic, constantly evolving and generating systemic tensions, awakened integral health teams need to enact from a balanced and centered consciousness which leads to deep, meaningful practice and embraces integral behaviours in perceiving, thinking, and serving (McGregor, 2008). Pragmatic use of Scharmer and Senge’s (2006) U-Process enables integral health teams through various states, where they can access diverse perspectives, to co-create and enact purpose-driven solutions to organisational imbalances. Also, integral practice involves humanizing innovative skills on several levels that is personal, professional, political and social. Collectively, skill enrichment has a positive impact on other skills creating balance and centeredness in all human dimensions and practices (Donkers, 2016). A dynamic on-going learning process evolves as these integral practices are consciously experienced within organisational dynamics, which Wilber (2006) describes as transformational guidance through expanded consciousness of leadership.
Gebser (1985, p.8) described integral consciousness as existence with a “worldview that goes beyond our conceptualization” or Being which comprises awakened awareness beyond our rational analytical mode of knowing the world, in addition to the notion of Wholeness which represents a transrational way of framing things. Chatterjee (1998) referred to consciousness as the fundamental characteristic of integral theory which is unchanging, indivisible and regarded as Wholeness. He also described that from Wholeness, our level of consciousness organizes all complex human brain activities, our self- sense, self-identity and Being. Furthermore, he emphasised that “leadership is not a science or an art, it is a state of consciousness” and that “we can now begin to grasp the phenomenon of leadership as the field of awareness rather than a personality trait or mental attribute” (Chatterjee, 1998).
It is the awakened integral leader’s consciousness (Chatterjee, 1998) that enables integral health teams to practice from a space of expanded awareness to attend to disconnects between technological advancements and essential societal needs. As organisations adapt to meet the global dynamics in the 4IR, integral leaders’ consciousness, behaviour and organisational culture within the systemic
complexities, impact transdisciplinary team’s awareness of their connectivity, emerge (Küpers, 2007).
Awakened integral leaders with extraordinary spiritual aptitudes, are compassionate and empathetic, also they tend to think systemically and are consistently aware of their interconnectedness with the psychosocial spiritual context, organisational teams and communities they serve (Zohar, 2004). Using these integral principles, leaders facilitate and create collaborative relationships among
transdisciplinary teams, which enable ethical enactment of behavioural patterns like sharing information, connecting with stakeholders and building relationships with co-workers inside and outside of the organisation (Buehler, 2016).
The 4IR requires digital transformation by many organisations, some of which are enthusiastically sponsoring youth to study science, mathematics, and engineering with the intention of increasing the cohort of future candidates with Information Technology (IT) skills. According to the WEF Report (2016), on the industry gender gap, females are significantly under-represented in the global
technology domain, and attracting more females into the information and communication technology (ICT) industry; organisations need to actively recruit women. Also, Forum (2016) noted that diversity thinking and dynamic systemic approaches encourages creativeness and inventiveness. Awakened integral leaders who understand the significance of society interrelating with relevant technology empowers stakeholders towards energized progress, and who consistently engage in learning new ways of leading, enable diverse teams by creating the space, to become resourceful and adapt to change.
In constantly adaptive systems like health organisations in the 4IR, awakened integral leaders also need to learn how to successfully manage quantify and incentivize teams in virtual simulated work
places, and how to fundamentally connect diverse skill sets that will produce optimal results. The significant employment strategy among the reforms in HR recruitment policies, is to employ more women, the most-qualified candidate and create diverse transdisciplinary teams in virtual workplaces (Forum, 2016). To successfully manage complexity and changing dynamics (Epstein, 2007) in transformative relationships, leaders need to explore various team engagements. Shifting from multidisciplinary teams within one tertiary hospital, for instance, to solve a common problem like the KZN oncology HR shortages, and identifying bottlenecks causing delays in patient’s treatment, to interdisciplinary teams in which collaboration among diverse stakeholders, create the space for possibilities to emerge. These changes occur at a meso level of the DOH; for example, redesigning the oncology policy, co-designing standard operating procedures and service level agreements for various actors. At the macro level, the national transdisciplinary teams with an integral perspective, will endeavour to expand team consciousness, in which collective agreement for various possibilities to co-exist, and engage in understanding the dynamic contexts, create synchronized coordination and energetic interactions.
These diverse elements of transdisciplinary teams also create motivation on multi-levels of the individual, team and organisation. Furthermore, integral teams engage in critical self-reflection, as well as learn to observe and represent expanded paradigms as describing diverse strata of team values, which also enables a more accurate reflexive exploration of leadership and organisational practice (Lewis, 2002). Additionally, the shift from the health care system focused medical model approach, to an integral health approach, will require multiple actors, working in integral
transdisciplinary teams, with a common goal, across several sectors, for example, health, social welfare, education, agriculture, and justice (Halfon et al., 2014).
The enactment of integral transdisciplinary teams requires a psycho-social and emotional ecosystem, in which the fundamental state of leaders enables relationships that lead to extraordinary performance.
These relational interactions among integral team’s awareness, perceptions, emotional balance and behaviours change, as their decisions and responses emerge (George, 2003). Awakened integral leaders who practise authenticity and commitment to enabling transdisciplinary teams to become empowered, create the contexts in which both positive and negative feedback is provided, and teams respond to pragmatic systemic dynamics (Morecroft, 2015).
According to Avolio (2013), as transdisciplinary teams become empowered, their confidence to express courage, transparent honest communication, collective decision-making and self-direction emerges. Empowered transdisciplinary teams also remain true to themselves, despite external pressures to conform. Moreover these teams’ proficiency in self-awareness and self-regulation (Avolio, 2013) their inward focus, self-examination, self-control, self-confidence, self-study with
emphasis on reflexivity and collective group character, result in reliable and trustworthy decision making, moral and ethical enactment (Lessard, 2007). Heidegger noted that when individuals try to fit in with the desires of others, they experience inauthenticity, whereas when individuals respond to their conscience, they experience authenticity, and when guilt is experienced, authenticity as resoluteness emerges (Gardiner, 2011). Being authentic can also be described as when one experiences focused listening to and heeds one’s unique capabilities and potential or being true to oneself (Escudero, 2014).
Another of Gardiner’s (2011) leadership theories of the self, that the self is never neutral, as it always occurs within systems of power. Thus, as contextual consequences of a person’s spatial and temporal position changes, authenticity manifests itself differently. When the integral leader opens up spaces for transformation of leadership practice, transdisciplinary teams recognize their interconnectedness, and become conscious of non-dualism (Wilber, 1997). This leadership practice reflects an
understanding of non-separation, selflessness, is values-based (Chibber, 2010) and is a conscious choice to mitigate duality, affecting unusual personal power energy. Similarly, energy in personal power results in determination to transform, to overcome polarization or differentiation among team members, as well as an initiative to resonate positivity (Cummings et al., 2014). Personal and collective team emphasise character, self-knowledge and skill to practice significant harmony in thought, word and deed (Chibber, 2010).
When awakened integral leaders facilitate transdisciplinary teams to engage in systems thinking (Goleman and Senge, 2014), the illusion of separateness and duality is deconstructed, and an
emergent ontological awakening through experiential learning results (Goode, 2007). Non-separation essentially is interconnected elements in dynamic systems , existing in relation to feeling connected with others, deepening consciousness and experiencing shifts in perception, within an integrated psychoemotional and spiritual environment (Pillay, 2016). Awakened integral leaders, policymakers and managers, for example, who practise integral leadership strategies through stakeholder analysis to identity the key actors, and to assess their knowledge, interests, positions, alliances, and importance related to policy design, interact more effectively by their inclusive approach, and gain increased support for a given policy or program (Schmeer, 2000).
As complexities of illness, disease, and aging are confronted, new models for health care are emerging. One such model is the integral health care model; that shifts from the medical model wherein reduction of symptoms was the focus, to recognizing various dimensions of life, therapeutics, and curative aspects; inclusive of relevant stakeholders enacting integral health teams (Schlitz, 2005).
Likewise, the integral health care model is grounded on a natural intuitive understanding of life and a pragmatic perspective of non-separateness, focusing on a holistic, multidimensional physical,
psychosocial-emotional and spiritual dimensions and a transdisciplinary approach (Wilber et al., 2005). As integral teams consistently enact this holistic approach, their personal, interpersonal, transpersonal, the institutional and organisational characteristics transform their daily life and work (Davidson, 1998). Also, clinical team leaders who enact collaboration, trust and respect, enable collective team education and improved responsibility, as these integral elementary values empower front-line staff to take ownership of their service provision, as well as to integrate organising, coordinating and delivery of services, thereby improving health care practices (Greenfield, 2007).
Goleman’s leadership typology offers a variety of leadership styles to access, in complex health care organisations, as the need to respond to, dynamically changing contexts shifts (Saxena et al., 2017).
Similarly, studies among nurses indicated that the manager’s responsibility is focused on health “care management work whereas the nurses duty is on care production work;” indicating a clear
separation of the organising of the managers’ work from the nurses work as delivery of services (Greenfield, 2007). Consequentially, the integral team approach provides an opportunity to shift from the separation of work and delivery of services to joint managerial and clinical responsibilities, decision- making and shared governance (Schieffer and Lessem, 2016).