Table 1.

How adaptive leadership concepts translate to person‐centred care

Adaptive Leadership Concept	Definition	How it Translates to Person‐Centred Care
Adaptive Conversation	Inspiring leadership in others by helping them to reflect on challenges, think ahead, and plan for the future.	Reviewing goals of care and priorities including how to prepare for the future and what to expect in the disease trajectory; patients, caregivers and care providers manage expectations of each other.
Alignment Conversation	Identifying and discussing the underlying reasons for people's resistance to change and providing a safe space to talk about concerns.	Explicitly asking about fears and concerns, demonstrating compassion and empathy when communicating.
Courageous Conversation	Correcting unacceptable behaviours or respectfully calling out a discrepancy in others’ behaviours.	Care providers being honest about the likelihood of a poor outcome due to a patient's behaviours. At the same time, patients and caregivers verbalizing their discomfort when they feel their preferences are not being considered. Patients and caregivers need to feel safe in speaking out without fear of reprisal.
Observing	Heifetz and Linsky 39 use the analogy of ‘getting off the dance floor and onto the balcony’. From the balcony, you can see the broader context or the ‘big picture’ which can inform a greater understanding of issues and actions.	For care providers, it is about understanding the social context of patients and caregivers to identify factors that will influence their ability or willingness to manage their conditions. For patients and caregivers, it is about recognizing care providers’ constraints in their ability to support them (such as a lack of time or resources, high patient demand, lack of evidence base of suitable treatments). Like any relationship, acknowledging the constraints of the other party is critical in creating a sustainable, respectful relationship and preventing burn‐out.
Interpreting	Reading between the lines and not taking everything at face value. Heifetz et al 39 describes interpreting metaphorically as ‘listening for the song beneath the words’.	Paying attention to body language, facial expressions and what is not being said. Such intentional listening requires patience, time, trust, probing and comfortable silence. Continuity of care between the care providers, patient and caregiver is required.
Intervening	Reflecting on the hypothesis of the problem. Any proposed ‘intervention/solution’ should be considered a ‘trial’ which may need to be adapted over time. The ‘intervention’ should be clearly connected to a shared purpose and take into account the resources available.	Trying a new treatment or care plan that reflects the shared goals of the provider(s), patient and caregivers with the caveat that things may need to be tweaked and changed over time (continually testing what works and what does not work). The new treatment/care plan needs to leverage available resources of the patient/caregiver (including their access to financial resources and caregiver capacity). It is important here that a balance be struck between giving a treatment or plan enough time to succeed versus pivoting to a new strategy too quickly. 40