Sustaining high performance: dynamic balancing in an otherwise unbalanced system

As Ovid said, "There is nothing in the whole world which is permanent." It is this very premise that frames the discoveries in this chapter and the compelling paradox it has raised. What began as a question of how performance is sustained, unveiled a collection of core organizational paradoxes. The findings ultimately suggest that sustained high performance is not a permanent state an organization achieves, but rather it is through perpetual movement and dynamic balance that sustainability occurs. The idea of sustainability as movement is predicated on the ability of organizational members to move beyond the experience of paradox as an impediment to progress. Through holding three critical "movements"--agile/consistency, collective/individualism, and informative/inquiry--not as paradoxical, but as active polarities, the organizations in the study were able to transcend paradox, and take active steps to continuous achievement in outperforming their peers. The study, focused on a collection of hospitals across the Unites States, reveals powerful stories of care and service, of the profound grace of human capacity, and of clear actions taken to create significant results. All of this was achieved in an environment of great volatility, in essence an unbalanced system. It was the discovery of movement and ultimately of dynamic balancing that allowed the organizations to in this study to move beyond stasis to the continuous "state" of sustaining high performance.