Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login


Initiativitis: a disease of organisations

by Jon Townsin

Plans A and B (Flynt/ debilitating disease is most acutely felt at the operational level of organisations by people who are engaged in delivering core products or services. Its presenting symptoms include a loss of focus, overwork, frustration, anger and demotivation.

The apparent cause of these signs of initiativitis is too many ideas being implemented in too short a timescale. The resultant bottleneck allows insufficient time for any one idea to take root and become established before the next comes along and diverts necessary resources.

The range of responses to initiativitis vary from on the one hand putting pressure on people to do more to tolerating slippage in timescales or the effectiveness of the initiative on the other. Both fall foul of the quart and the pint pot rule. A simple enough rule that requires no explanation, but one which is breached by most organisations, most days.

At the level of the individual research informs us that effectiveness is a function of focus and energy. Does the same hold true at the higher organisational level and, if so, what additions to this apparently simple solution do we need to add?



20 per cent

Take purposeful action

10 per cent


30 per cent

Be busy

40 per cent



What sort of leader are you?

Let’s start by exploring the link between focus and energy.

Research by Professor Heike Bruch found that a relatively small number of leaders managed to achieve effective performance by maintaining a tight focus around what they were intent on achieving and then putting in high levels of energy to achieve the goals they had set themselves.

The largest group of leaders were characterised by being excessively busy, working long hours on a wide range of activities but not being particularly effective overall. A similarly large group were caught in the headlights unable to decide where to put their energy and consequently putting it nowhere.

A smaller number of people had decided to switch off and disengage from the organisation. Bruch’s findings echo the symptoms of initiativitis, but provide a possible solution in the guise of maintaining focus and energy.

Focus demands clear boundaries

Of course, maintaining a tight focus is easier said than done. A single-minded approach requires that a leader has to carefully and publicly draw the boundaries that define what’s in and what’s out. Having been defined, the boundaries also require disciplined maintenance. Being effective means saying no more often than yes which, for many, is a tough choice.

In organisations with multiple stakeholders both internally and in the outside world the decision of where to focus is a difficult one but no less necessary. In a hierarchy each level will have its priorities that may or may not dovetail with each other. Each function will have its own initiatives to improve performance. Government initiatives put significant pressure on organisations to adopt new ways of working. So whose priority wins out?

One favoured approach is to agree a set of goals or strategic objectives at the top of the organisation and then cascade these down through the performance management process. But priorities conceived at an abstract level do not always translate sensibly into the pragmatic world of the operating units. The top-down approach loses its meaning on the way. Similarly a bottom-up approach lacks direction and connectivity. Each of the parts operates independently and without reference to the whole.

An effective dialogue between the individual parts and the whole(s) where one can engage with the other provides the means to join the dots.

The dialogue may be face-to-face or electronic, all at once or in stages. The purpose is more important than the means. A meeting to roll out an initiative rolls over the viewpoints of the people who are charged to implement it. A meeting to understand and jointly agree a focus of priorities encompasses those viewpoints and leaves them intact.

The disease is self-made. The cure is a shift in mindset.

Back to Provocative conversations

Citation: The Pharmaceutical Journal URI: 11035770

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics

    Introduction to Renal Therapeutics covers all aspects of drug use in renal failure. Shows the role of the pharmacist in patient care for chronic kidney disease.

    £38.00Buy now
  • Pathology and Therapeutics for Pharmacists

    Pathology and Therapeutics for Pharmacists

    An practical, integrated approach to the pathophysiological and pharmacotherapeutic principles underlying the treatment of disease.

    £54.00Buy now
  • Drugs and the Liver

    Drugs and the Liver

    Drugs and the Liver assists practitioners in making pragmatic choices for their patients. It enables you to assess liver function and covers the principles of drug use in liver disease.

    £38.00Buy now
  • Biological Therapeutics

    Biological Therapeutics

    An introduction to the treatment of disease using biological medicines derived from living plant and animal tissues.

    £33.00Buy now
  • Disease Management

    Disease Management

    Disease Management covers the diseases commonly encountered in primary care by system, with common therapeutic issues. Includes case studies and self-assessment sections.

    £54.00Buy now
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.