September 2, 2026: Salus Forum

In attendance on September 2, 2026, at this twenty-fourth Salus Forum, were Mitch Applegate, Bill Bergquist, Jenny Chen, Jeremy Fish, Bill Gillanders, Howard Haft, Mark Vukalcic, and Jack Westfall. The Trigger topic for this forum was provided by Drs. Bergquist and Westfall. They introduced the topic of Emergence as a major challenge in the provision of adaptive leadership within healthcare institutions.

Following is a Narrative based on the Forum conversation:

Jeremy

This series for Salus concerns leadership in action. Originally framed around masterful adaptive leadership, based on a session conducted by Walt Mills several months ago.  This is now the second in that series. We did masterful last month. This month is going to focus on adaptive leadership. Jack Westfall and Bill Bergquist were kind enough to volunteer to take on that very simple, easy topic that we can cover in two minutes or less.

Bill B.

I’ve written a lot about adaptive leadership in the past. Usually it’s fairly trivial. How do we adjust things? How do we move things around a little bit from day to day? However, I would say the real challenge of adaptive leadership comes when there is something that occurs that is called emergence.

The studies on emergence have really arrived in the last few years. In many ways, the concept of emergence actually goes back to Alfred North Whitehead and his introduction of process philosophy. More recently, an extraordinary group of scholars have produced something called Big History. The concept of Big History is built on an important premise. Big History Scholars say they can put all of the history of the universe from the Big Bang till today, all in one model. This basic premise of the model begins with the claim that there have been seven major emergences. And emergence is somehow where the system changes in fundamental way its character.

The classic piece of emergence, of course, is something called water. You have two properties, something called hydrogen and something called oxygen, which are both gases. But the remarkable thing is that when you put them together, you get something called water.

And as the people who’ve done the work on this say, one would never have predicted water. You can get every famous scientist in the world, and they would say, you bring together two gases and you get a liquid? Impossible. There’s an emergence that occurs when you bring oxygen and hydrogen together.