Collaborative Governance:
Key to Success in Era of Population Health
James A. Rice
[email protected]
The Champion of
Collaborative
Governance
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Collaborative Governance:
Key to Success in Era of Population Health
Objectives for Session:
1. Top 5 Challenges to govern CAHs
2. Define 3 Key Board Practices
3. Define 5 Actions for Impact
Collaborative Governance:
Key to Success in Era of Population Health
1. Top 5 Challenges to govern CAHs:
o
o
o
o
o
Physician and Advance Practice Nurse Recruitment
Threat to Medicare Payments
Growing out-of-pocket payments for patients
Expanding consumer demands for value
Calls for Population Health Partnerships
Expected to do more with less…
Population Health. Community
Heath Partnerships
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New Competencies & Investments
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Board Challenges in Population Health?
1.
2.
3.
4.
5.
6.
7.
8.
New Drivers for success
New Interventions
New Revenues
New Costs
New Partners
New Governance
New Systems
New Competencies
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Our Journey in this Session:
1. What is collaborative governance?
2. Why it is essential for effective community health
3.
4.
5.
6.
7.
needs assessment and planning?
What Boards should be doing differently?
What supports effective collaboration?
What are indicators of value of governance
collaboration?
Examples of collaborative governance?
Next steps?
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Many Sources for Insights
http://www.americangovernance.com/resources/reports/brp/2016/16-BRP-Learnings-on-Governance.pdf
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Collaborative Governance:
Key to Success in Era of Population Health
2. Three Smart Practices
o
o
o
Invest in Innovation
Enhance Community Engagement
Champion Collaborative Governance
Explore Nationally . Adapt & Engage Locally
Design
Thinking.
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Collaborative Governance:
Key to Success in Era of Population Health
3. Five Actions for Impact
o Community Health Council:
o Local Public Health Department
o Federally Qualified Health Centers (FQHCs)
o Schools and Coops
o Charrette Process for CHNA
o Community Health Backbone Organization
o Community Health Philanthropy
o Dashboard Reporting
Many Sources for Insights
Community Health Needs Assessment
is Key
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http://seekingcommunity.ca/
Concepts Woven into Sturdy Fabric
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Foster
http://www.aha.org/about/awards/foster/winners.shtml
McGaw Award Winners
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Many Stakeholders.
Shared Vision. Process is Key. Not Easy.
http://www.hewlett.org/uploads/files/HewlettCollaborativeGovernance.pdf
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Healthy Community Heritage.
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Minnesota Example:
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Minnesota Example:
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Enablers for Collaborative Governance
Action
The Lucky Seven:
1.
2.
3.
4.
5.
6.
7.
Engagement
Vision
Own Problem
Own Solution
Transparency
Accountability
Celebration
Enablers
1. Engagement
Wrap board to board collaboration in
stakeholder engagement. What is the
most good for the most people we
serve in eyes and language of the
stakeholders? Broad view of
stakeholders. Engage heart and mind
to engage hands and resources.
Change Management Classics.
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Engagement: Board Art and Science
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http://tamarackcommunity.ca/g3s26.html
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Charrette: Tool for Stakeholder Engagement
the word Charrette is from the French for "cart" or "chariot".
It was not unusual for student architects to continue working
furiously in teams at the end of the allotted term, up until a
deadline, when a Charrette would be wheeled among the
students to pick up their work for review while they, each
working furiously to apply the finishing touches, were said to be
working en Charrette, in the cart.
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Saves time and money Help
through
Charrettes
Reduced rework via short design feedback loops
Time-compressed work sessions
Creation of broad support from community
members, professionals, and staff
Increases probability for implementation
through
An integrated team design process
Early focus on engineering and finance
Bringing all decision makers together for a
compressed period of time
Promotes trust between citizens and
government through
Meaningful public involvement and education in
which input may effect the outcome
The building of long-term community goodwill
Broad stakeholder involvement – no one takes
over
Results in the best sustainable design
through
Integrating all viewpoints throughout design
Uninterrupted, focused team design sessions
Design based on shared guiding principles
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Explore
Experiences of Engagement
http://www.charretteinstitute.org/
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Enablers
2. Vision
Desired future state. How we would
like it to look and behave? Real
stories for real people. Protecting not
eroding heritage.
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Future Scanning
Explore alternate futures for
your organization and
community.
Scenarios
Teams to do “Trend Casting” to encourage
fresh thinking about factors that could
impact your plans and performance.
Build possible Scenarios from your trend
casting results.
Facilitate Critical Conversations about
factors that could increase probability for the
scenarios.
Examine the implications for these
Scenarios in SWOT and Start, Stop,
Continue Worksheets
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Hope Engine
Identify key stakeholders for your
services or activities.
Develop two lists: their Hopes
and their Fears in the year 2020
related to your mission.
Prioritize the two lists.
Define strategies to remove the
Fears, and strategies to achieve
their Hopes.
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Visioning
Look and behave in Summer of 2020?
Stakeholder Story 2020 for:
Pick Newspaper or Magazine
Obstacles for us to earn this recognition?
Key messages in story that celebrate what we
have become from perspective of this
stakeholder
Headline about achievement
Actions for us to earn this recognition?
These will be summarized to help guide future
strategy development and momentum building.
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Enablers
3. Own the Problem
Process more important than
the plan. Engage diversity.
Sincere questions … risks of
doing it, and not doing it.
obstacles, frustration factors.
Aikido Technique.
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 Step 1: fast brainstorm of everything group can think of
that would frustrate
achieving the job at hand (obstacles
Aikido
Planning
to goal);

Step 2: group prioritizes to the top 3-5 obstacles based
on their judgment about the relative importance and
likelihood of the obstacle (use simple or complex voting
to save time)

Step 3: assign each one of the top obstacles to a small
group and ask them to quickly define the top 3-5
practical ways to remove, reduce or work-around the
obstacle;

Step 4: list all the actions that could be taken to attack
the top obstacles;

Step 5: group prioritizes the long list of possible actions
into the top 3-5 actions … this list becomes the core of
your overall action plan
Aikido Technique
Engagement Leads to
Ownership
 Step 6: Write up the Action Plan with timetable and
accountabilities
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Enablers
4. Own the Solution
Engage in the process to
explore options in alternate
scenarios. Charrette tools
help. Balancing process
leadership. Sign the plan. Plan
the Work…Work the Plan.
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Impact
Spinner
High performance
organizations
anticipate the factors that are likely
to facilitate or frustrate the
successful implementation of their
plans and strategies.
Implications
Identify for each of your key
strategies, new program initiatives
or investments the reasonably
possible impacts.
Make sure all identify at least one
positive and one negative impact.
Each impact has a corresponding
set of secondary impacts. Map
them. Explore (spin) actions to
remove the negatives, and actions
to ensure the positives.
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Impact Spinning for Execution Planning
Implication:
Implication:
Implication:
Potential
Action/Strategy:
Implication:
Implication:
Implication:
Note: You must have at least one positive, and one negative impact!
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Enablers
5. Transparency
Stand With Executives and Clinicians.
Clear Objectives.
Invite In Public.
Engage The Media. Embrace Social
Media. Report Often.
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Enablers
6. Accountability
Board members hold executives
and clinicians to account for the
people.
Metrics matter.
Clear milestones. Progress
reporting.
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Enablers
7. Celebration
Find small and early wins.
Thank each other sincerely and
often.
Celebrate in public.
Complain in private.
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Recognition Matters.
http://www.aha.org/content/13/13fosterapplication.pdf
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Foster McGaw Recognition
Enablers. What can board do?
Principle 1
Focus less on defining the business plan and more on how you’ll work together
Principle 2
Develop metrics pegged not only to alliance goals but also to alliance progress.
Principle 3
Instead of trying to eliminate differences, leverage them to create value.
Principle 4
Go beyond formal governance structures to encourage collaborative behavior.
Principle 5
Spend as much time on managing internal stakeholders as on managing the
relationship with your partner.
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Take Away Messages:
Q: Why Collaborative Governance?
A: Wicked Problems
Q: Why Board-to-Board?
A: Credible Community Champions
Q: How to do it?
1.
2.
3.
4.
5.
Listen
Learn
Link
Leverage
Lead
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Via Collaborative Governance
Try Trust.
Engage with Enthusiasm.
Envision a Brighter, Bolder and
More Vital Future.
Thank you for your attention.
[email protected]
Collaborative Governance:
Key to Success in Era of
Population Health and Accountable Care
CAHs: A Beacon in Your Community
November 10, 2016 | Springfield Illinois
James A. Rice, Ph.D. FACHE
Gallagher Integrated
[email protected]
Insights from Audience
Do’s: Actions to improve chances for success of collaboration
Please check which perspective you are sharing your insights on
Taboo’s: Avoid these when planning the collaboration
Then please list 2-3 of the most important actions to either do or avoid
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Your insights will be distilled and shared to simulate local strategic
thinking and planning for smarter Board-to-Board Collaboration
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