What is collective impact?
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Transcript of What is collective impact?
What is Collective Impact?
Tomas J. Aragon, MD, DrPH
Health Officer, City and County of San FranciscoDirector, Population Health Division (PHD)San Francisco Department of Public Health
July 5, 2016
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 1 / 18
Overview
1 Complex health challenges
2 What is collective impact?
3 What is our future course?
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 2 / 18
Complex health challenges
Poster from collective impact conference, Australia, 2014
What is collective impact?
Why has it captured imaginationsworldwide?
What does this mean for SanFrancisco?
What does this mean for ourorganization?
What does this mean for our staff?
What are the limitations ofcollective impact?
How does collective impactcomplement other public healthapproaches to population healthimprovement? Source: http://www.collaborationforimpact.com/
collective-impact-2014-melbourne-in-pictures/
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 3 / 18
Complex health challenges
The Kresge-sponsored SFDPH LEAD* InitiativePublic health leadership is “the practice of mobilizing people, organizations, andcommunities to effectively tackle tough public health challenges”
* LEAD = Lean-inspired • Equity-focused • Aspirational goals • Disruptive innovation
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 4 / 18
Complex health challenges
Tackling social and health problemsProblems and solutions can be simple, complicated, or complex.
Simple (agreement on problem, cause,and effective solution)
Complicated (technical solutionsknown or solvable)
Complex (problems, root causes, andsolutions are unknown, poorlyunderstood, and/or not agreed upon)
“The temporary homeless shelter at Pier 80 wasa place for David Tompkins to find himselfagain. ‘People say I’m changing, but I’m notreally changing. When you’re out there, youbecome something you’re not,’ says Tompkins,56. ‘I’m becoming me again.’ The shelterallowed him to bring his dog, provided himaccess to a clinic and a place to sleep, andhelped him get the care that he needed.”
Source: Portraits of life on SF’s streets. SFChronicle, Photos by Lea Suzuki, June 28,2016; http://projects.sfchronicle.com/sf-homeless/faces-of-the-streets/
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 5 / 18
Complex health challenges
Tackling complex social and health problemsTraditional approaches are not solving our most complex social problems
Funders select individualgrantees
Organizations work separatelyand compete
Corporate and governmentsectors are often disconnectedfrom foundations and nonprofits
Evaluators attempt to measurean organization’s isolatedimpact
Large scale change is assumedto depend on scalingorganizations
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 6 / 18
Complex health challenges
Tackling complex social and health problemsImagine a different approach: Multiple partners working together to solve complex issues
Problems solving and solutionsarise from interaction of manypartners within larger system
Cross-sector alignment withgovernment, nonprofit,philanthropic and corporatesectors as partners
Organizations activelycoordinating their action andsharing lessons learned
All working toward the samegoal and measuring the sameindicators of success
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 7 / 18
What is collective impact?
The five conditions of collective impact (www.fsg.org)“Collective impact is the commitment of a group of key stakeholders from differentsectors to a common agenda for solving a specific social problem at scale.”
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 8 / 18
What is collective impact?
Collective impact “Principles of Practice” (www.fsg.org)“Collective impact is the commitment of a group of key stakeholders from differentsectors to a common agenda for solving a specific social problem at scale.”
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 9 / 18
What is collective impact?
The four phases of collective impact
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 10 / 18
What is collective impact?
The collaboration continuumCollective impact outlined in red
Source: The Tamarack Institute (http://www.tamarackcommunity.ca/)
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 11 / 18
What is collective impact?
Selected collective impact initiatives in San Francisco
Initiative Lead Common agenda
Vision Zero (VZ) PHD Zero traffic deaths by 2024
Getting to Zero (G2Z) PHD Zero HIV infections, deaths, and stigma
SF Health ImprovementPartnership (SFHIP)
DPH,UCSF,HC
Behavioral health, Access to care, Healthyeating and physical activity
Preterm Birth Initiative(PTBi)
UCSF,MCAH,PHD
Pre-term births, esp. African American
Our Children, OurFamilies (OCOF)
CCSF,SFUSD
Two-generational life course health andwell-being
Black/African AmericanHealth Initiative (BAAHI)
SFHN Heart health, Women’s health, Behavioralhealth, Sexual health
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 12 / 18
What is collective impact?
PHD—collective impact using results-based lean (RBL)RBL is the synergistic integration of lean management and results-based approaches.
Source: http://resultsbasedlean.com
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 13 / 18
What is collective impact?
Getting to Zero SF (http://gettingtozerosf.org/)
Goal
Zero HIV infections • Zero HIV deaths • Zero HIV stigma
Strategies
RAPID: Support for persons newly diagnosed with HIV
Retention: Engaging those living with HIV in high quality care
PrEP: Reducing HIV transmission among HIV-negative persons
Ending Stigma: Reducing HIV-related stigma
Population (1) and Performance (2, 3) Indicators 2012 2013 2014 2015
1. New HIV diagnoses (number) 453 382 309 2552. Diagnoses → First care (median days) 8 7 73. First care → Viral suppression (median days) 104 71 52
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 14 / 18
What is collective impact?
Vision Zero SF (http://visionzerosf.org/)
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 15 / 18
What is collective impact?
SF Health Improvement Partnership (http://sfhip.org)
Draft population health indicators (bottom)
VisionHealthy People, Healthy Families, Healthy
Communities for San Francisco
VisionHealthy People, Healthy Families, Healthy
Communities for San Francisco
MissionMobilizing San Francisco and resources to eliminate health disparities and inequities
ValuesHealth Equity: Providing opportunities for all San Franciscans to enjoy highest
level of health
Community Engagement: Partner with residents and community based organizations to support health and
well being
Alignment: Ensuring maximum impact of resources to advance
health priorities
Overarching GoalsCoordinated services and care, that are culturally and linguistically appropriate across the continuum
Have healthy hearts and access to nutritional meals to prevent complex chronic diseases
Are physically, emotionally and mentally healthy
Community Health PrioritiesBehavioral Health Access to Care Healthy eating + physical activity
Adult hospitalizations for major depression
Public school kindergarteners who have not experienced dental carries
Pregnant women on Medi-Cal who are food insecure
Emergency room rates due to alcohol abuse
Preventable hospitalizations due to heart attack
Seniors waiting more than 30 days for a home delivered meal
Rates of children experiencing child maltreatment
Preventable hospitalizations due to diabetes
Public school 5th graders meeting 6 of 6 Healthy Fitness Zone standards
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 16 / 18
What is our future course?
Public health tools for improving population health
Source:Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 17 / 18
What is our future course?
Selected bibliography
1 Kania J, Kramer M. Collective Impact. Stanford Social Innovation Review. 2011 Winter;Available from: http://www.ssireview.org/articles/entry/collective_impact.
2 Hanleybrown F, Kania J, Kramer M. Channeling Change: Making Collective Impact Work.Stanford Social Innovation Review. 2012. (Available from URL in no. 1)
3 Turner S, Merchant K, Kania J, Martin E. Understanding the Value of BackboneOrganizations in Collective Impact: Part 1. Stanford Social Innovation Review. 2012.(Available from URL in no. 1)
4 Kania J, Kramer M. Embracing Emergence: How Collective Impact Addresses Complexity.Stanford Social Innovation Review. 2013. (Available from URL in no. 1)
5 Friedman M. Trying Hard is Not Good Enough: How to produce measurableimprovements for customers and communities. 3rd ed. CreateSpace IndependentPublishing Platform; 2015. (Best book to understand Results-Based AccountabilityTM)
6 Maccoby M, Norman CL, Norman CJ, Margolies R. Transforming health care leadership: Asystems guide to improve patient care, decrease costs, and improve population health. 1sted. Jossey-Bass; 2013. (Modern leadership for knowledge [including health] professions)
7 Barnas K. Beyond Heroes: A Lean Management System for Healthcare. 1st ed.ThedaCare Center for Healthcare Value; 2014. (Lean management in health care settings)
8 Spetzler C, Winter H, Meyer J. Decision Quality: Value creation from better businessdecisions. 1st ed. Wiley; 2016. (Best book to learn strategic decision making and analysisin the face uncertainty)
Tomas Aragon, Health Officer (SFDPH) What is Collective Impact? July 5, 2016 18 / 18