Collaboration for System Leadership at a Governance Level
Edward Speicher
Board Chair, SHCHC edwardspeicher@gmail.com
Presenter Disclosure Presenter: Edward Speicher
Relationship to commercial interests: • Grants/Research support • Speakers Bureau/Honoraria • Consulting Fees • Other
None None None None
Starting Situation • City of Ottawa CHCs (Carlington, PQ, Somerset West, Centretown, South east, and Sandy Hill) • History of working together, particularly at the senior staff and ED level • Opportunity of aligning schedules for Strategic Planning and pooling resources • Realized that the challenges facing each of our organizations would be quite similar, from the overall health environment to the complex clients we were focused on. • Commissioned an Environmental Scan for our collective use in Strategic Planning.
Timeline: How we got here
PHASE 2: Creation of Joint Strategic Planning Framework
PHASE 1: Research on the Framework 2016
2017
2018
Research ------------------------------------------------ Conceptualize--------------------- Design-----------Plan----------------------- Operationalize
Jan
Apr
Jul
Oct
Jan
Apr
June Validation
Aug-Oct 2017 Environmental Scan
Multi-Board / ED Strategic Framework Session
ED Strategic Framework Session
Research Report
Executive Summary
ED Strategic Thinking Session
Environmental Scan
Multi-Board / ED Strategic Thinking Session Collaborative Strategic Framework
CHC Staff/Board Engagements
Collaborative Strategic Plan Year 1
Documentation Toolbox Coaching
What Kind of Problem? Simple
Complicated
Complex
Making Soup
Sending a Rocket to the Moon
Raising a Child
Right recipe essential Gives same results every time
KNOWN
Formulae & experts needed, Experience built over time and can be repeated with success
KNOWABLE
No right recipes or protocols, Outside factors influence, Experience helps, but doesn’t guarantees success
UNKNOWABLE
Source: Brenda Zimmerman, late Director of Health Industry Management Program, Schulich School of Business
5
Health System Transformation A Complex Problem Health Spending - No new money for system alignment Multiple inter-dependent organizations (people) involved Evolving opinions, ideas and isolated initiatives Current focus Emergency Department & Hospital Utilization
Aging Population Medical & Social Complexities – Multiple Co-Morbidities, Income, Education, Transportation, Food Security, Social Isolation Patient Experience - Not sure where to go and why they are going Referral System - No system connectedness
6
The Collaboration Spectrum Trust Compete
Co-exist
Competition for clients, resources, partners, public attention.
No systematic connection between agencies.
Turf Loose
Communicate
Inter-agency information sharing (e.g. networking).
Cooperate As needed, often informal, interaction, on discrete activities or projects.
Coordinate
Collaborate
Integrate
Organizations systematically adjust and align work with each other for greater outcomes.
Longer term interaction based on shared mission, goals; shared decisionmakers and resources.
Fully integrated programs, planning, funding.
Tight 7
Three modes of governing Fiduciary - Oversight Facts Figures Financials Risk
Strategic - Foresight What is happening now? What is the desired future? Closing the gap between the two
Generative – Digging Deeper Have we framed the issue correctly? How else could we look at this? What else should we consider? Link between organization governance & public interest 8
Characteristics of Each Mode Fiduciary
Strategic
Generative
Leadership
Hierarchal
Analytical/Visionary
Reflective Learners
Board’s Core Work
Technical – ensures accountability
Analytical – shapes strategy, review performance
Creative – discerns problems; engage in sense making
Key questions
What’s wrong?
What’s the plan?
What’s the question?
Way of deciding
Reaching resolution
Reaching consensus
Grappling and grasping
Performance Metrics
Facts, figures, finances, reports
Strategic indicators, competitive analysis
Signs of learning and discerning
9
What we have confirmed along the way
A collaborative partnership model between the 6 CHC is the right approach
Start small, build on success
Agreement on a complexitybased framework (5LF)
Change takes time
Engagement Board, EDs, Staff, Clients., Partners
•
Common Purpose
•
Resources / assets: physical, financial, knowledge and expertise, specialization
•
Scale/growth: greater impact, stronger voice, comprehensive services, efficiencies and effectiveness, leverage our strength in numbers
•
Use a comprehensive Adaptive Actions W3 model
Risk reduction: shared risks
Plan strategically in short iterations 1-3 years with a yearly reset and annual work plan
Allow for individual CHC priorities as part of the plan
• What? So What? Now What? • Same/Different
OUR NORTH STAR “Health Equity for all members of our communities” Working as a collective to address the systemic barriers and challenges to realizing health outcomes
This definition of success is reframed in the negative as a concrete principle for planning purposes as:
“In the future, in our communities, people are not subject to systematic barriers to health” All members of our communities
These are the people we work with and for.
This is us and our work. Other health care services provide this part.
Collaborative Strategic Priorities Access • Enhance access for people with complex needs
Quality • Demonstrate quality through impact
Enablers • Strengthen key success enablers internally
The Six Ottawa CHCs are proposing the following two strategies to address the Strategic Priorities: 1. Harmonizing data collection and analysis for Ottawa CHCs 2. Strengthening & maximizing organizational & collective capacity
Challenges • True collaboration requires similar or identical levels of commitment from all collaborators • Before any elements of a strategic framework can be put into practice, each collaborator must understand how the others functions • It is important to understand from the outset where your organization is willing to compromise and where it is not
Lessons learned • Examine your mission, what your organization’s stated goals and priorities are, and see where they overlap with a potential collaborator. • Develop a framework for collaboration, and understand what you would be willing to trade. • Ensure that the Board members engaging in the collaborative process know what success looks like from the Board’s point of view.
Questions / Comments?
Edward Speicher Board Chair, SHCHC edwardspeicher@gmail.com
Somerset West Community Health Centre
Collaboration for System Leadership at a Governance Level: A Board Member Perspective Janice Meisner, RN, BN Member, SWCHC Board of Directors
Presenter Disclosure
Presenter: J. Meisner, RN BN Relationship to commercial interests: • Grants/Research support • Speakers Bureau/Honoraria • Consulting Fees • Other
None None None None
Board members : How our roles and responsibilities contribute in an important way to the organization: ďƒź Advance the organizations mission ďƒź Address the needs of the clients and community ďƒź Have commitment and engagement from the board member
Governance
Leadership GENERATIVE
Generative Board Discussions Generating discussion using the right question Looking at an issue from different perspectives and viewpoints Reorganizing data into different patterns, seeking different frames of reference Thinking retrospectively to uncover patterns and to recognize the compelling stories and history
The value of working collaboratively Resources /assets physical , financial, knowledge and expertise , specialization Greater impact, stronger voice Comprehensive services Efficiencies and effectiveness Leverage our strength in numbers Risk reduction: shared risks (From Shared portal: 6 CHC Collaborative Strategic Planning Overview)
Contact: meisnerja36@gmail.com