Collective Impact: A Helpful Lens for Viewing 1305 and Its Outcomes

Transcription

1 By: Thomas J. Chapel, MA, MBA Chief Evaluation Officer CDC Collective Impact: A Helpful Lens for Viewing 1305 and Its Outcomes

2 Mistakes It could be that the purpose of your life is only to serve as a warning to others

3 Learning Thru Failure: My Journey Towards Appreciation of Collective Impact By: Thomas J. Chapel, MA, MBA Chief Evaluation Officer CDC

4 Today What is Collective Impact? What s different about Collective Impact? Does it really matter? What Collective Impact insights do we most need to push in 1305?

5 What is Collective Impact? Collective Impact is the commitment of a group of actors from different sectors to a common agenda for solving a complex social problem Kania, J and M Kramer Collective Impact

6 What s Different About Collective Impact?

7 Integrating Processes to Achieve Continuous Quality Improvement Continuous Quality Improvement (CQI) cycle What do we do? Planning What actions will best reach our goals and objectives. Performance measurement How are we doing? Evaluation Why are we doing well or poorly? Why are we doing well or poorly? How are we doing? How do we do it? 7

8 Enter Good M&E the = CDC use of findings Evaluation Framework 8

9 Enter Good M&E the = CDC use of findings Early steps key to best focus Evaluation Framework 9

10 What s Different About Collective Impact? Commitment of a group of actors from different sectors to a common agenda for solving a complex social problem Kania, J and M Kramer Collective Impact

11 What s Different About Collective Impact? For every problem in the world there s already a solution out there. We just to need to find it and scale it up Bill Clinton Clinton Global Initiative

12 What s Different About Collective Impact? Isolated Impact Funders choose individual grantees that offer promising solutions Orgs work separately and competitively to produce impacts Evaluation isolates a single org s impact Large scale change = scaling up single org efforts Sectors disconnected or operate independently

13 Complete Logic Model Inputs Activities Outputs Short-term Outcomes Intermediate Outcomes Long-term Outcomes/ Impacts What the program needs What the program does Who or what will change because of the program Context and Assumptions External factors that influence getting to outcomes 13

14 Caution: Buzzwords Ahead! Systemic Emergent Adaptive Developmental

15 Five Conditions for Success 1. Common agenda 2. Shared measurement 3. Mutually reinforcing activities 4. Continuous communication 5. Backbone organization Kania, J and M Kramer Collective Impact

16 Himmelman s Working Together Networking: Exchanging information about each other's activities, goals etc, for mutual benefit. Coordinating: Exchanging information and altering activities for mutual benefit and to achieve a common purpose. Cooperating: Exchanging information, altering activities, and sharing resources for mutual benefit and to achieve a common purpose. Collaborating: Exchanging information, altering activities, sharing resources, enhancing the capacity of another for mutual benefit and to achieve a common purpose.

17 Five Conditions for Success Common Agenda Shared vision for change Common understanding of the problem Setting boundaries of the problem Joint approach to solving Agreed upon actions Strategic action framework

18 Networked Interventions OUTPUTS Agency A Program A-1 SHORT-TERM OUTCOMES Program A-n LONG-TERM OUTCOMES Agency B Program B-1 SYSTEM OUTCOME Program C-1 Agency C Program C-n Program D-1 Agency D Program D-n

19 Resilient Communities Program Improved health outcomes, thru Community resilience Community health literacy Integrating health, environmental, and MBH into system 19

20 Components 1. Primary Care 2. Environmental Health 3. Community Alliance 4. Community Health Worker Program 5. Mental and Behavioral Health 20

21 Enterprise Logic Model Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Emerging scholars program Environmental Health referral network/place`ment of CHWs Improved capacity, services, practice management, and use of data by clinics Increased KAB of students and teachers Increased ability to refer for EH Stronger Integrated health care system (through partners)* [WHO] has Community Centered Health Homes Health system is more integrated and sustainable Community has sustainable access to better health/environmental health/mental health care Community is more resilient Training of CHWs Mental and Behavioral Health capacity Community mobilization and asset mapping CHWs with strong skills and capabilities Early ID and treatment of MH problems Increased knowledge, trust, and respect of community institutions and community members Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Health Literacy Improved population health outcomes 7

22 PCP Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Make financial and other investments and provide support to improve primary care capacity Emerging scholars program Environmental Health referral network/placement of CHWS Improved primary care capacity and services Stronger operations and practice mgmt Improved use of data and information Stronger Integrated health care system (through GRHOP partners)* [WHO] has Community Centered Health Homes Health system is more integrated and sustainable Community has sustainable access to better health/env health/mental health care Community is more resilient Training of CHWs Mental and Behavioral Health screening, treatment and referral CHWs with strong skills and capabilities Early ID and treatment of MH problems Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Improved population health outcomes Community mobilization and asset mapping Increased knowledge, trust, and respect of community institutions and community members Health Literacy 7

23 EH Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program Environmental Health referral network Training and placement of CHWs Mental and Behavioral Health screening, treatment and referral Community mobilization and asset mapping Improved EH knowledge of students and science teachers CHWs with strong skills and capabilities Communities connected with primary care Early ID and treatment of MH problems Increased knowledge, trust, and respect of community institutions and community members [WHO] has Community Centered Health Homes Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Health Literacy Community has sustainable access to better health/env health/mental health care Community is more resilient Improved population health outcomes 7

24 Community Alliance Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Environmental Health referral network Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program Training, recruitment, and integration of CHWs Outreach and community involvement activities CHWs with strong skills and capabilities are integrated into programs Stronger knowledge, and exchange of info among community, clinics, and stakeholders [WHO] has Community Centered Health Homes Specialty health, env health, and mental health referral systems are embedded into primary care Increased resident participation in building healthy communities Community has sustainable access to better health/env health/mental health care Increased social capital and community resiliency Community mobilization, training, and asset mapping Increased capability to build stronger communities Increase in community Health/Mental Health Literacy improved population health outcomes 7

25 CHW Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program Environmental Health referral network/placement of CHWs [WHO] has Community Centered Health Homes Community has greater access to health/env health.mental health care Training and placement of CHWs Mental and Behavioral Health screening, treatment and referral CHWs with strong skills and capabilities Early ID and treatment of MH problems Specialty health, environmental health, and mental health referral systems are embedded into primary care CHWs facilitate health care and preparedness activity Community is more resilient Community mobilization and asset mapping Increased knowledge, trust, and respect of community institutions and community members Increase in community Health Literacy improved population health outcomes 7

26 MH/BH Zoom In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Environmental Health referral network Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program [WHO] has Community Centered Health Homes Training and placement of CHWs CHWs with strong skills and capabilities Increase in community Provide integrated M/BH services and treatment Engage and train in models of integrated care and ev-based practice Public/community education on M/BH Increased (short term) capacity for M/BH services Increased KAB of clinic professionals Increased public KAB about M/BH issues Health Literacy Specialty health, env health, and mental health referral systems are embedded into larger systems Community has sustainable access to better health/env health/mental health care Community is /individuals are more resilient Community mobilization and asset mapping Increased knowledge, trust, and respect of community institutions and community members Early(ier) diagnosis and treatment of M/BH issues Improved population health outcomes 7

27 Five Conditions for Success Shared Measurement Collecting data consistently The power of strong and clear definitions Measuring results consistently small but comprehensive Sharing results Holding each other accountable

28 Five Conditions for Success Mutually Reinforcing Activities Participant activities Can (must?) be differentiated Must be coordinated Based on a mutual plan of action

29 Looking for Alignment OUTPUTS Agency A Program A-1 SHORT-TERM OUTCOMES Program A-n LONG-TERM OUTCOMES Agency B Program B-1 SYSTEM OUTCOME Program C-1 Agency C Program C-n Program D-1 Agency D Program D-n

30 Looking for Alignment 1. Define the outcomes 2. Broad picture that encompasses all players 3. Look for power of joint effort 4. Clarify lines of communication and accountability Irby, M and P. Boyle Aligning Collective Impact Initiatives

31 Attribution and Contribution OUTPUTS Agency A Program A-1 SHORT-TERM OUTCOMES Program A-n LONG-TERM OUTCOMES Agency B Program B-1 SYSTEM OUTCOME Program C-1 Agency C Program C-n Program D-1 Agency D Program D-n

32 Enterprise Logic Model Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Emerging scholars program Environmental Health referral network/place`ment of CHWs Improved capacity, services, practice management, and use of data by clinics Increased KAB of students and teachers Increased ability to refer for EH Stronger Integrated health care system (through partners)* [WHO] has Community Centered Health Homes Health system is more integrated and sustainable Community has sustainable access to better health/environmental health/mental health care Community is more resilient Training of CHWs Mental and Behavioral Health capacity Community mobilization and asset mapping CHWs with strong skills and capabilities Early ID and treatment of MH problems Increased knowledge, trust, and respect of community institutions and community members Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Health Literacy Improved population health outcomes 7

33 EH Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program Environmental Health referral network Training and placement of CHWs Mental and Behavioral Health screening, treatment and referral Community mobilization and asset mapping Improved EH knowledge of students and science teachers CHWs with strong skills and capabilities Communities connected with primary care Early ID and treatment of MH problems Increased knowledge, trust, and respect of community institutions and community members [WHO] has Community Centered Health Homes Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Health Literacy Community has sustainable access to better health/env health/mental health care Community is more resilient Improved population health outcomes 7

34 MH/BH Zoom In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Environmental Health referral network Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program [WHO] has Community Centered Health Homes Training and placement of CHWs CHWs with strong skills and capabilities Increase in community Provide integrated M/BH services and treatment Engage and train in models of integrated care and ev-based practice Public/community education on M/BH Increased (short term) capacity for M/BH services Increased KAB of clinic professionals Increased public KAB about M/BH issues Health Literacy Specialty health, env health, and mental health referral systems are embedded into larger systems Community has sustainable access to better health/env health/mental health care Community is /individuals are more resilient Community mobilization and asset mapping Increased knowledge, trust, and respect of community institutions and community members Early(ier) diagnosis and treatment of M/BH issues Improved population health outcomes 7

35 Reframing MT/LT Outcomes Outcome Stronger Integrated health care system (through GRHOP partners)* GRHOP Program Component PCCP EH Alliance CHW MH/BH Stronger Integrated Stronger Integrated Increased resident CHWs facilitate health care system health care system participation in health care and (through GRHOP (through GRHOP building healthy preparedness partners)* partners)* communities activity [WHO] has Community Centered Health Homes [WHO] has Community Centered Health Homes [WHO] has Community Centered Health Homes Increase in community Health Literacy Increase in community Health Literacy Increase in community Health Literacy Increase in community Health/MH/EH Literacy Increase in community Health Literacy Increase in community MH/BH Literacy Specialty health, env health, and mental health referral systems are embedded into primary care Specialty health referral systems are embedded into primary care Env health referral systems are embedded into primary care Mental/behavioral health referral systems are embedded into larger systems Early(ier) diagnosis and treatment 35 of M/BH issues

36 Five Conditions for Success Continuous Communication Consistent and open communication to assure: Sustained trust Mutual objectives Reinforce common motivation CONTINUOUS FEEDBACK LOOP: Measures Gaps and successes How to improve

37 Integrating Processes to Achieve Continuous Quality Improvement Continuous Quality Improvement (CQI) cycle What do we do? Planning What actions will best reach our goals and objectives. Performance measurement How are we doing? Evaluation Why are we doing well or poorly? Why are we doing well or poorly? How are we doing? How do we do it? 37

38 Intentionality and Emergence Look for emergent solutions while being intentional about outcomes Intentional= common agenda, strategic framework and mutually reinforcing activities Emergence=common measurement, communication, learning Hanleybrown, F, J Kania, M Kramer, Channeling Change: Making Collective Impact Work

39 EH Zoom-In Pathway Activities Outcomes--ST Outcomes--MT Outcomes--LT Primary Care Capacity investments Stronger Integrated health care system (through GRHOP partners)* Health system is more integrated and sustainable Emerging scholars program Environmental Health referral network Training and placement of CHWs Mental and Behavioral Health screening, treatment and referral Community mobilization and asset mapping Improved EH knowledge of students and science teachers CHWs with strong skills and capabilities Communities connected with primary care Early ID and treatment of MH problems Increased knowledge, trust, and respect of community institutions and community members [WHO] has Community Centered Health Homes Specialty health, environmental health, and mental health referral systems are embedded into primary care Increase in community Health Literacy Community has sustainable access to better health/env health/mental health care Community is more resilient Improved population health outcomes 7

40 Outputs and ST Outcome Measures EH Activities: If we do this EHS Academy and Teacher Workshop EH referral network and continuing medical education Placement of CHWs Outputs: In this way or with this level of quality HS teachers implement best practices in EH instruction HS students engaged in EHS through informal or formal educational experiences Primary care clinicians able to make EM referrals Availability of greater case study training in EM Trained CHWs employed at FQHCs and CBOs ST Outcomes: Then this will result Improved EH knowledge among students and science teachers Communities connected with environmental health care Improved environmental medicine knowledge among primary care physicians Communities connected with primary care [ST Outcome Measure] Academy pre- and posttest for students Completion of independent research project by students Follow-up survey/tracking of students academic and extra-curricular activities % of HS teachers who participated in workshop who have embedded EH in science curriculum Clinic surveys CME completion rates FQHC and CBO evaluation data 40

41 How and What of Emergence Pay attention to the how/why for both successes and failures Own your moderators

42 Lead Poisoning: Causal Roadmap Inputs Activities Outcomes Outreach Do Environment Assessment ID Source and Refer for clean-up Lead Source Removed Funds Staff R ships Screening Train Families Family performs in-home techniques Reducing EBLLs Improved Development and Intelligence Legal Authority ID kids with EBLL Refer for Medical Management Case Medical Treatment More Productive and/or Quality Lives Management Hazard politics Health insurance coverage Availability of new technology 42

43 Lead Poisoning: Causal Roadmap Inputs Activities Outcomes Outreach Do Environment Assessment ID Source and Refer for clean-up Lead Source Removed Funds Staff R ships Screening Train Families Family performs in-home techniques Reducing EBLLs Improved Development and Intelligence Legal Authority ID kids with EBLL Case Management Refer for Medical Treatment Medical Management insurance climate hazard politics More Productive and/or Quality Lives technology 43

44 How and What of Emergence What emerges? Outside resources or approaches applied locally Partners adapt and work together differently A local strategy is spread more widely

45 Five Conditions for Success Backbone Organization Separate organization(s) with staff and a specific set of skills to serve as the backbone for the entire initiative and coordinate participating organizations and agencies

46 Backbone Functions 1. Overall strategic direction 2. Facilitating dialogue among partners 3. Managing data collection and analysis 4. Handling communications 5. Coordinating community outreach 6. Mobilizing funding Hanleybrown, F, J Kania, M Kramer, Channeling Change: Making Collective Impact Work

47 Now They Tell Me! 3 Pre-Conditions for Success Influential champion Adequate financial resources Urgency for change

48 Thought Questions Where am I on each of the 5 conditions? Which will be easiest? Which will be hardest? Who will serve the backbone functions? Which of the 3 pre-conditions are in place? If not, what next?

49 Five Conditions for Success 1. Common agenda 2. Shared measurement 3. Mutually reinforcing activities 4. Continuous communication 5. Backbone organization Kania, J and M Kramer Collective Impact

50 Backbone Functions 1. Overall strategic direction 2. Facilitating dialogue among partners 3. Managing data collection and analysis 4. Handling communications 5. Coordinating community outreach 6. Mobilizing funding Hanleybrown, F, J Kania, M Kramer, Channeling Change: Making Collective Impact Work

51 Now They Tell Me! 3 Pre-Conditions for Success Influential champion Adequate financial resources Urgency for change

52 Resources on Collective Impact Stanford Social Innovation Review ctive_impact FSG Social Impact Consultants ectiveimpact.aspx Collective Impact Forum 52