Collective ImpactA Framework for Ontario Health Teams

June 25th, 2019 | 4:00 – 5:00 pm EST

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Collective ImpactA Framework for Ontario

Health Teams

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Today’s Webinar Hosts

Adrianna Tetley

Chief Executive Officer

Alliance for Healthier Communities

adrianna.tetley@allianceon.org

Camille Quenneville

Chief Executive Officer

CMHA, Ontario Division

cquenneville@ontario.cmha.ca

Sylvia Cheuy

Consulting Director

Tamarack Institute

sylvia@tamarackcommunity.ca

Leah Stephenson

Principal Consultant

Leah M. M. Stephenson Consulting

leahstephenson@gmail.com

Adrianna TetleyAlliance for Healthier

Communities

Camille QuennevilleCanadian Mental Health

Association, Ontario Division

Sylvia CheuyTamarack Institute

Leah StephensonLeah M. M. Stephenson Consulting

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Community Health Ontario (CHO) is the voice of the LHIN-funded community sector, a strategic partnership between :

This webinar series is hosted by:

In collaboration with: Adaptation and co-development by:

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Webinar Goals • Define Collective Impact (CI) and

review the 3 pre-conditions and 5

conditions of the Collective Impact

Framework

• Share an example of CI in Action

• Highlight Mindset Shifts needed to

implement CI effectively

• Explore CI as a framework to support

the co-development of OHTs

Collaborative Governance

(July 30)

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Collective Impact(Today)

A framework to mobilize large-scale systems

change across organizations, sectors

Collaborative Leadership

(July 9)

Leadership competencies that

support collaboration & systems change

Backbone support, organizing structures,

tools to manage multiple levels of

accountability

Trust, Power, Engagement

(July 2)

Enablers that are necessary for

successful long-term collaboration

Ontario Examplars(August 27)

International Examplar from

Bogotá, Colombia(September 3)

Examples of the theories in action &lessons learned for

OHTs

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A Poll

1. Very Little or

Nothing

2. Familiar With the

Theory

3. Implementing a CI

Initiative Now

What Is Your Knowledge of

Collective Impact?

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COLLECTIVE IMPACT A Framework for Ontario Health Teams

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A Definition of Collective Impact

“A disciplined, cross-sector

approach to solving

complex social and

environmental issues on a

large scale.”

- FSG: Social Impact Consultants

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3 Pre-Conditions of Collective Impact

• Influential Champion(s)

• Urgency of Issue

• Adequate Resources

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The 5 Conditions of Collective Impact

Source: FSG

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From Isolated Impact• Funders understand that social problems

& their solutions arise from multiple

interacting factors

• Cross-sector alignment with government,

non-profit, philanthropic & corporate

sector partners

• Organizations actively coordinating their

actions and sharing lessons learned

• All working toward the same goal and

measuring the same things

To Collective Impact • Funders select individual

grantees

• Organizations work separately

• Evaluation attempts to isolate

impact of a particular

organization

• Large scale change is assumed to

depend on scaling organizations

• Corporate & government sectors

often disconnected from

foundations and non-profits

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Collective Impact on the Collaboration Spectrum

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CI: Effective in Addressing Complex Issues

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Collective Impact…DOES NOT: DOES:• Employ a single organization or

single sector approach

• Focus solely on programmatic

outcomes

• Work on short-term priorities

• Resolve simple or complicated

problems

• Require backbone support to steward

the collective work forward

• Require diverse perspectives

• Use data to inform the issue and

outcomes

• Focus on the systemic barriers

• Leverage policy change opportunities

• Leverage existing assets & programs

in an intentional and aligned way

• Focus collective resources on high

impact priorities

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Collective Impact

Example in Action

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Collective Impact in Action

Shape Up Sommerville

https://m.youtub

e.com/watch?tim

e_continue=302&

v=R0hbHtb7njw

https://www.fsg.o

rg/publications/s

hape-somerville

https://www.som

ervillema.gov/de

partments/health

-and-human-

services/shape-

somerville

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Collective Impact in Action

Shape Up Sommerville

“People Think the Battle Against Obesity Takes Willpower; Somerville Knows It Takes the Will of an Entire Community”

- The Wall Street Journal*

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Collective Impact in Action: Shape Up Sommerville

Tackling Childhood Obesity Takes Multi-Sector

Commitment

• Somerville, Massachusetts is a socio-economically, racially diverse community near Cambridge and Boston. This data is from 2003.

• Source: “Shape Up Somerville,” School of Nutrition Science and Policy, Tufts University and FSG Interview:

http://www.nutrition.tufts.edu;

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Collective Impact in Action: Shape Up Sommerville

Mutually Reinforcing Activities at Multiple

Levels

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Collective Impact in Action: Shape Up Sommerville

A Culture of “Obesity Prevention”

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Work Groups Objective/Strategy Organizations Involved

Positive Education ProgramEnhance physical activities for 4th-8th Grades during and after school

Schools, ICH, Tufts, BG, EPH, YMCA, SPC

Fire Department Physical activity and nutrition initiative Tufts, City

Shape Up Coordinator Citywide health promotion campaign City, Tufts

Healthy Mind Healthy BodyTo educate Portuguese speaking community on physical activity & nutrition

MAPS

Shape Up Somerville 5K One day family fitness fair hospital initiative HH, CHA, Tufts, LB, R, City

Active Living by DesignAddresses walking promotion, policy, and extension of community path, traffic safety, and land utilization

City, GWS, WB, CHA, MAPS, FCP, BC

Greenline Community ForumEnsure extension of Green line & community path through Somerville

STEP, SCC, BC, MVT, City, ESNC, WB, LSA, USMS, FCP, Tufts

Safe Start Traffic safety City, Tufts, CHA, SPD

Growing HealthySchool Garden InitiativeTo increase healthy eating for families

GWS, FMFM, ICH, SPS

Healthy Eating by DesignUnion Square farmers marketTo increase healthy eating opportunities for low income families

FMFM, MAPS, USMS, CHA, City

WIC ProgramTo provide nutrition education and awareness to low income families

CHA

Nu

trit

ion

/H

ealt

hy

Eati

ng

Infr

astr

uct

ure

/P

olic

y

Ph

ysic

al

Exer

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&H

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h

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Collective Impact in Action: Shape Up Sommerville

Statistically Significant Decrease in BMI in Children From

2002-2005

On a population level, a reduction of ~1lb of weight gain over 8 months for an 8yr-old translates into large numbers moving out of the overweight category

Source: FSG Interviews and Analysis, Shape Up Somerville First year results

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Collective Impact: 3 Mindset Shifts

1. Rethinking Who’s Involved

2. Reconsidering Whose Eyes Are On the

Problem

3. Reimaging Programs & Systems

From Buy-In to Co-Ownership

28Association of Ontario Health Centres

Collective Impact Mindset Shift # 1: Rethinking Who Is Involved

Collective Seeing

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Collective Impact Mindset Shift # 1: Rethinking Who Is Involved

Important Consideration: Apply an Equity

Lens

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CONTENT:Subject Matter

Experts, including providers across

continuum, physicians, clinicians

CONTEXT:Patient Partners,

Community Members

Collective Impact Mindset Shift # 2: Reconsidering Whose Eyes Are On the

Problem

Collective Learning: How Do We Understand the

Problem?

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Collective Impact Mindset Shift # 3: Reimaging Programs AND Systems

Collective Framing: How We Believe Change Happens

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Mindset Shift #3:

Programmatic Versus Systems Change

• Programmatic

interventions help people

beat the odds

• Systemic interventions

seek to change the odds Karen J. Pittman

Co-Founder, President &

CEO of the Forum for Youth

Investment

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Mindset Shift #3:

Strategies to Get to Systems Change

• Increasing Coordination – Re-aligning

existing programs and stakeholders to

maximize system efficacy

• Learning Through Prototyping – Starting

small, co-learning from the experiences,

then expanding

• Enhancing Services – Enhancing

previously unnoticed practices,

movements or resources to enhance

existing local services

• Policy – Advocating together for policy

changes at local or provincial levels to

improve the systems and outcomes

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The Collective Impact Framework

A Pathway for Ontario Health

Teams

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Common Agenda for OHTs

• Common Vision: Create a connected, seamless system that improves Quadruple Aim outcomes

• Common Values: Patient Declaration of Values

Common Agenda

All participants have a shared vision for change including a common understanding of the problem and a joint approach to solving it through agreed upon actions

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Shared Measurement for

OHTs

• Integrated QIP

• Quadruple Aim outcomes and indicators

Shared Measurement

Collecting data and measuring results consistently across all participants ensures efforts remain alignedand participants hold each other accountable

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Mutually Reinforcing Activities for OHTs

• To achieve our common vision of a connected system and better outcomes, what are the experiences of diverse patients in the current system? What are the gaps? Strengths? What are the differentiated roles of different partners, including PC, MHA, CSS, LTC, Hospital, Others?

• Common Strategies

Mutually Reinforcing

Activities

Participant activities must be differentiated while still being coordinated through a mutually reinforcing plan of action

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Continuous Communications for

OHTs

• Common OHT Brand

• OHT-Level Communications Plan and mechanisms for partners (across all organizing bodies like Steering Committee, Working Groups, Boards); community members; patient partners; MD and clinical partners; funders and policy-makers; researchers, other key stakeholders

Continuous Communication

Consistent and open communication is needed across the many players to build trust, assure mutual objectives, and appreciate common motivation

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Backbone Support for OHTs

• OHT partners agree upon how to fulfill key functions of backbone support, including:

• Support common agenda

• Support aligned activities

• Support shared data and measures

• Support continuous communication, engagement, and co-ownership

• Advance policy changes required for the network

• Mobilize resources for the network

Backbone Support

Creating and managing collective impact requires a dedicated staff and a specific set of skills to serve as the backbone for the entire initiative and coordinate participating organizations and agencies

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Things to Consider in Collective Impact

• Building trusted relationships takes time

• Persistence is needed for longer term systems change results

• Align funders and policy-makers across sectors to common agenda

• Legitimize the work of the collaborative table

• No playbook, support and advance the skills and capacity of collaborative partners

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Common Agenda Planning Canvas

Tool

Pre-Planning (What do we know?)

• What data do we have and how might it inform our approach?

• What work is already underway related to our issue?

Strategy Development (What can we do?)

• What do we know re: community needs and assets to address the issue?

• What are the desired results & outcomes, results of our work?

• What assumptions are we making about our issue/opportunity?

• What influential factors should we monitor and/or leverage?

• What priority actions/strategies can we identify?

Engagement (Who else can help?)

• Who are key perspectives/audiences that we can engage to support this work? (public sector, business, lived-experience, other)

www.tamarackcommunity.ca42

Common Agenda Planning Canvas Tool PRE-PLANNING STRATEGY DEVELOPMENT ENGAGEMENT

Relevant Data: Potential Actions /Strategies: Assumptions: Government

Problem/Issue/Opportunity Desired Results, Outputs, Outcomes

Community Stakeholders (including Patient Partners & Community Members)

Ongoing Work: Influential Factors:

Community Needs & Assets

Other Stakeholders (including MDs and clinicians)

Create a connected, seamless health system that improves

Quadruple Aim outcomes

• Comments? Questions?

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To Follow…

FAQs that respond to questions we are hearing through the webinars.

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What’s Next?WEBINAR #3

Foundations for Transformative

Collaboration: Trust, Power &

Engagement

Trust, power, and engagement are three essential

aspects of collaboration. This webinar will explore how

successful collaboratives have navigated these three

vital elements and explore opportunities for applying

them in the creation of Ontario Health Teams.

What You Will Learn:

• Strategies for building and sustaining trust

• The role of power & privilege in change efforts

• How authentic engagement cultivates trust,

capacity-building, shared ownership and improved

outcomes

• DATE: July 2nd, 2019

• TIME: 4:00 – 5:00

pm

Register Now:

http://events.tamarackcommunity.ca/oht_webinar_3

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