I2: Transforming Community Health Jackie Lynton, Alexandra Nicholas & Jessica Perlo

Workshop I2

The presenters have

nothing to disclose

Friday, April 2414:00 - 15:00

Session Objectives:

Distinguish community organising from other

approaches to change

Learn how to transform using the power of

others

Apply organising skills and practices to health

and your own work

The IHI Open School Improvement

Change Agent Network (I-CAN)

Jessica Perlo, MPH

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“Advance health care improvement and

patient safety competencies in the next generation of

health professionals worldwide.”

IHI Open

School Mission

Content

ExperientialCommunity

Open School Strategy

32 online courses

More than 1.8 Million courses completed

More than 266,000 learners have completed a

course

More than 53,000 learners have earned the

Basic Certificate

More than 1,000 universities and

organizations use the courses for training

716 Chapters in 71 countries

IHI Open School Growth

The IHI Open School Improvement Change

Agent Network (I-CAN)

is a student-driven campaign to improve

population health through project-based

leadership training

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Robert Wood Johnson Foundation Survey

85% physicians say unmet social needs are

directly leading to worse health

85% physicians say patients’ needs are as

important to address as their medical conditions

80% are not confident in their capacity to

address their patients' social needs

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* Source: RWJF: Health Care’s BLIND SIDE;

The Overlooked Connection Between Social

Needs and Good Health

What We’re Testing

Change

Improvement Science

Organizing & Leadership

Training

Subject Matter

Knowledge

Improvement Change Agent Network ihi.org/ICAN

Course Information

12-week, semi-synchronous

Each week includes:

– 30-45 minutes of video lectures

– 60-minute coaching call

– 1-3 hours application

Improvement Change Agent Network ihi.org/ICAN

Change

Improvement Science

Organizing & Leadership

Training

Subject Matter

Knowledge

Shape Culture

Engage Across Boundaries

Create Vision

and Build Will

Deliver

Results

Develop

Capability

Driven by

Persons and

Community

Improvement Change Agent Network ihi.org/ICAN

Project Example: Tummy Time

Improvement Change Agent Network ihi.org/ICAN

Improvement Change Agent Network ihi.org/ICAN

Melissa Gilbreth,

medical student and

physical therapist

Community Organizing Theory of

Change

People:

Recruiting and

developing

leadership

Power:

Building a community

around that

leadership to create

power

Change:

Using this power to

address the challenge

the constituency is

called to face

… people acting together

to change the status quo

Improvement Change Agent Network ihi.org/ICAN

‘Leadership is accepting responsibility for

enabling others to achieve shared

purpose in the face of uncertainty.’

• A practice, not a position

• Authority is earned, not

bestowed

• Focus is on developing

others, not just yourself

What is leadership?

• Grounded in

values, interests

& assets

• Built through

relationships

Improvement Change Agent Network ihi.org/ICAN

Interdependent Leadership

“Snowflake Structure”

Improvement Change Agent Network ihi.org/ICAN

Tummy Time I-CAN Project18

Improvement Change Agent Network ihi.org/ICAN

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5- Hosted volunteer training event

(24 new team members)

1- Proposed project idea to Chapter

2- Recruited 16

interprofessional

leadership team

3- Gained

support from

the Vice

President of

the Hospital

Association

and Dean of

School of

Medicine

6- Developed

brochure &

video (which

won USC

competition on

improving

community

health)

7-Well on their way to

exceeding their goal of 2,000

pledges

4- Practiced educating parents

(supervised role play and identified

ways to educate future volunteers)

I-CAN Project ExamplesSara Golsby & Jennifer Baily (University of South Carolina)

– Organized students and volunteers to improve

health screenings

Kristin Tremmel(State College of Florida)

– Worked with homeless/at-risk young mothers on

applying for federal assistance programs

Brian Blaugrund(University of Texas)

– Organized to reduce the incidence of STDs in an

impoverished neighborhood

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I-CAN Project ExamplesAlesha Wright (Georgia Southern University)

Organized with medical staff, health educators, and

community members to employ a diabetes self

management program at a community-based medical

home

– One participant's HbA1C improved from 13.1 to 8.3.

– Participants level of confidence in diabetes management (i.e.,

meal planning, exercising, blood glucose monitoring) significantly

improved by the end of the six-week program

Jonathan Brach(Lake Erie College of Osteopathic Medicine)

Organized friends and colleagues to secure 1,000

pledges from the community not to text and drive

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You’re invited to:

Pledge to support this community of improvers:

– www.ihi.org/ICAN or #ICANImproveHealth

Lead I-CAN projects at your institution by

recruiting students and enrolling in our next

course offering – Feb 2016

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Improvement Change Agent Network ihi.org/ICAN

Transforming Community Health

Alexandra Nicholas@alexsnicholas

@alexsnicholas

Alexandra Nicholas, Lead Organiser

Community

Organising?

Pacific youth mental health

and wellbeing?

@alexsnicholas

Youth Leadership Team: 5

Kava

Fuavao

Atelaite

MapaLead Organiser: Alex

Nicholas

Va’a Lisone

Lomas

Maseali’i

Fono

McFarland

@alexsnicholas

This is what the

DATA says about

us…

This is

what WE

say….

@alexsnicholas

April 2013

@alexsnicholas

Campaign Timeline 2013

April: Pacific Youth Training

May: House Meetings

Jan: Fob 5 Leadership Team

July: Community Talanoa Fono

2014:Review

Campaign Goals

STRATEGIC GOALSept/Oct:

Workshop Event

Campaign Timeline 2013

Snowflake Campaign Team Structure

Fob 5

Fob 5Fob 5 Team

Leaders

25 Youth

trained 125 Youth

Fob 5

Pain Killers

Lumanai’

C.I.A

Rise Above

Awkward

@alexsnicholas

Mega Meeting

Workshop Event

@alexsnicholas

2014 Youth Leadership Team

Coaching Support

Peer Support

Alex

Fono

Kava

Ate

Lomas

Finau

Billy

MichelleAlisi

Isaiah

Willie

Danni Harrison

@alexsnicholas

Nearly 500 Youth

100 Community

Members

10 Workshops

…and more!

@alexsnicholas

1. Education (Uni)

2. Depression

3. Relationships

3x Sub-Campaigns addressing..

@alexsnicholas

July 2014

2015 Youth Leadership Team: FOB 12

YOUTH LEADERSHIP TEAM

12 leaders

BROWN

TOUCH

DOWN

THE BIG DREACH

OUT

@alexsnicholas

April 2015 – Trained 80 new youth!

ContactAlexandra Nicholas

Lead Organiser, Project Manager

alexandra.nicholas@middlemore.co.nz

@alexsnicholas

“Where there is no vision, the people perish”

Proverbs 29:18

Using collective power to take collective action

Jackie Lynton @Jackie Lynton

#NHSChangeDay #SHCRchat@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5

Me at 22 years old

Strong sense public service and community

Sharing power in the 5th biggest employer on the globe

Source: BBC

Building on a legacy of social movement thinking for the NHS

@HelenBevan #SHCR #QF15

Resources to improve health and care

Economic resourcesdiminish with use• money• materials• technology

Natural resourcesgrow with use• relationships• commitment• community

Based on principles from Albert Hirschman, Against Parsimony

The audacity to imagine….

Probably the biggest day of collective action for improvement in the history of the NHS

Create a mass movement of people working together in and with the NHS demonstrating the difference they can

make, by one simple act for sustainable improvement

Have to do

Want to do

Shared purposeGoal – 65,000 pledgesCore leadership team

Set a dateWebsite

Personal pledgeSocial media

Took risksCourage & belief Kept it simple!

2013

Change starts with me..

Maker

...Making a

difference

Anyone can pledge – it’s personal to you!

Change Activist

What was happening in ‘the system’ at the time that

resonated and enabled Change Day to happen?

‘Can I really make the change?’

Will ‘the system’ really ALLOW me?

Owned by the grassroots

The more you do what you love the more energy you have Leadership Freak

Vs

Unleashing the energy

Volunteers – leaders everywhere

98% of activity via volunteers

Holding each other to account

rather than performance management

Bottom up approach with top down support

I urge as many people as possible to give their support“

"NHS Change Day is a fantastic opportunity to join a movement of young leaders who want to make a

difference in the NHS

Jeremy Hunt Secretary of State for Health

Jane CummingsChief Nursing Officer England

It's especially an opportunity for the next generation of junior doctors to effect change

in a practical and sustainable way"

Professor Sir Bruce Keogh National Medical Director

13th March 2013

189,000actions

13th March 2013

more than 800,000 pledges to take action

• 81 separate Campaigns

• 86 million twitter impressions

• 35,400 video views

• 95,000 daily reach on Facebook

Change Day 2014:

Change Day pledges and stories

‘…the floodgates of change open’

My pledge…..Don’t let hierarchy get in the way of

patient careWhat I did

Worked with senior leaders at an early stage,

seeking their support with an explicit understanding that they respected the

grassroots nature of Change Day

Fun day for children Support group with a stomas

NHS CEO national pledge

National campaign to get speedy access to NHS wheelchairs for those with complex

needs

Ashley Brooks Patient Champion

‘Change Day gave me the permission to use my energy in the direction I wanted to use it’

30% improvement in staff survey to question:‘Would you feel confident your hospital would

address your concern?’

Change in University nursing curriculum

Louise Trowse – Second year student

Students swap places with patients in a mock nursing unit

Tasting common medicine for children

Discussing pharmacy methods of improving the taste

Dr Damian Roland

“The single most important skill I learned from improvement leaders was narrative. It connects us to the reasons we were called to work for the NHS. It will stay with me the rest of my career.”

‘I wanted to say thank you to NHS staff for the way my brother was looked after when he got knocked over,’

Staff feel appreciated

Jeharna sings forchildren in hospitalto say thank you

2013 2014 2015

189,000 pledges 800,000 pledges12 hours

ChangeAthonwith over

2000 locations

TransformAthon

Coming…..Jan 2016

Google Searches Twitter

Google Searches and Twitter posts tell the same story: 50% bigger than last year at peakOnline mentions: 4x bigger than last year (Source — OLR) 9,274 vs1,869 in 2014

Changeathon:

Changeathon peaked on Twitter around 09:00 and 11:00

46 Million Twitter Impressions14 Thousand Tweets9 Thousand online mentions4,859 individuals tweeting200 events flagged on Twitter60 events notified to team

Biggest ever

Events acrossEngland

Twitter:

50% bigger than 2014(tweets & searches — online is 400% bigger)

CHANGEATHON

A global movement was born

Lessons Learned

1. Do with, not to

2. Activate grassroots staff / learners, who are

incredibly powerful and motivated forces for

change

3. Connect to values – build public relationships

4. Prioritise relationships not organisational

requirements

5. From the top of the hierarchy, we need to learn

to give power away

Thank you!

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