Accelerating Results, Strengthening Leaders:  Accelerating Results, Strengthening Leaders:  Aligning Actions for Results and Aligning Actions for Results and the Leadership in Action Programthe Leadership in Action Program

An Approach to Making Measurable An Approach to Making Measurable Improvements in HealthImprovements in Health

GIH Maternal and Child Health Audioconference SeriesGIH Maternal and Child Health Audioconference Series

Friday, January 30, 2009 Friday, January 30, 2009 3:00 p.m. Eastern / 2:00 p.m. Central / 1:00 p.m. Mountain / 12:00 p.m. 3:00 p.m. Eastern / 2:00 p.m. Central / 1:00 p.m. Mountain / 12:00 p.m.

PacificPacific

Roderick K. King, MD, MPH, Harvard Medical SchoolJolie Bain Pillsbury, PhD, Sherbrooke ConsultingJennifer Gross, The Annie E. Casey Foundation

Why Results Based Why Results Based Leadership?Leadership?

Annie E. Casey Foundation mission◦Kids do better when families do better.

Families do better when their communities do better.

Recognition of the critical importance of leaders to affect change.◦Leadership development model for

“leaders in the middle” Develop a set of core leadership skills Immediately and constantly direct those skills

towards a common population level result.

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The Leadership in Action The Leadership in Action ProgramProgramWhat it’s designed to do…What it’s designed to do…

Double bottom line◦ Accelerate measurable improvements in the

well-being of children & families. ◦ Strengthen the leadership skills among

government, nonprofit, business & community leaders.

How?◦ Align & focus the strategies and efforts of

stakeholders, providers and investors working on the result.

◦ Move to action in one measurement cycle.

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The Leadership in Action ProgramThe Leadership in Action ProgramImplementation – 13 sitesImplementation – 13 sites

Implementation Partner – James MacGregor Burns Academy of Leadership at UMD

LAP results◦ School Readiness (Maryland, Georgia,

Connecticut, Iowa)◦ Family Economic Success (Texas)◦ Babies Born Healthy (Maryland)◦ Successful Offender Re-Entry (Indiana)

Funding partners◦ State and local government ◦ National and local philanthropy

RWJF in health

Results Based Leadership: Results Based Leadership: The application of a theory The application of a theory

The Theory of Aligned Contributions (TOAC) allows people to come together as results based leaders to create something that has meaning for them.•Critical mass of leaders from different sectors•Commitment to a common result for a

population•Aligned actions contributing at a scope and

scale to make a measurable difference in short period of time

Leaders Take Aligned ActionLeaders Take Aligned Action

Accelerated improvement in population level result, Accelerated improvement in population level result,

Sense of Urgency & Pubic

Accountability

Sense of Urgency & Pubic

Accountability

Mid-to-high level leaders develop skill in four

competencies that move people from talk to action

Mid-to-high level leaders develop skill in four

competencies that move people from talk to action

Aligned ContributionsA critical mass of multi-sector leaders makes an

unequivocal commitment to take aligned actions in their home agencies and

communities.

Aligned ContributionsA critical mass of multi-sector leaders makes an

unequivocal commitment to take aligned actions in their home agencies and

communities.

Focus on a Single Measurable

Result

Focus on a Single Measurable

Result

The Way it works: The Way it works: Call to Action, Container, and Capacity Call to Action, Container, and Capacity

to Collaborateto CollaborateLeaders are called to action to make a

measurable difference in their communityA container is created where the leaders

have the space and time to come together and build relationships, be vulnerable, and do the work

While responding to the call and doing the work, the leaders develop the capacity to lead together by using four leadership competencies

Leadership CompetenciesLeadership Competencies

Results Based AccountabilityRace, Class, Culture DialogueCollaborative ActionLeading from the Middle

What we are learningWhat we are learningTOAC sparks call to action to a resultPeople respond to the callLeaders make aligned contributions in

many different ways (Policy, Practice, Public Will)

The emergent capacity to collaborate accelerates measurable progress ◦Not just talk◦Public accountability to work together ◦Skills make a difference (decision-making,

accountability, conflict resolution)

Results Based Leadership Results Based Leadership Programs: Programs: Evidence based Leadership Evidence based Leadership PracticesPracticesLAP: 18 months, 40 leaders (Healthy

Babies)Performance Partnership Summits: 3-6

months, 12 – 100 leaders (Smoking Cessation)

Results Based Leadership Technical Assistance: 1- 3 months, groups and teams of leaders (primary care, chronic conditions, and improvements in quality and access)

Results Based Leadership:Results Based Leadership:Application to Health and Application to Health and Health careHealth careWhy now?

◦Growing awareness that addressing health/health care issues for populations (e.g. quality of care, disparities) requires cadre of leaders, sectors working together Oral Health (OHF support statewide plan to

address OH in MA) Health Disparities (efforts in communities to

reduce disparities) Quality of Care (efforts to improve the quality of

care within communities- RWJF Aligning Forces for Quality, HRSA Statewide/Community Performance Improvement)

◦Babies Born Health LAP~ RWJF 2007

Baltimore Babies Born Healthy Baltimore Babies Born Healthy LAP LAP (Baby-LAP)(Baby-LAP)

• Approached by RWJF re: application of this model to a health result.

• In October 2006 we launched the Baltimore Babies Born Healthy LAP supported entirely by RWJF.

• Convene 40 leaders from health care & social services sectors, philanthropy and community based organizations–Result:

Babies born healthy in the City of Baltimore

BBH- How LAP worksBBH- How LAP works

LAP participants are “Leaders in the Middle”◦ Cross-sector leaders in the field, already

working on the result◦ Usual suspects and unlikely partners

What do they do?◦ Come together for nine, 2-day sessions, every

4-6 weeks over 14 months◦ Together develop and immediately apply a set

of core leadership skills to a specific result.◦ Develop specific strategies and actions based

on what works and guided by their result with goal of turning indicator curves

BBH IndicatorsBBH Indicators

Indicators:

Fetal death rate Infant mortality rate Neo-natal mortality rate Pre-term birth rate Low birth weight rate

BBH AchievementsBBH AchievementsDevelopment of a City wide plan to

implement strategies to improve infant mortality in Baltimore

Launch of a public awareness campaign for city leadership and general public

Coordination of home care services to better meet the needs of new mothers at the various hospitals in Baltimore

Integration of the BBH “group” into the Baltimore Health Department system and performance management program

Renewed energy and commitment by newly elected Mayor to address the problem of infant mortality in Baltimore.

Leadership In Action Leadership In Action ProgramProgram

Return on Investment Return on Investment (ROI)(ROI)

ImpactInfluenceLeverage

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Return on Investment: Return on Investment: ImpactImpact

Composite: Maryland & Baltimore Students Assessed Fully Ready - Composite Score

2002 - 2008

60

67 68

27

35

58 5758

5255

49

3228

40

0

10

20

30

40

50

60

70

80

2002 2003 2004 2005 2006 2007 2008

Per

cent

of K

inder

gar

tener

s

All StudentsBaltimore

LAP Launch Dates

MLAP 2002

BLAP 2004

Return on Investment: Return on Investment: InfluenceInfluencePublic Policy

◦ Maryland: 5 Year Action Agenda for School Readiness adopted by

state legislature Early Care and Education Committee established as a

permanent committee of the Governor’s Sub-Cabinet for Children, Youth and Families.

MD county management entities (Local Management Boards) adopted Results Accountability Framework

◦ Baltimore: LAP participants from BLAP and Baby-LAP working with the City to align their efforts in support the City’s broader school readiness agenda.

Programs◦ Baltimore: Increased/realigned funding by Health

Department, schools & libraries to school readiness programs

◦ Georgia: DeKalb Refugee Center creation of services to serve children 0-6, coordination of child care resources towards pre-K within DSS.

Leadership◦ Leaders doing their work differently - using LAP

competencies and tools in home organizations

Return on Investment: Return on Investment: LeverageLeverageState and local government dollars

leveraged to support LAP results.◦Maryland: $5 million leveraged in

support of early childhood. ◦Georgia: Collaborative efforts of LAP

leaders leverage state and philanthropic dollars for early childhood efforts in DeKalb County.

◦Indiana: Private dollars leveraged to further LAP leaders collaborative efforts to ensure the successful re-entry of offenders into the community.

ConclusionConclusionFor more information about the Leadership in

Action Program and/or Casey’s ROI, contact:Jennifer Gross

Senior Consultant – Leadership DevelopmentAnnie E Casey Foundation

jgross@aecf.org For more information about developing

programs that apply Results Based Leadership:

Jolie Bain Pillsbury, PhDSenior Fellow, James MacGregor Burns Academy of

LeadershipPresident, Sherbrooke Consulting, Inc

jolie@sherbrookeconsulting.comRoderick K. King, MD, MPH

Senior Fellow, James MacGregor Burns Academy of Leadership

Instructor, Harvard Medical SchoolRoderick_King@hms.harvard.edu