Turning Point Effective Collaboration Utilizing Partnerships: Lessons from the Turning Point...
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Transcript of Turning Point Effective Collaboration Utilizing Partnerships: Lessons from the Turning Point...
Turning Point
Effective Collaboration Utilizing Partnerships:
Lessons from the Turning
Point Initiative
Bobbie Berkowitz, PhD, RN, FAAN
Professor and Department Chair
University of Washington
Turning Point
Challenges to Public Health Infrastructure
Limitations in public health information technology Need performance measures for the public health system Need to develop strategic public health leaders Limited integration across healthcare and public health
Health status ratings of the USThe US ranks 25th in the health status compared to
other countries; trailing most European countriesDespite healthcare spending and advances, the US
moved from 13th in 1960 to 25th in 2000 Need for stable and predictable public health funding
Turning Point
National Perspectives on Public Health
Institute of Medicine 2002 RecommendationsState public health law reformSupport public health worker competencyPrioritize leadership training with government public
health agencies and academic institutionsBroad-based national dialogue to explore perspectives
on workforce credentialingRegularly assess the state of the nation’s public health
system and its capacity
Turning Point
Turning Point: A Framework for Change
Improve and transform public health infrastructure through collaborative models
Build relationships and create an environment for public health improvement
Improve public health accountability Improve population health outcomes Impact health policy Increase public health technology effectiveness Build the public health research base Enhance the public health workforce and leadership
Turning Point
Collaboration
A method used by members of communities when developing coalitions, by organizations when doing strategic planning, and by researchers who desire the partnership of those being studied.
Berkowitz, B. 2000 Journal of Public Health Management and Practice
Turning Point
Key Factors Creating Success Clear Vision/Mission Action Planning Leadership Resources for Mobilizing Documentation and Feedback on Intermediate
Outcomes Technical Assistance Making Outcome Matter (incentives)
Fawcett, S et al. 1999 Public Health Reports
Turning Point
Expectations Realistic
Info exchangeCommon goalPromote collaborationLegitimize issue
Realistic with ReservationsProgram planning Influence policy Influence resource
allocation
UnrealisticProgram
implementation Influence
organizational or systems change in a community
Influence health outcomes
Kreuter et al. 2000. Health Promotion Practice
Turning Point
Turning Point National Excellence Collaboratives
Initiated in 2000Infrastructure themes common to many
statesFive National Excellence CollaborativesStates, National partners, invited experts,
and others
Turning Point
National Excellence Collaboratives
Performance ManagementInformation TechnologyLeadership DevelopmentPublic Health Statute ModernizationSocial Marketing to Improve Population
Health Outcomes
Turning Point
New Tools & ProductsA suite of products designed to increase
effectiveness, improve the quality of practice, and advance national priorities.CDCynergy-SOCModel public health lawPerformance management modelCollaborative leadership curriculum Information technology gateway
Turning Point
A Little Background on Partnerships
Mostly community level and health promotion
Major reviews: Kreuter, Lezin, & Young (2000)
Roussos & Fawcett (2000)
Foster-Fishman et al (2001)
Israel, Schulz, et al (1998)
Lasker & Weiss (2003), Lasker (1998)
Turning Point
State Level Partnerships
What themes and key elements are associated
with state-level partnerships?
How do these compare with partnerships in
the literature?
Turning Point
Structure & Process
Hard work, long time
Formal structure & decision-making
Interpersonal relationships & material
support
Choosing projects wisely
Local context and variability
Turning Point
Working in & across Existing Systems
Categorical funding – “silos”
Relationships between state and local agencies
Proximity to power & political ‘transitions’
Turning Point
Sustaining Collaborative Partnerships
What are the strategies in use by Turning Point partnerships to sustain their innovations for change?
Turning Point
Sustainability
Sustaining programs & systemsTransitions from grants to more “permanent” funding
Finding replacement or successor grants
Sustaining principles and values Incorporation into continuing programs & policies
Turning Point
Integration within Government
Institutionalizing specific initiatives
Linking with other programs
Diffusion and incorporation
Turning Point
Outside Government: Alternative Structures
Setting up new structures (e.g. 501c3 agencies), or linking with pre-existing ones
Collaboration, not competition, with state agencies
Turning Point
How Does Sustainability Happen?
Intentional relationshipsCommunication & visibilityContext-driven decisions
Turning Point
Turning Point Partnerships Impact Public Health
Working to eliminate health disparitiesColorado creates a Minority Health Surveillance System,
an Office of Minority Health, and increases grants received by community-based organizations with health disparities programs
Oklahoma coordinates a legislative taskforce to eliminate health disparities
Minnesota supports development of an “Unequal Treatment” report, participates in the creation of the Minnesota’s Health Disparities Initiative, and brings health care system executives together to help resolve health disparities.
Turning Point
More Impacts Promoting a collaborative model and resources for
community-based programsLouisiana enhances the capacity of local public health
programs by providing technical assistance, modest funding, facilitation, and training.
North Carolina’s Healthy Carolinians links community assessment, the 2010 Health Objectives, and community level health improvement efforts for 90% of the state.
Turning Point
More Impacts Building infrastructure in public health
Nebraska covers the state with local health departments
South Carolina serves as a catalyst for community engagement planning using MAPP and institutes a performance management system based on Silos to Systems performance management tool and creates benchmarks for improved public health performance
Oklahoma creates community-based Turning Point coalitions
Turning Point
More ImpactsPromoting innovative use of resources
New Hampshire establishes the Public Health Network to leverage people, training, knowledge, and resources to ensure a public health system accessible to 60% of the state’s population
Oklahoma finds ways to use categorical state and local funds (WIC, tobacco, immunization) to support needed infrastructure improvements
Turning Point
More Impacts Louisiana creates the National Network of Public
Health Institutes bringing non-governmental public health entities together to respond to the challenges facing public health
Virginia pioneers engaging the business community in health issues through business roundtables and meetings with chambers of commerce, designs workplace-based health intervention programs together with business community, and creates an online health data atlas to promote informed decision making.
Turning Point
More Impacts Developing a stronger public health workforce
New York leverages resources to acquire funds for workforce development and training, develops a nationally broadcast, monthly satellite training series “Third Thursday Breakfast Broadcast” (T2B2), and develops an online nursing curriculum
Minnesota establishes the Emerging Leaders Network to develop future public health leaders and provide support training, and networking opportunities.
Illinois receives legislative approval for the State Health Improvement Plan Act
Turning Point
Partnerships are Essential
Expansion of partnership model to state level systems change has been critical to success
Challenge in creating new systems and new relationships
Selecting goals that are big enough to matter but not so big the partnership loses interest
Require high level support
Turning Point
Strategies for Sustainability
Within government: institutionalization of system changes
Outside government: new or pre-existing structures
Changes spun off and sustained by other organizations and systems
Turning Point
Alternate Structures for Public Health
Public Health InstitutesSustainability/ institutionalizationFlexibility for policy developmentFlexibility for advocacyFlexibility for administrative purposesNeutral ground convener/ independent
Turning Point
Public Health Preparedness
Turning Point “set the stage” Preparedness planning shared a common
infrastructure with Turning Point work Preparedness planning has challenged
public health infrastructure development
Turning Point
Challenges and Hopes
Institutionalization of collaborative partnership approach
Permanent broad-based citizen involvement in public health
Dual-use, steady & predictable funding sources Linking system change with public health
preparedness Informing policy makers about public health
improvement