Collaboration

1. Collaboration Dick Endress President Access DuPage

2. A Common Mindset A conference is a place where people who are individually powerless go to decide collectively that they can’t do anything. Ambrose Bierce

3. But Consider This Possibility A collaboration is a place where people who are individually powerless go to decide collectively that they can make a significant difference.

4. My Learning Curve – 4 Examples Example #1 – Access DuPage Inception: 2 DuPage County coalitions identified the uninsured as a major issue My Role: Process facilitator, then president Current Outcome: 180 organizations, working together, annually provide $33 million of medical care to the uninsured

5. My Learning Curve – 4 Examples Example #2 – Positive Parenting DuPage Inception: Topfer Family Foundation identifies child abuse as a major concern My Role: Process facilitator, then Chairman of the Board Current Outcomes: 85 organizations, working together, provide education and support to the parents of children 0-3

6. My Learning Curve – 4 Examples Example #3 – DuPage Mental Health Access Plan Inception: DuPage County Chairman (with orchestration) identifies mid-level mental illness as a concern My Role: Process facilitator Current Outcomes: Phase I implemented & working well; About 25 mental health leaders form Mental Health Leadership Council to plan for next phases

7. My Learning Curve – 4 Examples Example #4 – DuPage Safety Net Plan Inception: DuPage County Chairman (with orchestration) calls Healthcare Summit to improve the Safety Net My Role: Process facilitator Current Outcomes: To be determined

8. Taking the DuPage County “Safety Net” to the next plateau • Jan. 18, 2007 – County Chairman convenes Healthcare Summit • Assembled group agrees to form Safety Net Council, responsible for developing & funding improved DuPage Safety Net • Safety Net Task Force chartered – will make recommendations on May 30, 2007

9. Who attended the Healthcare Summit? The Chief Executive Officers of: • 7 hospitals • The county’s 2 largest physician groups (300+ physicians) • DuPage County Government • The Health Department • The Medical Society • The nation’s largest FQHC network (45 sites) • The local “free clinic” • DuPage Federation on Human Services • The Illinois Hospital Association • BlueCross/BlueShield of Illinois • A large foundation

10. The vision of the future to which the Safety Net Council committed itself The DuPage County Safety Net system will be a model for the others to follow in managing the health of low-income populations effectively and efficiently across the entire continuum of care

11. Strengths that the Safety Net Task Force is building on • Strong existing programs with demonstrated results & credibility • Excellent set of existing partners • Culture of Collaboration • A developing integrated approach • Sufficient facilities & providers • Strong financial vitality • Strong internal & external relationships & linkages

12. Some Probable Recommendations from the Safety Net Task Force • Rapid expansion of the FQHC network • Development of Specialty Clinic specifically for low-income patients • Expansion of the Mental Health Access Plan • Initiation of a county-wide plan for oral health • Adoption of “System integrators” • Expansion of Disease Management programs • Robust tracking and analysis capabilities • Coordinated political advocacy

13. The Basic Idea of Collaboration • You can get a lot further addressing a complex problem by working together rather than by working separately • Which of your organizations has all of the resources required to perfectly fulfill your organizational mission?

14. Some Things that Enhance the Prospect of Collaboration • Trust (noun) A firm belief in the honesty and reliability of another. (verb) To put something confidently in the charge of another

15. Some Things that Enhance the Prospect of Collaboration • Trust • Relationships

16. How Change Really Works

17. Some Things that Enhance the Prospect of Collaboration • Trust • Relationships • A strong sense of Mission Why does your organization truly exist? (Be honest)

18. Some Things that Enhance the Prospect of Collaboration • Trust • Relationships • A strong sense of Mission • “Enlightened” Self-Interest Does anyone here not operate in their own perceived self interest?

19. Some Things that Enhance the Prospect of Collaboration • Trust • Relationships • A strong sense of Mission • “Enlightened” Self-Interest • Leadership

20. The best definition of leadership I know A leader is best When people barely know that he exists, Not so good when people obey and acclaim him, Worst when they despise him. “Fail to honor people, They fail to honor you;” But a good leader, who talks little, When his work is done, his aim fulfilled, They will all say, “We did this ourselves.” Lao Tzu Tao Te Ching (6th century B.C.)

21. Some things that diminish the prospect of collaboration • Fear What exactly are you afraid of? • Turf What exactly are you protecting?

22. The Continuum of Collaboration • Networking – Exchanginginformationfor mutual benefit • Cooperation – Exchanging information and modifying activities for mutual benefit • Coordination – Exchanging information, modifying activities, and sharing resources for mutual benefit and to achieve a common purpose

23. The Continuum of Collaboration • Collaboration – Exchanging information, modifying activities, sharing resources, and enhancing the capacity of anotherfor mutual benefit and to achieve a common purpose by sharing risks, resources, responsibilities, and rewards.

24. Asset Orientation “If communities are viewed from their needs, the policies and interventions will be based on needs. If they are viewed from their assets, the policies and interventions will be based on the community’s capacities, skills, and assets.” Bernard J. Turnock, Public Health

25. Neighborhood Needs Map Mental Illness Slum Housing Lead Poisoning Boarded-up Buildings Truancy Gangs Dropouts Welfare Dependency Teenage Pregnancy Drug Abuse Pollution Fear Unemployment Crime Domestic Violence Aids Broken Families Child Abuse Alcoholism Homelessness Abandonment Rat Bites Illiteracy

26. Neighborhood Assets Map Religious Organizations Individual Capacities Social Service Agencies Capital Improvement Expenditures Personal Income Individual Businesses Parks Home-based Enterprise Vacant Land, Buildings, etc. Public Schools Fire Depts. Libraries Citizens Associations of Business Associations Cultural Organizations Hospitals Educational Institutions Energy/Waste Resources Hope Interested individuals Police Welfare Expenditures

27. Key Steps in Organizing Partnerships • Recognize and define a concern • Get the right people involved • Get buy-in upfront • Organize the planning process • Develop a focus • Set goals and priorities • Develop a plan • Implement the plan • Evaluate outcomes • Refine & tinker towards success • Communicate successes and learning • Maintain commitments

28. Step One: Recognize and Define a Concern • Precisely what situation are you trying to improve? • What is the “current reality” regarding that situation? • Fact • Interpretation

29. Step One: Recognize and Define a Concern • How can you get other people to recognize and believe your version of current reality? • The power of information, succinctly and elegantly organized • The power of stories

30. Data alone is not enough Datum – a fact without relation to other things Information – Data that is processed to be useful Knowledge – A pattern of understanding many elements within a broad yet defined array of information that provides a high level of predictability Wisdom – A systemic understanding of the fundamental principles embodied within knowledge

31. Step Two: Get the Right People Involved • What organizations are crucial for the success of the initiative? • What factors within those organizations might influence the organization to support the initiative? • Who are potential champions within each organization? How can I get them involved? • Who are my natural allies?

32. Step Two: Get the Right People Involved • Potential levers (i.e. why might someone be willing to get involved?) • Altruistic reasons I believe in your cause • Pragmatic reasons I can see some advantage for me • Personal reasons • I or someone I love has been affected by this issue

33. Step Three: Get Buy-in Upfront

34. Step Three: Get Buy-in Upfront • Call up and meet • Sit down and talk • The power of “conversations for possibility” • Prepare and organize • The power of precise requests

35. Step Four: Design a Planning Process Some elements of a well-designed planning process • Defined planning group composed of the right people • Regular meetings • Clear and defined goal • Specific timetable • Accountability for a defined outcome • Well-designed process • Frequent communication & work between meetings

36. Step Four: Design a Planning Process • Who will play these key roles? • Sponsor • Organizer • Facilitator • Leader • Worker • Advocate • Representative/liaison

37. Step Five: Develop a Focus Answer: One bit at a time Question: How do you eat an elephant?

38. Step Six: Set Goals & Priorities …she was a little startled by seeing the Cheshire Cat on a bough of a tree a few yards off. “Cheshire-Puss”, she began, rather timidly… “Would you tell me, please, which way I ought to go from here?” “That depends a good deal on where you want to get to”, said the Cat. “I don’t much care where -----” said Alice. “Then it doesn’t matter which way you go,” said the Cat. “----- so long as I get somewhere,” Alice added as an explanation. “Oh, you’re sure to do that,” said the Cat, “if you only walk long enough.” Lewis Carroll, Alice in Wonderland

39. Next Steps • Develop a Plan • Implement the Plan • Evaluate Outcomes How can you show me that things are working well and that challenges are being successfully addressed?

40. Tinker your way to Greatness Remember: The Titanic was built by engineers The Ark was built by common folks

41. Don’t forget to: • Celebrate successes • Learn from mistakes • Share your learning • Maintain commitments • Communicate…communicate… communicate