CoP/Training Call From Improvement to Activism: How the Tools of Community Organizing can transform the work of the QIO. Speaker: Ella D. Auchincloss, Director ReThink Health: An Initiative of the Fannie E. Rippel Foundation

September 10, 2013

2:00 PM Eastern Time

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October 1st Virtual Conference

Save the Date Data Driven Action: Pathways to Health Equity October 1, 2013 12:00 PM ET- 4:30 PM ET

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Virtual Conference Agenda

12:00-12:15 Introductory Remarks by Jean Moody Williams Director, Quality Improvement Group

12:15-1:00 Building Trust and Capacity for Respectful Engagement (preliminary title) by Dr. Stephen Thomas, Director, Maryland Center for Health Equity, University of Maryland.

1:00-2:00 Community Engagement: QIO Perspective Panel Participating QIOs -TBD

2:00 – 2:15 Break 2:15-3:00 Using Data for Health Equity (preliminary title) by Dr. Darrell Hudson is an

Assistant Professor, Brown School of Social Work and Faculty Scholar, the Institute of Public Health at Washington University in St. Louis

3:00- 4:00 QIO Data Panel 4:00-4:20 Closing Remarks by Dr. Stephen Thomas and Dr. Jie Chen, Assistant Professor,

Health Services Administration, University of Maryland, College Park

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Today’s Speaker

Ella D. Auchincloss, Director, ReThink Health:

An Initiative of the Fannie E. Rippel Foundation

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How the Tools of Community Organizing can Transform the Work of the QIO

From Improvement to Activism:

Ella Auchincloss, MTS, Director, ReThink Health

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1. To introduce the “theory of change” 2. To show how the tools of community organizing

can be used to help the QIO's map the local health care system, convene disparate stakeholders and mobilize them towards a common goal.

3. To show examples from ReThink Health’s work in the field

4. To spark your interest in learning more

Webinar Goals

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Hierarchical instruction: require/incentivize compliance

Technical innovation: redesign the process or technology to remove the problem

Training: make sure that people have the right skills and knowledge

Social marketing: ‘sell’ the cause and exhort action

Awareness raising: make sure people know about the problem and action will follow

Common theories of change in healthcare

What is our theory of change?

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Community Organizing and Mobilizing

…people acting together to change the status quo

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

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What is Power? The ability to achieve purpose

Community Organizing and Mobilizing

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What is leadership?

Leadership is taking responsibility for enabling others to achieve shared purpose in the face of

uncertainty.

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What We Teach: The Community Engagement Curriculum

Con

stitu

ency

Resources

The Key Leadership Practices

GOAL

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Snowflake Model:

The ideal for gathering on the basis of shared values

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29203: The Challenge

In South Carolina: •More that 60% of the population is overweight

•30% of the state has high blood pressure •11% of the state has diabetes

In 29203:

•One of the highest amputation rates due to diabetes in the US

•30% of residents are uninsured •Average resident makes two ED visits per year

•Translates into 90,000 visits per year including 30,000 from residents who can’t pay

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29203: The Challenge

Limited access to

care

Delayed medical

treatments & overuse

of emergency

rooms

Poorer patient

outcomes & rising

medical costs

Cost increases for private & public

insurance programs

More employers drop health

plans; public

sector cuts services

The Vicious Cycle

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Campaign Goals: 29203

• Develop organizing and leadership skills within community

• Increase access to quality, affordable care • Increase the community members’ commitment

to health and wellness • Improve health outcomes • Reduce costs (i.e. a reduction in unnecessary ER

visits) • Develop a team to reinvest savings

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Constituencies in Columbia, SC

(1) Community members in 29203 and Columbia - Church members, neighborhood associations, parents, citizens, senior

groups

(2) Health care providers - Physicians, nurses, community health centers, hospitals, care givers,

(3) Volunteer health coaches - Nurse practitioners, engaged citizens

(4) Private and public insurers - BlueCross / BlueShield, employers

(5) Students - Undergraduates, graduates, future health care professionals

20 participants

Core Leadership

Team Training

July 13-14

91 leaders attend Town Hall Meeting

Aug. 16

32 participants Leadership

Team Training +

Launch of House Meeting

Campaign Sept 27-28

Community Issues

Assembly with

decision-making

on campaign focus

November 16th 200

attendees

Team Training with 100 leaders January

2012

500 people Official

Campaign Launch

March 3, 2012

(8) Vision Team

Trained

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29203 House Meetings: By the Numbers

• 45 House Meetings in 6 Weeks • 739 Newly Engaged Citizens Attended a House

Meeting • 16 Citizens on Average Attended Each House

Meeting • 4 Healthy Columbia Team Members On Average

Supported Each House Meeting

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29203 Community Assembly

188 community members from 29203 attended Celebrated the house meeting campaign Conducted a collective decision making process to

select a campaign focus in 29203 Selected the “Community Covenant” campaign:

• All constituencies commit to working together to: – Increased access to primary care in 29203 – Support for healthy behaviors + accessing care in new ways – Development of stewardship body to reinvest savings in system

back into community effort

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The Leadership Training for Campaign Kickoff

• 100 leaders attended 2 day leadership training

• Training led by community • Developed a recruitment

strategy for kickoff event • Launched Turf Teams,

Provider Teams, Care Access Teams, Data Teams and a Media Team

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Kickoff

• 500 attendees • Public commitment ceremony where

the state, the payers, providers and the community agreed to the community covenant.

• Exercise demonstrations • Health Screenings • Healthy Food Donations

Campaign Launch

March 3, 2012

Core Team Re-Launch

Healthy Cooking Classes 30 For You/

Resource Training

“Health Watchers”

New Care Access Sites

Stewardship Coordinator

Care Coordinator (PC & Access Points)

Campaign Support Community Coordinator

Policy

Sustainability Team

Student Providers Health Coaches

Turf #1 Team Turf #3

Team Turf #2

Data

Media Media

Trainings

Covenant and Governance

Healthy Columbia Campaign Snowflake: OFH’s Goal

HC Core Team

(Plus more turfs)

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Foundational Work of the Core Leadership Team

8 “Vision Team” leaders trained in Spring 2011 • Vision team conducts 20 1:1 meetings and recruits local leadership team

35 core leaders recruited Summer 2011 • Core LT maps the values, interests and resources of 29203 community

130 1:1 meetings in 29203 • Core Team recruits leaders for House Meeting campaign

House Meeting Campaign in Fall, 2011 with 750 attendees • Core Team plans Community Issues Assembly

Community Issues Assembly-200 attendees Community Covenant decision made

• Core Team recruits leaders for kickoff training

Leadership Training in Jan.2012 –100 leaders attend • Core Team plans kickoff event

Kick off March 3rd (500 attendees)

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Key Lessons thus far……

• Community, community, community! • Find the right kind of community leaders

• Don’t launch until you have a strong core team • This is really hard

PERFECTION IS THE ENEMY OF THE GOOD!

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For more information, please contact Ella Auchincloss

at eauchincloss@rethinkhealth.org or 617 686 4169

and visit our website: rethinkhealth.org

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Q&A Please type your question into the chat box or press

14 on your telephone.

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New DNCC Resources

Look for these new learning toolboxes during the month of September:

• Data and Health Outcomes currently on CMS PULSE website • People with Disabilities v 2.0 coming soon • Health Literacy coming soon

Also coming soon: • Consumer Cardiovascular Health Resource Guide

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Affinity Groups

DNCC Affinity Groups will provide a forum for discussing useful, practical information with peers who share your interests and concerns.

Topics: • Disparities Data • Rural Health • Behavioral Health • Community Engagement

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CMS Pulse Website

Your QIO’s work could be featured on the CMS Pulse website.

• Success stories • Pictures (with signed consent from beneficiaries, please)

Please send to: dncc@sdps.org.

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Thank you for participating in today’s webinar.

At the close of the presentation, you will automatically be directed to an evaluation screen.

This material was prepared by the Delmarva Foundation for Medical Care (DFMC), the Disparities National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS),

an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS

policy. 10SOW-MD-DNCC-090913-260..