The Stew BLOG

Identify Strengths and Areas for Improvement: A Tool to Assess Regional Health Transformation Strategy

Rebecca Niles, Senior Strategy Consultant | 11/27/2018

Over the past several weeks, ReThink Health team members and guest bloggers have discussed the concept of a comprehensive regional health transformation strategy. The authors who have contributed to this series on strategy bring myriad perspectives and experiences to the topic. If you haven’t spent time on this series yet, I urge you to acquaint yourself with the previous six posts, each of which approaches strategy from a different angle:

    • ReThink Health’s Bobby Milstein, who directs the organization’s system strategy work, launched the series with two posts: the first defined a comprehensive regional strategy for those who may not be familiar with the idea, and the second brought the idea to life by telling the story of a multisector partnership working to transform health and well-being in King County, Washington. As Bobby explains, the key components of a comprehensive strategy are a theory of system change—in effect, a plan for how to achieve desired outcomes—and a portfolio of interventions—the policies, programs, and practices that will bring that theory to life.
    • In the third post, ReThink Health’s Tami Gouveia delves further into these two essential components of a comprehensive transformation strategy. Tami explains why a theory of system change a portfolio of interventions are fundamental if multiple stakeholders from across a region are going to drive real change rather than simply tweaking details at the margins within the confines of a single organization or institution. Tami then tells the story of Trenton, New Jersey, where a group of stakeholders is using these techniques to refine their transformation strategy and achieve their vision.
    • For the fourth post in this series, Bobby Milstein joined his former colleague Kalila Jackson-Spieker to introduce the concept of system boundaries. Kalila and Bobby make the case for establishing system boundaries—essentially, parameters that help clarify the ideal scope of your efforts—as part of a comprehensive transformation strategy. They explain that the act of setting boundaries can help diverse stakeholders, whose goals inevitably differ, come to agreement and make decisions by uncovering sticking points and illuminating shared priorities. By establishing clear boundaries, Kalila and Bobby say, the path toward a transformed system can become much more obvious.
    • In the fifth post, Stacey Chang and Beto Lopez, executive director and managing director, respectively, of the Design Institute for Health at The University of Texas at Austin, discuss system prototyping—a quick method of learning about a system and the likely outcomes of potential interventions that could make up your portfolio. Prototyping is a valuable method of testing your strategy ideas before making wholesale change, allowing regions to be innovative and nimble with bold ideas that can be scaled up if and when they succeed.
    • Finally, in the most recent post, ReThink Health’s Ruth Wageman highlights the importance of effective stewardship—particularly organizational participation, leadership, and trust—when a region is developing a comprehensive transformation strategy. Ruth offers solutions to the most common pitfalls that can plague multisector partnerships when stakeholders from across the region commit to a shared vision and priorities beyond their own individual and organizational self-interests.

One of the reasons ReThink Health created this series is to get you thinking about the possibilities for a comprehensive regional strategy in your own region. We to hope to inspire you and your colleagues to lead the kind of transformation efforts that will produce greater health and well-being for all the people who live, work, and play in your region.

It’s possible that this series has excited you about the possibilities, but you still think a regional strategy for health transformation is a pipe dream. The fact is, whether or not you’ve articulated a comprehensive strategy, a de facto strategy is, in fact, being enacted in your region. It’s quite likely, however, that this “regional” strategy is more accurately described as a cluster of individual organizational strategies, which may not be aligned or designed in pursuit of the same end goal.

If this sounds familiar, I encourage you to check out our Regional Transformation Strategy Assessment Tool. This simple tool offers criteria by which to appraise your overall theory of system change and the portfolio of interventions in place to enact it. You can use the tool to assess the quality of your current transformation strategy or one you are developing for the future. It asks questions such as: Do you have a credible theory of system change? Does that theory strive to make a real and lasting difference on important issues? Does it build on your region’s understanding of past trends? Is a broad range of stakeholders engaged and committed to it? You’ll ask these and other questions in assessing your theory of system change, then turn to your portfolio of interventions and consider its potential to advance the theory.

Whether you are assessing your current strategy or getting ready to propose a new one, the assessment tool can help identify strengths and areas for improvement so that you and your colleagues are in a better position to make progress toward transforming your health system. I hope you will try it and then email us at [email protected] to let us know if and how the tool works for you. If you have questions or feedback about anything related to this series, I encourage you to comment below.