Guest Post: Self-care through collective impact

Guest Post: Self-care through collective impact

Posted on April 12, 2013 by Jim Firman

Editor's Note: James Firman is the President and CEO of the National Council on Aging. The Patterson Foundation is a partner in NCOA's cross-sector self-management alliance. This article was originally shared in Ernst & Young's Progressions 2012 report.

The mission of the National Council on Aging (NCOA) is to improve the lives of millions of older adults, with a special focus on the problem of chronic illness. The increasing burden of chronic illness is exacerbated by the fact that patients often have not one but multiple chronic conditions — increasing the risk of co-morbidities and the complexity of managing these conditions.

In such circumstances, it is critical to engage and empower patients to take charge of their health. We have therefore created the Self-Management Alliance (SMA) to advance the second goal of the Health & Human Services (HHS) Strategic Framework for Multiple Chronic Conditions: maximizing the use of proven self-management and other services by individuals with multiple chronic conditions.

The SMA is a trisector collaborative that brings together several key players from the government, business and nonprofit sectors to change the health ecosystem and achieve our shared goals.

We have built the SMA using the collective impact framework, focusing specifically on its five key elements:

  • Common agenda. Our goal is to make self-management an integral part of health in the US by 2020. As part of this objective, we want to make sure that at least 4 million older adults participate in evidence-based self-management programs during this time frame.
  • Shared measurement systems. The SMA will have at least two categories of shared measurement systems. First, we will work with HHS to develop and/or select specific individual and population-level metrics to gauge national progress toward achieving our shared goals. Second, we will facilitate dialog among participants to work toward common metrics that can be used to evaluate the outcomes of R&D initiatives undertaken by federal agencies, private foundations, health plans and pharmaceutical companies.
  • Mutually reinforcing activities. Members will engage in a number of mutually reinforcing activities, including: strategic planning and sharing knowledge about evidence for various interventions; identifying and overcoming barriers to implementation and national scaling; and identifying outcome measures. In addition, collaborative-wide initiatives may be initiated in specific areas, such as consumer research, R&D, public policy and education.
  • Continuous communication. To encourage continuous communication among all our members, the SMA will rely on regular meetings, skilled facilitation and sophisticated electronic platforms.
  • Backbone support organization. Lastly, to make all of this happen, the SMA will have a small, highly skilled team focused solely on ensuring the success of the alliance by fostering strategic collaboration among all of its members.

Given that the number of people with multiple chronic conditions is expected to increase dramatically in the years ahead, initiatives that encourage self-management are sorely needed.

The collective impact approach is particularly suited to this challenge, given the complexity and the number of stakeholders involved. But, this is by no means the only issue area where the collective impact approach could be applied. Indeed, at a time of limited resources and increasingly unsustainable health care costs, there are many areas where health care could be made more effective and efficient through collective impact alliances.

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