Nemours Lab Shares Lessons of Multi-Sector Collaboration
Besides being a pediatric health system offering care in five states, Nemours Children’s Health System has a national office focused on population health efforts. In 2020, Nemours led an Integrator Learning Lab, a learning-and-action collaborative in which teams from nine population health networks received customized technical assistance from a faculty of national experts.
“We have a national scope of helping all kids become healthy through policy, through best practices — not just caring for young people and infants and who walk through the doors of Nemours for care,” said Kate Blackburn, manager of practice and prevention at Nemours Children’s Health System.
The Learning Lab tested the idea that strategic alignment of integrative activities and network strategic plans would strengthen network efforts.
“One of the national office’s areas of exploration in the past decade or so has been health care's role in cross-sector networks that are aiming to move the needle on measures of health and wellness for whole communities,” Blackburn said. “A recent piece of our work was the 2020 integrator Learning Lab, which is a short-term learning and action collaborative where multi-sector teams, including healthcare, established shared goals and then received self-directed resources, coaching, and technical assistance from faculty there. The 2020 Lab focused on strengthening use of integrative roles and functions within cross-sector networks.”
Nemours thinks of integrative activities as that collection of governance and coordination activities that enable networks to carry out tasks that support their shared goals. “This could include taking the lead on ironing out data-sharing agreements between partners, facilitating the network strategic planning process, thinking about who's at the table, who's missing, how to pull in the missing people, and figuring out how to capture, quantify and share the value and the impact of the network,” Blackburn said. “It involves all that behind-the-scenes work that is essential to the network's ability to move forward and be successful.”
In October 2018, Nemours’ Exploring the Roles & Functions of Health Systems within Population Health Integrator Networks initiative focused on understanding how healthcare institutions and their partners share responsibility for integrative activities, which are the governance, oversight, and administrative functions that enable population health networks to carry out tasks and strategies related to the network’s shared population health goals.
In the first phase, the team scanned the field to understand the state of knowledge of multi-sector networks for population health. The team interviewed more than 40 researchers and practitioners who were participating in these partnerships across the United States to understand the opportunities and challenges that exist for forming and sustaining these networks.
The 2020 Integrator Learning Lab was the second phase. It worked with multi-sector teams, including healthcare organizations, on shared population health goals had an opportunity to receive self-directed resources, coaching and technical assistance.
The 2020 Lab focused on strengthening the use of integrative roles and functions within cross-sector networks to strengthen and sustain work toward the shared population health goals of each network. The Lab provided an opportunity to test how the lessons from the first phase of the project could be applied in a real-world context.
Within the Lab, work focused on developing strategies for centering racial and health equity in network decision-making; establishing equitable, distributed leadership within networks; using data to promote population-level solutions; and making the case to residents, partners and funders for sustaining networks over the long-term.
During a recent webinar put on by All In: Data for Community Health, Lab leaders and members of two partner organizations, Partners for a Healthier Paterson (Paterson, N.J.) and Sharswood Thrive (Philadelphia) discussed some achievements, challenges and lessons learned in the work.
“We went through a process of defining a theory of change, creating an impact statement, determining what kinds of things we wanted to measure and what the areas that we thought we wanted to work on in housing, workforce development and education, health, food, which is what Philabundance brings to the table, and community development, which really has to do with the physical aspects of the neighborhood and then advocacy,” said Mary Gainer, director of research and evaluation of Philabundance and Ending Hunger for Good as part of Sharswood Thrive, a neighborhood project in North Philadelphia.
Hanaa Hamdi, Ph.D., is director of health impact investment strategies and partnerships at New Jersey Community Capital. She is responsible for directing the development and implementation of existing and emerging community health investment and development strategies with national, regional, and health-focused partners, supporting the organization’s holistic approach to neighborhood revitalization. She said that although this may seem very specific, their effort has been around quality and safety of housing. The narrow focus allows the partnership to address the full array of pathways of health and housing.
“In order for get to that health equity piece, you need to align the partnerships in the way that you have this cumulative impact, a cumulative investment,” Hamdi said. So whether it's in Paterson, or across New Jersey, our partnerships with healthcare are aligned with private partners, health payers, and banks. We’re constantly building a foundation that addresses the immediate need, but then also begin to look at how to undo some of the long-term structural issues that have led us to this moment. So working to the future for us means looking back in forging partnerships that can address multiple layers of need.”
Bilal Taylor, senior program and policy analyst at Nemours, gave a few examples of success from communities working with the Lab. “One that stands out for me is the idea of naming a bold goal, such as preventing gentrification in a community addressing structural racism. I know one of our partners set a bold goal of eliminating health disparities that were showing up in babies born to mothers of color throughout Guilford County, North Carolina. I think when you set a bold goal in that way, it also calls into question everyone's agreement upon really reaching that north star,” he said. “Who would say that young people don't deserve to have an opportunity to be healthy and well? Who would say that certain types of young people should be born with disparities? In theory, we all want to get there, but stating that bold goal, naming it, I think has allowed for some of our communities to be able to at least grow up with our disagreements. We have different reasons that we think healthcare is not working, but if we want to be healthier, how do we then bring folks together from disparate communities or political beliefs and value systems to say equity is a goal?”
Taylor noted that the Lab partners are finding ways to amplify the voices of persons with lived and learned experience. He said the partner in Washington, D.C., at the DC Health Matters collaborative found out it wasn't just about resetting expectations of what health and wellness looks like for communities. People said they didn’t want to participate in a separate advisory board to bring their words to the power brokers in the space. “They said, we want to figure out how we build this within the existing structures, and not have this adjacent structure for us,” he said. “It’s not only just people talking about widening the table, it's not building another table. It's really demystifying who has this power and making sure there is just one table, not a community advisory board that will report back to our big steering committee, with doctors and heads of institutions. Folks wanted to feel like their voices were heard. That’s a couple of ways that we've seen folks work it into the workflow that is literally changing how you work, changing the north star, changing the strategic plan, Once you do have these basics, it may change the very structure in which your network may be working.”
