Tag Archives: Collaborative Improvement and Innovation Network

Communicate, Collaborate and Innovate to Reduce Infant Mortality

Peter Gloor, PhD
Peter A. Gloor, PhD

Compared to other Western countries, infant mortality in the US is shockingly high.
High infant mortality is a social problem that can only be solved through massive collaboration and out-of-the-box innovation.

To tackle this issue I propose to tap into the “creativity of the swarm,” using collaborative innovation to help parents and caregivers take the best possible care of their children even before they are born and increase the quality of care in the first years of an infant’s life.

A good starting place, I believe, is to connect parents and healthcare providers in what I call Collaborative Innovation Networks (COINs). These are dynamic teams in which diverse stakeholders with a shared vision collaborate to achieve a common goal. COINs form from the interaction of like-minded, self-motivated individuals who enable innovative ideas to be pushed forward. The participants join because they are committed to the common vision and want to be part of the innovation that “will change the world.”

How many people could be motivated by the goal of reducing infant mortality?

Through COINs, we can collectively address key topics such as breastfeeding, screening for developmental delays, and recognizing maternal depression. We can increase the quality of care for infants by creating peer learning and innovation groups of parents, where knowledgeable parents help others learn to take better care of their babies. Weaving a network of social support around parents in need helps them weather the storms of daily life. Just like in the beehive where bees take care of their young as a community, mothers and fathers in a collaborative innovation network can learn from and support each other.

One of the key factors for high-functioning COINs is communication. As we have found in our research, better communication leads to better collaboration, which in turn leads to more innovation. Ultimately, we want to increase the collective intelligence of these teams. In research at the Center for Collective Intelligence, my colleagues found that there are four key predictors that will increase collective intelligence of groups:

  1. The more team participants communicate with one another, the more collectively intelligent the team is.
  2. When participants communicate equally, instead of a few participants doing most of the talking, the collective intelligence of the team is higher.
  3. When everyone contributes equally to team success, a team is more collectively intelligent.
  4. The higher the emotional intelligence (measured through a test called “Reading the Mind in the Eyes”) of each team member is, the higher the collective intelligence of the team is.

It all starts with connecting parents and healthcare providers, encouraging them to better communicate such that they can innovate more. Talking more, talking more evenly, contributing ideas more evenly, and taking care of the emotional needs of each other will help to create better networks that will generate better ideas to reduce infant mortality.

Peter Gloor, PhD, is a research scientist at the Center for Collective Intelligence at MIT’s Sloan School of Management and is the pioneer of the Collaborative Innovation Networks (COINs) concept upon which NICHQ’s Infant Mortality Collaborative Improvement and Innovation Network (CoIIN) project is based. Mr. Gloor is serving as an expert advisor to NICHQ on this project.

Overcoming the Epidemic of Compassion Fatigue

Lauren A. Smith, MD, MPH
Lauren A. Smith, MD, MPH

As I take on my new role at NICHQ as leader of a national initiative to reduce infant mortality, I find myself in a struggle very familiar to those of us in public health who focus on promoting the health and wellbeing of entire communities – that is, how to maintain the public’s engagement and interest in the health priorities we are championing. Given the many priorities and important issues that are competing for our collective attention, it is easy to understand how policy makers and the public become numbed to the recurrent “calls to action” and the exhortations to pay more attention to: domestic violence, bullying and teen suicides, opiate addiction, gun violence, breast cancer, diabetes, obesity, prematurity and infant mortality…and the list goes on. All of these issues are incredibly important and for those families and communities who are touched by them, each leaves a lasting legacy of sorrow and lost potential. If all of these causes (and more) are worthwhile, how do we make gains on any when the initial response might be to lament that we can’t do everything?

When faced with seemingly overwhelming challenges, humans can be very effective at partitioning the huge into the feasible. The first step is maintaining our faith that our efforts, when thoughtfully and creatively applied, can actually change outcomes. Once we have that confidence, then we need to gain the attention of our communities and key stakeholders whose insights and collaboration are required for our efforts to be successful. How do we break through the cacophony of dire statistics and grave warnings about so many “epidemics”?

I believe we need to adjust our language, not to substitute our appropriate reliance on data with sensationalized attention grabbing headlines, but rather to make the problem more concrete for those who don’t confront it every day.

Infant mortality is a good case in point. The US rate of 6 deaths per 1,000 live births doesn’t really have much tangible meaning to the general public. In fact, if anything, six seems like a pretty small number. But what about 24,586? That is the number of US infants who died before their first birthday in 2010. This is the equivalent of about 1,000 kindergarten classrooms of children that will never be filled. Recognizing that not all infant mortality is preventable, the question then becomes not what do we do with the number six, but how many of those kindergarten classrooms can we commit to filling with children who are healthy, happy and ready to learn. Suddenly the problem and the motivation to fix it become more real. For a state with an infant mortality rate of 9.7 per 1,000, a 20 percent decline to 7.7 would be incredibly impressive in the world of public health. But realistically, how many people will really be excited by a change from 9.7 to 7.7? For most, that hardly seems like a change at all. Yawn – turn the page, flip the channel and move on. But if we were to say that this equates to saving three entire classrooms of future kindergarteners, it might pique more interest. People can visualize a classroom of giggling kindergarteners, while describing a change from 9.7 to 7.7 has none of the same power to evoke our basic human desire to protect our offspring.

Thinking of our social “epidemics” in this way changes the discussion from statistics to people, from counting to compassion. It will help the public better understand the issue, commit to solutions, and recognize and applaud successes – and, most importantly, support more efforts to save the next classroom of children and the next.

Let the wild rumpus start! Your ideas wanted!

mariannephd

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Those who teach the Model for Improvement often ask, “What will you do by next Tuesday?” It’s a quick way of jump starting the rapid testing that is one of the hallmarks of improvement science. At the end of this post, I offer a “next Tuesday” challenge.

Today, Peter Gloor, founder of the concept of Collaborative Innovation Networks, led a session with NICHQ on how to bring more innovation into our work. (His concept is one of the methods at the core of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality, the expansion of which we are honored to be leading.) Peter shared with us his most simple roadmap for innovation, and it went like this:

  1. Collect crazy ideas.
  2. Select the craziest.
  3. Find people willing to work on the craziest ideas.

Peter is an innovative thinker, to say the least. Yet his approaches are also very grounded…

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Collective Impact: Coloring a New Vision of Collaboration

Marianne McPherson
Marianne McPherson

My colleague Karthi Streb* and I recently attended a Champions for Change event to learn more about how to achieve collective impact. Collective impact happens when a group of participants from different sectors commits to a common agenda for solving a complex social problem. The concept was first articulated in a 2011 Stanford Social Innovation Review article by John Kania and Mark Kramer.

During the trip, Karthi and I talked a lot about a lot of things (our work, our kids, the amazing Pacific salmon and Vancouver scenery…) as we grew more and more excited about the possibilities of more explicitly using a collective impact framing in our work at NICHQ. And as we talked about our work and our kids, I remembered the book The Day the Crayons Quit by Drew Daywalt. (I have a habit lately of connecting my work to children’s books.) As I reread this book, it hit me that Daywalt provides a beautiful illustration of the kind of partnership we hope to achieve in collective impact.

In the book, Duncan’s mission is just to color, but his crayons are sowing seeds of discontent. Purple is going to “completely lose it” if Duncan continues to color outside the lines. Peach feels naked without his paper wrapper and refuses to leave the crayon box. Blue feels overworked and has become short and stubby, no longer able to see. White reports that not being in the rainbow “leaves me feeling… well… empty.” Pink is tired of being typecast as “girly.” And Yellow and Orange have stopped speaking to each other because each one feels they alone are the color of the sun. They share this with Duncan in letters that they sign, “Your naked friend, Peach crayon…Your overworked friend, Blue crayon…”

Duncan is not deterred by the frustrations of his drawing partners. He listens, addresses some of his partners’ complaints (for example, using the overworked Blue crayon more sparingly) and finds a way to bring out the best in all of his crayons.

There is a lot to learn about partnering for collective impact from Duncan’s story. Paul Born, a leading collective impact and community-building practitioner at the Tamarack Institute, describes collective impact as how to “make the work of working together better and more effective.” Duncan and his crayon partners built a more effective working relationship and ultimately Duncan achieved the outcome he wanted—to just color.

Collective impact is in NICHQ’s DNA, although until recently we haven’t had the benefit of this language or framework. In our newest project, we are using collective impact concepts to engage federal, state, and local leaders, public and private agencies, professionals and communities to reduce infant mortality and improve birth outcomes. NICHQ is honored to have been selected to be what collective impact would refer to as the “backbone organization” in this important initiative to save lives with an exceptional group of partner organizations.

A backbone organization is the coordinating center for an initiative, but it is not the only driver of the initiative or the work. In fact, there’s a risk that the backbone organization “owns” the effort rather than the effort belonging to the whole partnership; so it’s important to find the right balance between leading and leading too far.

NICHQ’s mission is to improve children’s health. This mission is so big we couldn’t possibly achieve it alone. It is fundamentally about partnerships, about finding effective ways to collaborate and build on each other. It is a vision that builds on pillars of collective impact to generate collaboration for social change.

We hope to achieve the right balance with our partner organizations that share our mission and we welcome suggestions from our partners for how might continually improve our approach. We certainly do not want to argue like the Yellow and Orange crayons about who is the color of the sun. In our world, the sunshine comes from “collaboration” and “partnership” rather than “ownership.”

Let’s just color!

Your energized friend,
Marianne

* Karthi and I collaborated on writing this post and on the ideas behind it. More partnership in action!

What Rosie Revere, Engineer Teaches Me About Innovation

Marianne McPherson
Marianne McPherson

My daughter loves to read Rosie Revere, Engineer, a children’s book about a young girl who dreams of and practices at becoming an engineer. Rosie nearly gives up that dream when she’s laughed at by some of the people closest to her after her first few inventions aren’t first-time successes. But with some encouragement from her great-great-aunt Rose (homage to Rosie the Riveter), young Rosie keeps at her innovating and engineering, building a flying machine called a heli-o-cheese-copter. In the process, she comes to realize that:

“Life might have its failures, but this was not it. The only true failure can come if you quit.

I’ve been thinking about innovation a lot lately, in large part due to a renewed commitment at NICHQ to be a hub for creating and spreading innovations. I am so excited about this commitment because I know that new ideas and new approaches—and building them together—will help create a world in which all children achieve their optimal health.

“But questions are tricky, and some hold on tight…”

Further advancing my excitement for innovation, NICHQ was recently awarded a cooperative agreement by HRSA’s Maternal and Child Health Bureau to lead the national expansion of the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality. This initiative provides a platform to transform children and their families’ lives, drawing on quality improvement, collaborative improvement, and innovation to do so. We feel privileged to join with an incredible group of partners and build on the work of CoIIN participants in the first 19 states in which this initiative is already underway. As we spread the effort to up to 31 new states and eight territories, we are honored to hold on tight to the tricky question (as young Rosie would say) of how to reduce infant mortality, improve birth outcomes, and address health disparities in this country. We hold onto that question because we are committed to the vision of a nation in which every child celebrates his or her first birthday. (If you are, too, and especially if you’re already working in this area, please comment on this blog post so we can follow up.)

Baby Luke
Baby Luke

One of the reasons that I hold onto this question is that my cousin, Luke, never got to see his first birthday. In 2010, 24,586 families experienced the life altering heartbreak that my family experienced. We can do so much better. For every family to celebrate their child’s first birthday, we will learn and work in partnership, we will improve where the path is clear, and we will innovate where it is not.

“You did it! Hooray! It’s the perfect first try! This great flop is over. It’s time for the next!”

I invite you to join our conversation and join in our work. As Rosie knows—she has a closet full of parts for building her inventions—and as Steven Johnson writes in Where Good Ideas Come From, “the trick is to get more parts on the table.”

What might that look like, exactly? To start, NICHQ will be putting more of our parts (and combinations of parts) on the table externally in, for example, more blog posts like this one. We invite you to join the conversation and help us make the next great flying machine (tell us if we’re flopping and how to fail forward!). Bring some parts to put on the table (maybe even guest blog about them!), follow us on social media like Twitter (@NICHQ, @mariannephd). Our table is not just the one in our office conference rooms. That table is in our conversations with those who, like we at NICHQ, are committed to a world in which all children achieve their optimal health. We recognize that those parts may come from healthcare, or from architecture, or from children’s literature. So please, come to our table and join the conversation, and invite others to join it, too.

“It crashed. That is true. But first it did just what it needed to do. Before it crashed, Rosie…Before that…It flew!”

As Rosie taught me, getting parts on the table means that some combinations of those parts won’t work, either on the first try or ever. Just as I’m committed to NICHQ putting more parts on the communal table as we iterate and innovate, I’m committed to us sharing what combinations haven’t worked. In the months that I’ve been leading our innovation initiative and learning a TON as I go, I’ve held onto a few things:

  • Innovation is rare. Because it’s so rare, it’s both a destination and a journey. And that journey involves a lot of great flops on the way to the flying machine.
  • Innovation is not a solo flight. (See above re: parts on the table in public!)
  • Innovation has a lot of buzz, but it’s buzz worth striving for, especially if it means that just one more child will have her first birthday, that just one more family will have a safe outdoor space for their child to play, or that just one more adolescent receives timely treatment for substance abuse.

So, what is your heli-o-cheese-copter? What is the next one we’ll build together? Join us at the table, and please bring some parts.

Marianne McPherson is the Director of Applied Research and Evaluation at NICHQ.