What if our nation’s health industry leaders put their personal agendas aside and came together to collectively fix health care?
What if, for a few days, they unplugged their computers, turned off their cell phones and devoted their full attention––their minds, expertise and energy––to reforming a system that, in its complexity, has defied decades of attempts at reform?
Sounds nice, but unrealistic, maybe even impossible.
But last summer, 33 executive-level women, the Titanesses of health care, convened in a Washington DC hotel with that very goal in mind. The group, which became known as Women of Impact, began by contemplating individually what they wanted their legacies to be, and then asked how collectively that might translate to health care.
It was transformative, according to participants invited to reflect Saturday on the experience at the Association for Academic Medical Centers’ annual meeting in Chicago.
Collective impact is making inroads with some of the biggest problems we face today, such as, failing schools, poverty and obesity, according to the Stanford Social Review, which defines it as: “The commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem.”
Applied to health care by Women of Impact, it gave rise to a three-pronged agenda for fixing the “broken windows of health care,” said Joanne Conroy, Women of Impact’s convener and CEO of Lahey Clinic.
- In order to level the health care playing field, we need to truly empower people to reclaim their health and reclaim their access to health care.
- We need to shift the current context from a delivery system focused on illness to one focused on health, moving from survival to well-being.
- We need to reduce disparities by identifying and remediating the behaviors in the health care environment that communicate that some people are expendable.
The broken windows theory is grounded in a successful effort in New York City to reduce crime by cleaning up the streets.
“When you have subways littered with detritus, you’re setting up a subliminal message that crime is OK. People would snatch bags and assault people and it was just ignored,” said Conroy. “When they removed the garbage and graffiti, the difference was remarkable. There were so many things that changed because the context of what was acceptable changed.”
Changing what’s acceptable in health care is not something that will happen overnight. It will take an ongoing commitment from everyone. And it starts with everyone asking some hard questions of themselves and the institutions they lead, said Women of Impact member, Vivian Lee, M.D., M.B.A., Ph.D., Senior Vice President at University of Utah Health Sciences. “As yourselves, what do you most want to contribute. What are you really passionate about? What might be a fulfillment of your life and career?”
It takes a forward-thinking mindset, said Amy Mansue, CEO and President of Children’s Specialized Hospital in New Jersey. “Instead of just saying, what is it you want to be, ask how it is that you are going to get there?”
And it takes courage, said Rhonda Moore Johnson, M.D., a pediatrician and medical director of health equity and quality services at Highmark Inc. in Pittsburgh, for whom it helped to develop a legacy statement: Unleash the impossible.
Want to join the cause? Here’s what you can do individually and institutionally, said Conroy. Ask yourselves:
- What do we do that disempowers, devalues, or stereotypes people in health care?
- What kind of language do we use?
- What do we accept as a normal inconvenience?
- Are you a partner in your own health care?
- As a consumer, how would you redesign the system?
- Where can you write or talk about these ideas?
- What is the current context of your world and what are the “broken windows”—markers of dysfunction in the system?
- What efforts has your group made to mitigate these behaviors? Have you addressed them in your organization’s strategic plan?
- How can you leverage your relationships and networks to continue the conversation outside of your organization?
- How does this change your perception of what is possible and your potential impact?
Kirsten Stewart is a senior writer for University of Utah Health Sciences.