Module 1: Collaborative Leadership

Multi-stakeholder Community Inventory Modules

Community quality collaboratives are community-based organizations of multiple stakeholders, including health care providers, purchasers (employers, employer coalitions, Medicaid and others), health plans, and consumer advocacy organizations, that are working together to transform health care at the local level. The Agency for Healthcare Research and Quality offers these organizations many tools to assist in their efforts.

Your Goals in This Inquiry

  • Identify initiatives, multistakeholder groups, and individuals that demonstrate collaborative leadership in your community. Examples of collaborative leadership can be drawn from anything that is relevant to value-driven health care in your community (e.g., performance measurement, quality improvement).
  • Identify potential experts and resources to assist your Community Quality Collaborative in getting the right people to the table, developing and maintaining relationships, gaining momentum, sustaining commitment and participation, and supporting efforts over time.
  • Identify new key organizations, individuals, and leaders that need to be brought into the new Community Quality Collaborative, even if they do not have a history of working with members of the collaborative.
  • Identify whether assistance is needed to fully realize the benefits of collaboration because of unbalanced power among stakeholders, or historical relationships or events that prevent a collaborative approach. Assistance may include bringing in a facilitator or neutral party to guide the group, educating stakeholders on the principles of collaboration, and increasing the skills of leaders in the collaborative.
  • Identify opportunities for multiple stakeholders to collaborate rather than compete in order to improve health and health care.
  • Identify ways to continually increase the value derived from the Community Quality Collaborative's collaboration.

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Information You May Want to Gather

  • Identify collaborations, individual organizations, and leaders within organizations who have track records of collaboration.
  • Identify successful community initiatives where collaboration was the vehicle for its success.
  • Identify local resources that have facilitated collaborative efforts.
  • Identify collaborations that have not succeeded and reasons why.

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Key Individuals to Contact

  • Members of your Community Quality Collaborative.
  • Other individuals representing the four stakeholder groups involved in the Community Quality Collaborative who have been involved in collaborative efforts.
  • Leaders of other collaborative efforts, especially those that are longstanding.
  • Experts and facilitators who have supported past collaborative efforts.

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Other Individuals to Consider Contacting

  • Leaders and other individuals who have been involved in past or existing multi-stakeholder collaborations related to the eight focus areas including:
    • Key clinician leaders, physician groups.
    • Hospitals, health care systems.
    • Purchasers, employers, Medicaid and government leaders, business coalitions involved in value-based purchasing.
    • Health plans.
    • Consumer advocacy organizations and individuals.
    • Government officials involved in the regulation of health care.
    • Legislative leaders in health care.
    • Labor leaders.
    • Quality Improvement Organizations (QIOs).
    • Other organizations involved in quality improvement (QI).
    • State data organizations.
    • Regional Health Information Organizations (RHIOs)/Health Information Exchanges.

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Suggested Questions

Communitywide Collaborative Leadership

  • What communitywide multi-stakeholder collaborative efforts come to mind when you hear about the vision of the Community Quality Collaborative?
  • Which ones have been/are the most successful in this market?
  • What was/is the driving force behind their success?
  • Who were/are the leaders?
  • What were/are the characteristics of the leader that led to its success?
  • What other factors contribute/d to their success?
  • If applicable, how would you ensure that rural areas are represented in collaborative efforts?
  • Are there geographic issues, such as distance, market service areas, local jurisdictions, or other boundaries that may pose challenges to this collaborative?
  • Are there demographic issues such as age, income, or education levels that may pose challenges?
  • Do you see any individual stakeholder as dominant in this market, for example, purchasers, providers, or health plans? If so, how might that impede or support the Community Quality Collaborative's goals?
  • How do you anticipate supporting representation of consumers in the Community Quality Collaborative leadership?
  • Who are potential funders of Community Quality Collaborative initiatives?

Stakeholder-Specific Collaborative Leadership

  • What initiatives have your organization and others in your stakeholder group undertaken that incorporate collaborative leadership?
  • What are the lessons learned?
  • Are there other individuals in your organization who could provide additional insight on collaborative leadership?

Future Community Quality Collaborative Collaborative Leadership

  • What knowledge, skills, and relationships will the individuals involved in the Community Quality Collaborative require for success, and are they present?
  • Who else, individuals and stakeholders, should be involved in the Community Quality Collaborative, why and how?
  • What could your organization contribute?
  • How do you envision being involved in achieving the goals of the Community Quality Collaborative?
  • What advice do you have for the Community Quality Collaborative in its multi-stakeholder collaboration to advance the four cornerstones of Value-Driven Health Care; interoperable health information technology, quality standards and transparency, price standards and transparency, and incentives?

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Compiling Results

Tracking your activities and results of your inventory in a table similar to the one below will be useful for reporting activities to the Leadership Team.

Collaborative Leadership — Activities and Results
Interviewee NamePosition, OrganizationSummaryConclusions/Next Steps
    
    
    
    
    
    
After data have been gathered from all sources in the focus area, the Focus Area Team Leader and members may analyze the results by reviewing the goals identified at the beginning of this section and by identifying and summarizing the following aspects of the inventory findings with each other and with other Focus Area Team Leaders.
Collaborative Leadership — Analysis
Gaps 
Overlaps 
Opportunities for Alignment 
Challenges 
Lessons Learned 
Resources 
Leaders 

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Consensus Score Card

You may wish to develop a score for your Community Quality Collaborative's stage of development in each focus area to facilitate comparison of its stage of development across focus areas. You may discover differences in scores of individual key stakeholders for the same question. Identifying the degree of consensus among stakeholders will be useful in clarifying differing perceptions and goals and areas where consensus building may be useful for more effective collaboration.

If a quantitative approach doesn't fit in your situation, you may wish to use a more qualitative approach such as identifying areas of strengths and weaknesses or specific challenges and solutions.

  • Ask each team member to answer the following questions on a scale of 1-10 with 1 being the least developed and 10 being the most developed.
  • Average the scores of the team members, for each question, to get an average score per question.
  • Discuss any major differences between team members' scores to gain an understanding of each other's perspectives and knowledge.
  • Total the scores for all the questions and divide by the number of questions to get the score for this focus area.
  • Compare your Community Quality Collaborative's strength in this focus area to its strength in other focus areas in the overall Community Inventory Consensus Score Card when compiling and analyzing overall results from the tool.
Collaborative Leadership Consensus Score CardSCORE
(1-10)
1.  Our community has a history of multi-stakeholder collaboration or cooperation. 
2.  These collaboratives have been successful. 
3.  Health care leaders in our community support collaboration. 
4.  The collaboratives have involved the Community Quality Collaborative stakeholders: purchasers, plans, providers, and consumers. 
5.  The Community Quality Collaborative is seen as a leader in the community. 
6.  The Community Quality Collaborative includes the right stakeholders. 
7.  The Community Quality Collaborative includes the right individuals. 
8.  The individuals at the table are open to, or are drivers of, innovation. 
9.  The individuals at the table are willing and able to advocate on behalf of the Community Quality Collaborative goals in their respective organizations. 
10.  The members of the collaborative share a common vision of the purpose of the Community Quality Collaborative. 
11.  The members of the Community Quality Collaborative know each other and/or have worked together on other initiatives. 
12.  These individuals have been involved in other communitywide initiatives related to one or more of the eight focus areas. 
13.  The individuals at the table are willing to share relevant knowledge openly. 
14.  The organizations involved in the Community Quality Collaborative are willing to share knowledge, expertise, and capabilities for the benefit of the community. 
15.  The organizations are willing to share resources, in-kind, financial or other, in this multi-stakeholder collaborative. 
16.  There are sufficient resources for this Community Quality Collaborative to be successful. 
17.  The individual participants will devote adequate time and resources to the Community Quality Collaborative. 
18.  Individuals will continue to support the Community Quality Collaborative even through changes in goals, members, and other conditions. 
19.  The Community Quality Collaborative will seek outside expertise if necessary to achieve its goals. 
Total Score 

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Current as of March 2009
Internet Citation: Module 1: Collaborative Leadership: Multi-stakeholder Community Inventory Modules. March 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/cimodules/cimodules1.html