Health System Foundation in the Vanguard

Like every other community hospital/system in the U.S., HealthEast Care System is grappling with the mindset (and operational) shift triggered by the Affordable Care Act. Payment mechanisms are leading hospitals to engage with their communities in different ways. Their foundations are similarly facing sweeping changes. Working with a current client, HealthEast Foundation (St. Paul, MN), I am witnessing a courageous group of leaders trying to personally navigate these changes to gain clarity AND trying to inspire others to adopt a whole new perspective: that is, acting WITH a community and not ON a community.

Kathryn Correia, the system CEO, challenged the entire system to lean into a newly adopted vision of “optimal health and well-being for our patients, our communities, and ourselves.” Foundation Executive Director, John Swanholm, was the first to grab hold of this challenge, using the Foundation’s planning process as a vehicle for rethinking the role of the health system foundation and its value to donors and to community. John’s team spearheaded a comprehensive approach to arrive at a clear systems view of health and well-being in the East Metro service area. He guided the team through several exercises over six months:

  1. Charted the behavior over time (last 30 years) of key indicators of community well-being and philanthropy
  2. Used a vision deployment matrix to clarify the scope of changes embedded in the adopted vision
  3. Articulated a clear and compelling “theory of change” for the health system/foundation vision
  4. Used a scenario thinking process with system and community leaders to reimagine the future, resulting in 4 viable scenarios of the East Metro in 2030
  5. Charted the imagined behavior over time of key indicators per each of the 4 scenarios
  6. Inventoried and mapped the existing East Metro well-being community assets, using social network analysis 7. Developed a 36-month Foundation plan around 3 core strategies, while redeploying his professional staff and reconceptualizing the role and focus of his board.

No small undertaking, to be sure! The early challenges were largely around people at every level being locked in to outdated mental models of how a hospital and its foundation worked. Based on the Foundation’s leadership, which by the way was hand-in-hand with the system CEO, we are now seeing an organization considering what is right being and wise action. Prior behavior was rewarded (implicitly and explicitly) by being the best responder to the presented situation (medical issue/illness) and building brand around awareness of that posture. Foundations were uber-promoters of that position. While laudable on the surface, this position left the health system disconnected from the community. Despite its huge set of assets and resources, the overall health and well-being of the community was not impacted. In reality, small groups of citizens, individual churches, and small agencies were trying their hand at solving some small (and often big) social problem. Now at HealthEast, the health care system AND its foundation (which they now refer to as HE/F, reflecting the growing integration of what was previously separate entities), have a powerful role of convener and catalyst. Correia and Swanholm recognize that they must view their work through a long lens and they will succeed only if they foster sufficient trust equity that others believe the health system is not acting out of a marketing agenda but out of a true, authentic desire to be part of a bigger solution–not dictating the solution or imposing the “program” on the community. This is a much harder path to take, requires a long term perspective, and great leadership grit–all of which HE/F possesses.

Kudos to John Swanholm for employing social network analysis to better understand how to enter the community well-being dialogue in a targeted and value-added way. Social network analysis is the social science methodology of applying statistical analysis to the distances between members of a network or a set of networks. This science has been in use since the early 1950’s, particularly in the fields of disease management, crime prevention, and counter-terrorism.

We apply the statistical practice of social network analysis to help nonprofit organizations understand and leverage the inherent strengths in their relationships networks. This approach uses nodes to represent individuals and organizations, the lines between the nodes represent their connections to each other. It also measures the connectedness between nodes within the network as a whole, using a set of algorithms that identify opinion leaders and connected clusters. By visually representing this analysis, we can better understand the connectedness between nodes in a network and understand which individuals or organizations within a network have the greatest influence within that network.

The objective of using social network analysis for HealthEast Foundation is to better understand the various formal and informal networks that support health and well-being in St. Paul. By understanding how these networks function—and the key players within these networks—the Foundation (and, by extension, HealthEast Care System) are now better equipped to connect externally and accomplish its objectives within the community. HE/F now has a tool that can be used to support strategy development and relationship building and will enable HealthEast/Foundation leaders to effectively engage the community in the most efficient manner.

The whole conversation about health care, well-being, and philanthropy is changing at HealthEast. That’s pretty cool.

Trust deficit or trust equity?

Say what you will about the demonstration of leadership during the president’s State of the Union address last night (and the response of the House members and Senators seated before him), President Obama’s speech reinforces for me some earlier reflections and new perspectives on leadership.

The president talked about the current trust deficit; something no leader welcomes nor treats lightly, regardless of the sector. He clearly addressed how tough it is in the current environment to make decisions and to reach consensus. My memory sufficiently jogged, I reached for my little copy of Ten Things to Do in A Conceptual Emergency1, and seized upon an embedded phrase that applies so well: “simply accept the complexity and participate in it.” Regardless of sector-government, business, social (nonprofit)-we are nothing if not in community. Our participation is required to advance the common good. The bridges we build (literally and/or metaphorically) are necessary to transcend barriers of all kinds. Leadership-solid, selfless, intentional leadership-revolves around building trust equity and pursuing bold objectives. 

1, International Futures Forum, Ten Things to Do in a Conceptual Emergency, (Axminster, Devon, United Kingdom: Triarchy Press Ltd., 2003), 8.