Collective Impact Approach and Process
The Task Force has been actively engaged in a process of Collective Impact to develop a Road Map of recommendations. Collective Impact, a collaborative-based model, brings people together, in a structured way, to achieve social change. It involves a centralized infrastructure, a dedicated staff, and a structured process that leads to a common agenda, mutually reinforcing activities, shared measurement, and continuous communication.
Collective Impact has gained visibility as an approach that is highly successful in creating social impact. In the Stanford Social Innovation Review (SSIR), scholars of this model share eight findings from a study of collective impact initiatives, including their effect on systems and population-level outcomes. Although this model is more commonly used in the social sector, there is urgency in the health professions to draw on approaches that can effectively promote social change.
Collective Impact’s five core components served as a guide for the Task Force’s planning over the past six months and are the framework in which the recommendations were developed and thus outlined in the Road Map section of this report. It is also the Task Force’s strong recommendation that the Collective Impact model be implemented in the execution and rollout of any of the Task Force’s recommendations.
To establish the common agenda, the Task Force worked together to develop a strategic action framework that shaped the strategic thinking of the workgroup teams and helped to determine alignment of approach. The framework was flexible to changes as new hypotheses and data became available to the Task Force.
The Task Force examined data gathered from its members to identify and define core issues and problems. As a second step, the Task Force gained consensus on an overarching goal to address the scope of the problem. The third step included creating system-wide strategies for change toward the goal by looking broadly at what we do as an organization to deliver more equitable care and education; to invest in and retain a diverse workforce; to redesign business structures with an anti-racist and equity lens; and to more effectively instill anti-racism as a core element of the Mount Sinai culture. Lastly, the Task Force identified guiding principles to drive the proposed work and instill values that are fair, just, anti-racist, and equitable with respect to MSHS staff, patients, students, trainees, and community members.
Mutually Reinforcing Activities
Once the key strategies were defined, the Task Force worked with subject matter experts and representative staff, students, and faculty to define interventions and initiatives that would mutually reinforce each other to achieve the specific strategic recommendations. The first step of this process was to conduct an inventory of existing activities and work across the system that could be enhanced or scaled up. Once that was completed, new interventions and initiatives were developed to fill in the gaps. Each intervention or initiative was then prioritized, and some preliminary work was done to smooth possible pathways forward so that the recommendations could more easily be turned into action.
Shared Measurement System
A workgroup of issue-specific experts created a multi-phased subset of recommendations that offered sample metrics for tracking progress of each intervention or initiative as well as suggested resources to support that tracking and reporting.
Where possible, the shared measurement system can build on existing initiatives, such as the system-wide process for collecting patient registration data on race, ethnicity, language, sexual orientation, and gender identity, and the development of a Disparities Dashboard to inform research and patient care.
Strategic Structure and Backbone Support
Based on the scope of the strategies, interventions, and a shared measurement system to monitor and track progress, the Task Force Executive Team offered additional recommendations on a structure that would support and sustain this effort over time and help to continuously align the effort toward the guiding principles.
The strategic structure as recommended is designed to:
Leverage existing groups across the Health System that have a record of promoting diversity, equity, and inclusion.
Promote participatory decision-making so that the strategy remains inclusive of voices and perspectives that have been historically marginalized, and promotes patterns of behavior that fully embody equity.
Facilitate partner-driven action across the Health System and support the accountability structure for each intervention or initiative.
Have the necessary staffing and administrative structure to implement and support the recommendations.
Early in the process, the Task Force developed a workgroup team to support omni-directional communication, recognizing the importance of building trust and relationships and enhancing the diversity of voices. The communications team launched a Health System broadcast email strategy, developed a website to disseminate information about the Task Force and its progress, created omni-directional communication opportunities, and developed communication strategies for events such as the National Day of Racial Healing.
The Communications Team is ready to continue to work toward supporting these recommendations.