Lessons for Cross-Sector Improvement. APAC Forum September 27, 2013. The Triple Aim. Better Health for the Population. Better Care for Individuals. Lower Cost Through Improvement. The Problem.
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September 27, 2013
Better Health for
When we seek to bring different sectors together to solve shared problems, it’s very difficult and it very rarely happens.
“The deprivation proﬁles of Glasgow, Liverpool an Manchester are almost identical. Despite this, premature deaths in Glasgow are more than 30% higher, with all deaths approximately 15% higher. This ‘excess’ mortality is seen across virtually the entire population”
Dr Harry Burns (Chief Medical Officerof Scotland) suggests stress in early childhood can lead to long term chronic ill health
Sir Harry Burns
Walsh D, Bendel N, Jones R, Hanlon P. It’s not ‘just deprivation’: Why do equally deprived UK cities experience different health outcomes? Public Health
To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed
To ensure that women experience positive pregnancies which result in the birth of more healthy babies as evidenced by a reduction of 15% in the rates of stillbirths (from 4.9 per 1,000 births in 2010 to 4.3 per 1,000 births in 2015) and infant mortality (from 3.7 per 1,000 live births in 2010 to 3.1 per 1,000 live births in 2015).
To ensure that 85% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review, by end-2016.
To ensure that 90% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017.
Source: The Scottish Government
An implicit recognition of the unique
drivers that will exist and persist
across localities and which are
linked to geography
True collaboration between Civil Service
(Health, Education, Social Welfare, Judicial), Private Enterprise, and the Third Sector (non-profits and charitable organizations)
Community Planning Partnerships as a key leverage point for local intervention
Build of Previous Success
Choose Something Meaningful
Leverage Existing Structures
Focus on Asset Based Development
Equip Communities with a Mechanism for Introducing
Change (Model for Improvement)
What local assets exist in your community to bring together dispirit leaders?
What issue can be framed across sectors that most would be excited about?)
A Community Collaborative
Judge Ema Aitken
AIM: to stop the cycle of crime – imprisonment – release – crime – imprisonment for AOD dependent offenders.
HOW: by using the coercive power of the Court to get offenders into treatment, and the collaborative effort of the community to change and maintain behaviours.
OUTCOME: to reduce reoffending, save money and restore our people to their families and communities as healthy productive citizens.
Big City & County:
25% of resource and effort
assume house 25% of c&v
or 12,000, total
Special populations & mid/small cities:
25% of resource and effort
assume 75 mid-sized cities house 250 ea
and 125 small cities house 100 ea
or 31,000 individuals
+ 10,000 families
+ 5,000 Hospital to Home
25,000 by 18 months
50 core cities (>1,000 unsheltered):
50% of resource and effort
assume 25 house all c&v and
25 house 50% of their c&v
or 43,000, total (average of 300/city/yr)
100,000 by 3 years
Tenacity (Rhythm) and Leadership (“Team 42”)
Do you face similar challenges in your work?
Where are you stuck?