Magazine article Policy & Practice

Driving Change: The Continued Evolution of Health and Human Services

Magazine article Policy & Practice

Driving Change: The Continued Evolution of Health and Human Services

Article excerpt

Discussions about creating modern and responsive health and human services are not new conversations but they come at a critical time. There are significant federal policy considerations in play, new governance models are emerging, and technology continues to advance at an increasingly rapid pace. Engaging in the discussions is a start, but action must be taken for it to matter. As a leader, driving system change can invite critics, raise operational challenges, and feel risky and uncomfortable, but in the long run it isn't about comfort, it's about better outcomes.

The following section is a framework checklist I have used in both managing business as usual and in driving change. All of these elements are critical in changing the way we do business.

Framework Checklist

Define a Clear Vision. Have a clear vision for success; periodic benchmarks against the vision can create momentum and a sense of achievement. Some benchmarks may be process oriented but should tie to the long-term vision.

Define Success. Don't start if you didn't define it. Lack of clear success measures inhibits motivation and can send people on different paths.

Return on Investment (ROI). You must show that the change or initiative is a good investment of public funds. You need a clear case on what the investment is, how the investment improves outcomes, and a defensible way to measure the return for your funders and the general public. It's not just math, you must frame up and articulate a compelling case.

Sustainability. Think about sustainability up front, during, and after. Having a plan makes for an easier sell, but sometimes you have to move ahead without one, knowing that if you drive the right outcomes and show a significant ROI, you will find a way to sustain it.

Create a Clear Governance Structure and Accountability.

Define decision-makers, stakeholders, influencers, funders, and service operators and what is expected of everyone. Recognize the voice of the customer. Check your governance against the Human Services Value Curve (see the February 2017 issue of Policy and Practice for an in-depth article on this topic).

Develop Leadership. It's easy to rely on the usual leaders. Remember that leaders come from all levels, don't have to be managers, and don't have to have years of experience. Creating nontraditional leaders as part of the solution can be both motivational and developmental (bonus earned for succession planning).

Change Management and Communication. New models are exciting to some and scary to others. Convey a clear set of expectations and provide supports and opportunities to help staff, program participants, and other key stakeholders understand and accept what the changes are and why. Be open to their feedback, look for actionable input, and be prepared for attrition by those who can't adapt.

Policy Impacts. Consider how dramatic shifts in policy might affect the plan and vision. Look for opportunities to pursue policy goals via evidence-based practices and always look for both opportunities and unintended consequences for cross--and inter-program impacts.

Service Delivery. It's easy to defer how services will be delivered but it's not a good idea. Planning should include testing, pilots, implementation, and contingency plans. Think about in-house capacity and competencies and whether to procure for capacity and competencies, noting that procurement may also allow redirection of existing resources to other mission-critical areas. Look for ways to encourage service delivery innovation; I define innovation three ways: new things, improving on old things to drive better results, and using old things for a new purpose.

Performance Orientation. Think through how to imbed a performance orientation into service delivery via measurements, contract vehicles, and other design elements. Performance-based contracting has grown in use as a vehicle to share risk, provide incentives to encourage innovation, and drive better outcomes. …

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