1. Accelerating Results, Strengthening Leaders: Aligning Actions for Results and the Leadership in Action Program An Approach to Making Measurable Improvements in Health GIH Maternal and Child Health Audioconference Series Friday, January 30, 2009 3:00 p.m. Eastern / 2:00 p.m. Central / 1:00 p.m. Mountain / 12:00 p.m. Pacific Roderick K. King, MD, MPH, Harvard Medical School Jolie Bain Pillsbury, PhD, Sherbrooke Consulting Jennifer Gross, The Annie E. Casey Foundation

2. Why Results Based Leadership? Annie E. Casey Foundation mission ◦ Kids do better when families do better. Families do better when their communities do better. Recognition of the critical importance of leaders to affect change. ◦ Leadership development model for “leaders in the middle”  Develop a set of core leadership skills  Immediately and constantly direct those skills towards a common population level result.

3. 3 The Leadership in Action Program What it’s designed to do… Double bottom line ◦ Accelerate measurable improvements in the well-being of children & families. ◦ Strengthen the leadership skills among government, nonprofit, business & community leaders. How? ◦ Align & focus the strategies and efforts of stakeholders, providers and investors working on the result. ◦ Move to action in one measurement cycle.

4. 4 The Leadership in Action Program Implementation – 13 sites Implementation Partner – James MacGregor Burns Academy of Leadership at UMD LAP results ◦ School Readiness (Maryland, Georgia, Connecticut, Iowa) ◦ Family Economic Success (Texas) ◦ Babies Born Healthy (Maryland) ◦ Successful Offender Re-Entry (Indiana) Funding partners ◦ State and local government ◦ National and local philanthropy  RWJF in health

5. Results Based Leadership: The application of a theory The Theory of Aligned Contributions (TOAC) allows people to come together as results based leaders to create something that has meaning for them. Critical mass of leaders from different sectors Commitment to a common result for a population Aligned actions contributing at a scope and scale to make a measurable difference in short period of time

6. Leaders Take Aligned Action Accelerated improvement in population level result, Sense of Urgency & Pubic Accountability Mid-to-high level leaders develop skill in four competencies that move people from talk to action Aligned Contributions A critical mass of multi- sector leaders makes an unequivocal commitment to take aligned actions in their home agencies and communities. Aligned Contributions A critical mass of multi- sector leaders makes an unequivocal commitment to take aligned actions in their home agencies and communities. Focus on a Single Measurable Result

7. The Way it works: Call to Action, Container, and Capacity to Collaborate Leaders are called to action to make a measurable difference in their community A container is created where the leaders have the space and time to come together and build relationships, be vulnerable, and do the work While responding to the call and doing the work, the leaders develop the capacity to lead together by using four leadership competencies

8. Leadership Competencies Results Based Accountability Race, Class, Culture Dialogue Collaborative Action Leading from the Middle

9. What we are learning What we are learning TOAC sparks call to action to a result People respond to the call Leaders make aligned contributions in many different ways (Policy, Practice, Public Will) The emergent capacity to collaborate accelerates measurable progress ◦ Not just talk ◦ Public accountability to work together ◦ Skills make a difference (decision-making, accountability, conflict resolution)

10. Results Based Leadership Programs: Evidence based Leadership Practices LAP: 18 months, 40 leaders (Healthy Babies) Performance Partnership Summits: 3-6 months, 12 – 100 leaders (Smoking Cessation) Results Based Leadership Technical Assistance: 1- 3 months, groups and teams of leaders (primary care, chronic conditions, and improvements in quality and access)

11. Results Based Leadership: Application to Health and Health care Why now? ◦ Growing awareness that addressing health/health care issues for populations (e.g. quality of care, disparities) requires cadre of leaders, sectors working together  Oral Health (OHF support statewide plan to address OH in MA)  Health Disparities (efforts in communities to reduce disparities)  Quality of Care (efforts to improve the quality of care within communities- RWJF Aligning Forces for Quality, HRSA Statewide/Community Performance Improvement) ◦ Babies Born Health LAP~ RWJF 2007

12. Baltimore Babies Born Healthy LAP (Baby-LAP) Approached by RWJF re: application of this model to a health result. In October 2006 we launched the Baltimore Babies Born Healthy LAP supported entirely by RWJF. Convene 40 leaders from health care & social services sectors, philanthropy and community based organizations – Result: Babies born healthy in the City of Baltimore

13. BBH- How LAP works LAP participants are “Leaders in the Middle” ◦ Cross-sector leaders in the field, already working on the result ◦ Usual suspects and unlikely partners What do they do? ◦ Come together for nine, 2-day sessions, every 4-6 weeks over 14 months ◦ Together develop and immediately apply a set of core leadership skills to a specific result. ◦ Develop specific strategies and actions based on what works and guided by their result with goal of turning indicator curves

14. BBH Indicators Indicators :  Fetal death rate  Infant mortality rate  Neo-natal mortality rate  Pre-term birth rate  Low birth weight rate

15. BBH Achievements Development of a City wide plan to implement strategies to improve infant mortality in Baltimore Launch of a public awareness campaign for city leadership and general public Coordination of home care services to better meet the needs of new mothers at the various hospitals in Baltimore Integration of the BBH “group” into the Baltimore Health Department system and performance management program Renewed energy and commitment by newly elected Mayor to address the problem of infant mortality in Baltimore.

16. Leadership In Action Program Return on Investment (ROI) Impact Influence Leverage

17. 17 Return on Investment: Impact LAP Launch Dates MLAP 2002 BLAP 2004

18. Return on Investment: Influence Public Policy ◦ Maryland:  5 Year Action Agenda for School Readiness adopted by state legislature  Early Care and Education Committee established as a permanent committee of the Governor’s Sub-Cabinet for Children, Youth and Families.  MD county management entities (Local Management Boards) adopted Results Accountability Framework ◦ Baltimore: LAP participants from BLAP and Baby-LAP working with the City to align their efforts in support the City’s broader school readiness agenda. Programs ◦ Baltimore: Increased/realigned funding by Health Department, schools & libraries to school readiness programs ◦ Georgia: DeKalb Refugee Center creation of services to serve children 0-6, coordination of child care resources towards pre-K within DSS. Leadership ◦ Leaders doing their work differently - using LAP competencies and tools in home organizations

19. Return on Investment: Leverage State and local government dollars leveraged to support LAP results. ◦ Maryland: $5 million leveraged in support of early childhood. ◦ Georgia: Collaborative efforts of LAP leaders leverage state and philanthropic dollars for early childhood efforts in DeKalb County. ◦ Indiana: Private dollars leveraged to further LAP leaders collaborative efforts to ensure the successful re-entry of offenders into the community.

20. Conclusion For more information about the Leadership in Action Program and/or Casey’s ROI, contact: Jennifer Gross Senior Consultant – Leadership Development Annie E Casey Foundation jgross@aecf.org For more information about developing programs that apply Results Based Leadership: Jolie Bain Pillsbury, PhD Senior Fellow, James MacGregor Burns Academy of Leadership President, Sherbrooke Consulting, Inc jolie@sherbrookeconsulting.com Roderick K. King, MD, MPH Senior Fellow, James MacGregor Burns Academy of Leadership Instructor, Harvard Medical School Roderick_King@hms.harvard.edu