Putting  New  Paradigms  into  Practice:  

Transatlantic  Lessons  in  Population  Health  Improvement    

Developing  Leadership  for  Population  Health  Improvement    

November  8,9,  &  10,  2011    

University  of  Wisconsin  Union  South  University  of  Wisconsin-­Madison  

Madison,  WI,  USA      

Purpose  of  the  Meeting    The  purpose  of  this  meeting  is  to  learn  how  we  can  better  identify  and  train  leaders  for  population  health  improvement.    Through  dialogue  with  knowledgeable  observers,  leaders  of  innovative  health  initiatives,  and  experts  on  leadership  development,  we  will  lay  the  foundation  for  planning  and  implementation  of  new  methods  of  public  health  education  and  training.        The  meeting  will  be  highly  interactive,  as  participants  consider  the  following  general  questions:    

• What  are  the  most  important  threats  to  population  health  and  what  are  the  most  appropriate  strategies  for  addressing  them?  

 • What  can  public  health  leaders  and  advocates  do  to  engage  government,  health  systems,  business,  

mass  media,  and  the  general  public  in  efforts  for  population  health  improvement?    

• What  are  the  key  factors  that  determine  the  success  or  failure  of  initiatives  for  population  health  improvement?  

 • What  knowledge,  skills,  and  strategies  are  needed  for  effective  leadership  in  population  health  

improvement?    How  can  leaders  simultaneously  improve  the  performance  of  their  own  organizations  and  build  multi-­‐organizational  partnerships  for  health  improvement?    

   Background:  The  Need  for  Intersectoral  Leadership  and  Action    There  is  increasing  acceptance  of  the  view  that  the  health  of  the  public  must  be  considered,  and  pursued,  by  institutions  and  leaders  in  all  sectors  of  society.    The  new  paradigm  of  “health  in  all  policies”  is  a  product  of  extensive  research,  experience,  and  cross-­‐national  learning:      

• It  recognizes  the  enormous  physical,  mental,  and  economic  burdens  associated  with  chronic  disease  and  preventable  injuries      

• It  reflects  greater  understanding  of  the  social  determinants  of  health  and  targets  the  root  causes  of  death,  disease,  and  disability    

   

 • It  emphasizes  the  importance  of  designing  policies,  systems,  and  environments  that  can  better  

protect  individuals  and  make  healthier  behaviors  easier    

• It  depends  upon  participation  beyond  the  confines  of  traditional  public  health  agencies  and  health  services.      

 To  achieve  the  dual  objectives  of  sustaining  population  health  improvement  and  containing  the  costs  of  health  care  services  will  require  actions  and  resources  from  outside  of  public  health,  through  “whole  of  government”  and  intersectoral  initiatives.    But  who  will  lead  such  initiatives?    Do  we  have  the  right  types  of  leaders,  in  the  right  places,  and  in  adequate  numbers,  at  this  critical  time?    Jim  Collins  identified  leadership  as  a  crucial  factor  in  his  book,  Good  To  Great:  Why  Some  Companies  Make  the  Leap  .  .  .  and  Others  Don’t.    He  subsequently  wrote  a  short  monograph  on  going  from  good  to  great  in  the  social  sectors.    Collins  emphasizes  that  “business  thinking  is  not  the  answer”  in  the  social  sectors.    He  recognizes  that  social  sector  leaders  often  need  to  build  and  work  within  a  network  and  set  of  organizational  partnerships,  whereas  business  leaders  sit  at  the  top  of  a  relatively  fixed,  hierarchical  organizational  structure.        In  both  for-­‐profit  and  non-­‐profit  organizations,  “Level  5  leadership”  is  a  key  component  of  moving  from  good  to  great.    Collins  describes  a  Level  5  leader  as  one  who  demonstrates  “a  unique  blend  of  personal  humility  with  professional  will,”  seeks  to  set  up  one’s  successors  for  success,  gives  credit  to  others  for  successes  while  taking  responsibility  for  poor  results,  and,  crucially,  makes  the  “right  decisions  happen.”    A  Level  5  leader  outperforms  leaders  at  Levels  1-­‐4:      

Level  4  Effective  leader:  catalyzes  commitment  to  and  vigorous  pursuit  of  a  clear  and  compelling  vision,  stimulating  higher  performance  standards  

Level  3  Competent  manager:  organizes  people  and  resources  towards  the  effective  and  efficient  pursuit  of  predetermined  objectives  

Level  2  Contributes  individual  capabilities  to  the  achievement  of  group  objectives  and  works  effectively  with  others  

Level  1  Highly  capable  individual:  makes  productive  contributions  through  talent,  knowledge,  skills,  and  good  work  habits    To  be  successful,  an  organization  needs  an  appropriate  mix  of  leaders  at  levels  1,  2,  3,  and  4.    Collins  concludes  that  the  key  difference  between  a  good  and  a  great  organization  is  that  the  latter  has  a  Level  5  leader,  who  is  often  an  unassuming  personality  with  a  low  public  profile.      So,  how  we  can  better  identify  and  train  Level  5  leaders  for  population  health  improvement?    How  do  we  develop  more  effective  leaders  within  the  field  of  public  health,  and  how  do  we  educate  and  recruit  Level  5  leaders  from  outside  of  public  health  to  join  us  as  partners  in  intersectoral  initiatives?      

   

Day  1,  November  8,  8:30-­‐12:20  Time   Topic   Key  Questions     Speaker   Duration  

8:30am   Welcome  and  Preview     Tom  Oliver   10  min  8:40am   The  Public  Profile  of  

Public  Health:Implications  for  Leadership  Development  

1.  Do  you  think  public  health  issues  are  receiving  appropriate  attention  from  government,  the  general  public,  and  mass  media?    Why  or  why  not?    2.  Can  you  give  any  examples  of  public  health  issues  that  were  addressed  particularly  well  or  particularly  badly,  and  why?    3.  What  makes  an  effective  leader  in  public  health  or  health  more  generally?    4.  What  are  the  characteristics  of  any  leaders  (in  whatever  context)  that  you  have  particularly  admired,  and  why  have  they  been  effective  in  achieving  their  goals?  

Nick  Ross   60  min  

9:40am   Why  Do  We  Need  Level  5  Leadership  in  the  UK?  

1.  What  types  of  action  are  needed  for  population  health  improvement  in  the  U.K.?        2.  What  knowledge,  skills,  and  strategies  are  best  suited  to  lead  intersectoral  initiatives?  

 

Kevin  Smith  &  Response  from  Sian  Griffiths  

80  min  

11:00am   Break   20  min  11:20am   Why  Do  We  Need  Level  5  

Leadership  in  the  US?      1.  What  types  of  action  are  needed  for  population  health  improvement  in  the  U.S.?        2.  What  knowledge,  skills,  and  strategies  are  best  suited  to  lead  intersectoral  initiatives?  

Julie  Willems  Van  Dijk  

60  min  

12:20pm   Lunch  (Served  at  Union  South)  

   

Day  1,  November  8,  1:20-­‐5:00  Time   Topic   Key  Questions     Speaker   Duration  

1:20pm   Afternoon  Preview     Darren  Shickle  

10  min  

1:30pm   Corporate:  Employee  Wellness  for  Target  Corporation  

1.  How  does  the  strategy  underlying  the  Minnesota  State  Health  Improvement  Program  compare  to  the  strategy  for  improving  employee  health  for  Target  Corporation?  (or,  more  generally,  how  do  government-­‐led  strategies  for  population  health  improvement  compare  to  corporate-­‐led  strategies?)    2.  What  is  the  business  case  for  population  health  improvement?    3.  What  is  required  for  leadership  in  and  from  the  business  community?  

Cara  McNulty   60  min  

2:30pm   Break   20  min  2:50pm   NYC  Active  Design  

Guidelines,  Leadership,  and  Public  Health  

 www.nyc.gov/adg  

1.  What  are  the  key  elements  in  the  development  and  implementation  of  the  NYC  Active  Design  Guidelines?        2.  What  are  the  lessons  learned  about  leadership  from  the  Active  Design  Guidelines  process?  

Karen  Lee   60  min  

3:50pm   Public  Health  Advocacy:  Coalition  Building  in  

Lithuania  

1.  What  was  the  situation  in  Lithuania  that  led  up  to  the  need  for  broad-­‐based  coalition-­‐building  to  create  new  action  on  alcohol  and  tobacco  control?    2.  How  was  the  coalition  built  and  who  were  the  key  leaders  enlisted  in  doing  so?    3.  What  is  the  scope  of  organizations  that  are  coalition  members?  How  did  the  coalition  develop  support  within  the  government  for  action?  

Aurelijus  Veryga  

60  min  

4:50pm   Wrap  Up   Tom  Oliver   10  min      

 

Day  2,  November  9,  8:30-­‐1:00  Time   Topic   Key  Questions     Speaker   Duration  

8:30am   Morning  Preview     Tom  Oliver   10  min  8:40am   Community:  Lindsay  

Heights  Neighborhood  Health  Alliance  

1.  How  did  community  leaders  come  to  focus  on  health  as  an  important  aspect  of  reviving  the  Lindsay  Heights  neighborhood  in  Milwaukee?    2.  What  partners  are  needed  to  achieve  the  Health  Alliance’s  goals?    3.  How  do  community  members  and  local  leaders  establish  priorities  and  assign  responsibilities  for  action?    

Sharon  Adams  

60  min  

9:40am   Promising  Partnerships  for  Population  Health  Improvement  in  Canada  

1.  How  do  intersectoral  partnerships  exemplify  the  “health  in  all  policies”  paradigm?    2.  What  leadership  roles  and  skills  are  required  to  sustain  and  replicate  these  partnerships?  

Sylvie  Stachenko  

60  min  

10:40am   Break   20  min  11:00am   Intro  and  Overview     Ken  

Zakariasen  10  min  

11:10am   Knowledge,  Skills,  and  Strategies  of  Level  5  

Leaders  

1.  What  are  the  essential  components  of  emotional  intelligence,  and  what  is  the  relationship  between  emotional  intelligence  and  leadership  effectiveness?    2.  Are  there  differences  in  the  levels  of  emotional  intelligence  between  Level  5  leaders  and  lower-­‐level  leaders,  and,  if  so,  are  these  differences  generally  “across-­‐the-­‐board”,  or  are  there  particular  areas  of  emotional  intelligence  where  the  highest  level  leaders  clearly  excel?    3.  What  is  the  emotionally  intelligent  workplace  or  organization,  what  difference  does  it  make,  and  how  does  the  effective  leader  promote  and  facilitate  higher  levels  of  emotional  intelligence  in  their  organization?  

Cary  Cherniss  

90  min  

12:40pm   Lunch  (Served  at  Union  South)  

 

 

Day  2,  November  9,  1:40-­‐5:00  Time   Topic   Key  Questions     Speaker   Duration  

  Afternoon  Preview        1:40pm   Knowledge,  Skills,  and  

Strategies  of  Level  5  Leaders  

1.  How  should  we  train  individuals  (or  groups)  to  be  leaders  in  multi-­‐sector  partnerships,  systems  change  and  population  health  improvement?    2.  What  differentiates  top-­‐level  leaders  in  their  approach  to  making  high  impact  change,  as  compared  to  others?      3.  What  skills  or  strategies  are  used  by  leaders  in  a  given  sector  that  should  be  adopted  by  leaders  in  other  sectors  for  the  sake  of  promoting  healthier  populations?    4.  How  do  leaders  recruit  team  members  (to  their  own  organization,  and  as  partners  from  other  organizations)  and  what  information  do  they  need  to  create  and  implement  intersectoral  policies,  programs,  and  practices?  

David  Altman    

90  min  

3:10pm   Break   20  min  3:30pm   Profiling  a  Level  5  Leader:  

 Larry  Meskin  1.  An  exceptional  leader/mentor/colleague  and  friend:  What  does  over  35  years  of  close  association  and  observation  tell  us  about  the  nature  of  a  Level  5  leader?  

 

Ken  Zakariasen,  

Tony  DeAngelis,    

90  min  

5:00pm   Wrap  Up   Tom  Oliver   15  min  

   

Day  3,  November  10,  8:30-­‐2:00  Time   Topic   Key  Questions     Speaker   Duration  

8:30am   Morning  Preview     Tom  Oliver   10  min  8:40am   Promising  Institutional  

Forms  of  HiAP  in  Europe  1.  What  are  the  most  promising  forms  of  “health  in  all  policies”  strategies  in  Europe?    2.  Where  is  effective  leadership  coming  from,  where  is  it  lacking  at  this  time?  

Scott  Greer   60  min  

9:40am   Review   1.  What  did  we  learn  about  types  of  leadership  development  needed  for  population  health  improvement?  

All   60  min  

10:40am   Break   20  min  11:00am   Models  for  Leadership  

Development  1.  What  further  research  do  we  need  to  do  on  leadership  training  and  where  are  the  current  gaps?    2.  What  models  should  we  be  looking  at?  

All   75  min  

12:15pm   Lunch  (Served  at  Union  South)  

1:15pm   Planning  Next  Steps   1.  What  are  the  next  steps  for  research,  program  development,  and  implementation?  

All   60  min  

2:15pm   End    This  meeting  is  collaboratively  supported  by  the  following  institutions