Who Should Be at the Table? Lessons from Collective Impact Role Play

I had the privilege of speaking at a recent Leadership Retreat hosted by Randolph Hospital in Asheboro, North Carolina, focused on “Engaging our Community in Population Health.” As a native North Carolinian, I enjoyed returning to my home state to meet with local leaders and discuss the potential application of collective impact in addressing complex health challenges.

Asheboro is the county seat of Randolph County, which has a population of about 150,000 people. Located in the center of the state, Randolph County has rolling countryside dotted with several small towns, and is fairly accessible to two large metro areas in the state — including the Greensboro / Winston Salem 30 miles to the north and Raleigh / Durham 60 miles to the east.

In preparing for this meeting, I learned that communities across North Carolina are facing significant health challenges. For example, the percentage of people who are overweight or obese in North Carolina has more than doubled over the last 20 years. These challenges are accentuated in Randolph County. In 2013, the Randolph County Community Health Needs Assessment found that 72% of adults in the county are overweight – compared to 65% statewide.

Given the health challenges facing the county, Randolph Hospital decided to convene 70+ hospital executives, nurses, doctors, faith-based leaders, business executives, and other community leaders to discuss the need and opportunity for collaboration in improving population health.

One memorable moment from the meeting was a role play exercise where meeting participants experienced collective impact first-hand. The role play asked attendees to assume different randomly assigned roles (e.g., hospital executive, local funder, insurance executive, parent of a child with a chronic health issue) and participate in a “simulated discussion” on the opportunities for collective impact to address a significant health issue in the area.

After completing the role play, participants shared a few lessons learned about who should be at the table in a collective impact initiative:

  • Embrace diverse points of view: Get out of your comfort zone by interacting with stakeholders who might share a different point of view. Hearing a parent describe their challenges with finding quality care for their child while working a 12-hour job changed the dynamic of the role play conversation about access to care.

  • Be up front about conflicting points of view: Accept the fact that interests are not always aligned, particularly when meeting for the first time. For example, the motivations and interests of a hospital executive might differ from that of an insurance executive. Surfacing potential areas of divergence can help clarify expectations on the front-end, and then open the door for constructive dialogue about potential areas of agreement

  • Consider who is missing from the conversation: Make sure that the conversation reflects inter-connected systems. Several participants noted that faith-based leaders and education leaders also need to be at the table with talking about population health.

  • Clarify next steps to sustain momentum: Do not end a conversation without clear action items for what happens next. Meeting participants cautioned that partnership discussions could stall without clarity of intent and ownership of the process moving forward.

What are other lessons learned you have seen when gathering people at the table to discuss collective impact?

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