When public health services, health care and social services promote cross-system alignment, they can work more effectively for the good of their communities. Shared measurement is a tool to get there. Learn how to use it to uplift community voices in this webinar recap.
- Tamika Cowans, Senior Researcher at American Institute of Research
- Al Richmond Executive Director Community Campus Partnership for Health
Lack of cooperation among multiple systems, including public health services, health care, and social services, often makes new initiatives yield undesirable outcomes. Operating independently impedes the communities they serve from staying well-connected. For all systems to work together, some suggest using the process and principles of shared measurement to create cohesion. Taking a cohesive and holistic approach allows more inequities to be spotted, more community voices to be heard, and more targeted action to be taken to ensure patient-centered care is being delivered.
These insights were shared during the webinar entitled “Shared Measurement: Collaborating With Communities Toward Equitable Health Outcomes,” hosted by the American Institutes for Research (AIR), in collaboration with Community Campus Partnership for Health (CCPH) on July 16. The speakers, Tamika Cowans and Al Richmond are just the two out of the many contributors who helped the communities they studied develop a set of principles to ensure shared measurement was used in an equitable, accurate and beneficial fashion. This foundation allowed the communities they worked with to engage more members who could help reduce health disparities.
What is Shared Measurement?
As defined in the webinar, shared measurement is a strategy to use a common set of measurable goals that reflect shared priorities across systems and with community members. Cowans quoted one participant in their study (later explained) who said that community members need to “have a seat at the table, and not on the menu.”
The process of using shared measurement includes:
- Defining what/how/where/when to measure, as well as from whom to collect data and why the measures are important
- Choosing specific metrics, data sources and methods
- Using measurement to support cross-systems alignment
- Understanding what measurement means in the context of communities’ own history, narratives and experiences
Shared measurement encourages cross-system alignment by defining collective goals, monitoring progress, generating buy-in and trust, creating external accountability and supporting learning. This idea can be crucial to changing health outcomes in communities because it can shift mindsets, as well as rebalance power around resource sharing, decision making, and accountability.
“This project focuses on measurement as an overarching strategy that can be used to evaluate the voices of community members with initiatives,” Cowans said during the webinar. “To advance equity it is essential for central community systems to work together to improve how they function and serve community members.”
How to Incorporate Shared Measurement
The process of launching a web of shared measurements starts with defining what principles will be interwoven into every aspect of the initiative. As defined in the webinar, principles are the foundational values that shape and govern system policies and objectives. They help organizations recognize what is desirable and undesirable. Cowans said these principles serve as a “North Star” in helping people foster collaborative relationships and ensure intention and equity behind measurement.
To start the process of finding these principles, AIR and CCPH had to first look at themselves. Who was at their table mattered– because it paved the way for how diverse their perspectives would be while launching a new initiative. They ensured team members had a broad range of lived experiences, to cover any gaps minds with the same lived experience might create.
The team then dug into real-world examples of what cross-system alignment looks like in different communities. They wanted to understand what they did and why they did it. But as this webinar continued to highlight, looking from the outside in will never show the full picture. So as partners, AIR and CCPH surveyed community-based organizations’ (CBO) experiences in communities before and after the COVID-19 pandemic. What they found was that more than half of their CBOs surveyed had formed new partnerships during the pandemic. These CBOs cited lack of lack of time, lack of shared funding and lack of shared data as some of the most monumental challenges in their new partnerships.
AIR and CCPH also held community listening sessions with community members and leaders to hear what mattered most to their individual communities. The two organizations gleaned four major insights from this process of interviewing:
1) You have to start with the communities when determining priorities, goals and measurements of success for cross-system initiatives. Begin any new plan with the community’s vision for improvement and how systems can work together to best meet their needs.
2) Engage initiatives where they are. Create opportunities for community members to engage and improve initiatives in ways that do not add burden to the members themselves. This may require more planning on behalf of the systems to allow these members to have a voice, while also helping them fulfill their needs. For example, systems may need to compensate individuals for their time if they choose to host similar listening-sessions. This can most obviously be in the form of monetary compensation. However, if, for instance, an individual was unable to receive the monetary compensation for some reason such as tax complications, other forms of compensation can be used. This could include buying groceries for an individual or providing them with a ride-share credit.
3) Scale is important. Community members have different ideas about how they define the confines of their communities. AIR and CCPH found that for some individuals, a community meant just a block, for some it meant a city, for others a zip code, a county, or even a state.
4) Initiatives should emphasize multiple perspectives. No individual in a community will have the exact same lived experiences. When launching new initiatives, systems must recognize that communities are often overflowing with mixed outlooks. For an initiative to become a success, all of this must be taken into consideration.
When systems that want to collaborate understand what it means to be a community, according to their communities, they can then more effectively align their priorities to meet the most eminent needs of that population.
The Principles That Align Systems in Shared Measurement
For AIR and CCPH, the organizations found these four principles to be a guide in advancing equity through shared measurement. For the communities they serve, shared measurement is most effective:
- -When it requires upfront investment in communities to develop and sustain community/partner capacity
- -When it is co-created by communities to center their values, need, priorities and actions
- -When it creates accountability to communities for addressing root causes of inequities and repairing harm
- -When it focuses on a holistic and comprehensive view of people and communities that highlights assets and historical context, rather than reinforces negative stereotypes about the communities
- – When it reflects shared values and intentional, long-term efforts to build and sustain trust
While these principles may have worked for their organizations, others should use the same processes to develop their own principles which fit their unique communities. Richmond highlighted how these principles are meant to be a living document. He urged systems to reflect on how they’ll use the principles they develop to not only advance cross-system alignment, but also to enhance mutual understanding and appreciation for equity and justice.
How We Can Help
Certintell’s mission is founded in putting the patient first in everything we do. We cater to underserved populations, using a holistic and accessible approach to care. Our virtual medical practice is powered by patient-centered telehealth services, we’d love to help you advance your mission of equity through health care by providing patient services and patient education when and where it matters. To learn more about our efforts, contact us here (insert link).