A special thing happened in Baltimore this month. Upstreamists from 31 healthcare organizations around the country—trailblazers who have been working to move care upstream in their own institutions, in their own cities, some for as long as two years now—finally met in person.
The HealthBegins team and I traveled to Baltimore to meet them. These leaders hail from the 31 organizations participating in the CMS Accountable Health Communities initiative, which aims to build clinical-community bridges to better address beneficiaries’ health-related social needs. And we are privileged to partner with them to provide technical assistance on their journeys.
There, amid the in-depth sessions and spontaneous conversations about common struggles, we saw evidence of an important fact that has been on my mind: that the right tools and workflows are essential but not enough to ensure us a successful journey upstream. For that, we need one more thing: great upstream leaders.
The pioneers in Baltimore showed me again that this work ultimately hinges on motivating people.
This idea was at the core of our recent webinar: “Preparing Clinic Leaders and Staff for Success.” We explored why the complexity of big change demands that we actively work to identify diverse stakeholders, reach out to them and engage them. As the HealthBegins Upstream Clinic Engagement Strategy outlines, those stakeholders can include everyone from clinicians to case managers to IT specialists to receptionists — and they must include the natural champions as well as the natural curmudgeons. We need them all on our team.
For leaders, that means cultivating more than the skills to implement Upstream Quality Improvement. It requires different ways of thinking and acting — certain essential habits of behavior and mind. A recent NEJM Catalyst article outlines a core set of them: curiosity, humility, willingness, perseverance, and self-discipline.
These are the kinds of qualities we’re inspired to see in a rising wave of upstream-improvement leaders — including those in Baltimore, those in the American Hospital Association’s new Hospital-Community Collaborative, and those we spotlighted in my 2013 TED Book, The Upstream Doctors, who carry on their mission today.
(Know an upstream leader whose work could inspire and instruct us all? Please nominate them to be spotlighted as an Upstreamist in Action on the HealthBegins blog here.)
Leaders like these teach us that institutional culture is as important a concern as tidy charts, that listening is more than an accidental act, and that new leadership can and should spring from unconventional corners — from colleagues such as community partners, social workers, or patients themselves.
We believe so much in these leaders’ role that we’re helping to grow a whole new generation of them. We’re designing a soon-to-debut Community of Practice for the courageous organizations and leaders engaged in this work.
This learning space will thrive on the insights and experience of all of you, teaching and learning with each other. Together, we will show the impact of a new kind of leader for a new kind of care. We’ll cultivate not just the leaders we have, but also the leaders we need.