Improving Systems: Lessons Learned in Facilitating a State Health Department Learning Collaborative

The Association of State and Territorial Health Officials (ASTHO) provided funding and technical assistance to five state health departments and over the course of 14 months, ASTHO facilitated a five-state team learning collaborative. The purpose of the learning collaborative was to improve states’ rankings in United Health Foundation’s America’s Health Rankings, by improving state public health systems and reducing rates of diabetes, obesity, infant mortality, and/or smoking (states chose 1-2 content areas). Using primary research findings and literature review findings, ASTHO identified themes essential to drive systems change, at the policy, state, local, and community-level. These themes – leadership, vision, communication, data, and partnerships, and evidence-based/promising practices – were the framework for ASTHO’s work with the learning collaborative. ASTHO also utilized the Institute for Healthcare Improvement’s Plan-Do-Study-Act (PDSA) cycle rapid change model in guiding state teams’ efforts. In working with the five state teams, ASTHO identified facilitators and barriers to systems improvement efforts, as well as strengths and opportunities for improvement in ASTHO’s learning collaborative model. Additionally, ASTHO disseminated a pre- and post- learning collaborative needs assessment to the state teams to determine TA needs and measure progress of the teams and ASTHO. ASTHO’s findings will help state agencies attempting systems improvement efforts, as well as technical assistance providers who use the learning collaborative model in their work.