Health systems transformation: Using systems thinking and science to assess organizational effectiveness

This session will provide an overview of the key concepts and principles involved in using a structured organizational assessment process to guide the development of highly effective health systems capable of achieving population–level outcomes. The passage of the Affordable Care Act and increasingly demanding expectations about performance management and outcomes are requiring new knowledge and changes in organizational practice and capacity. The assessment tools and frameworks presented in the session are based on systems research and have been successfully applied in a diverse array of municipal, state, tribal and territorial health organizations to enhance organizational performance. Key areas of analysis include system organization at the agency and sub-agency levels; cross sector coordination and partnerships; theoretical and operational frameworks guiding health administration activities; contextual conditions (e.g., demographics, socio-economics, geography, political and policy environment); health trends; data infrastructure and needs assessment; workforce development and capacity; strategic planning; operations (e.g., funding and budget, contracting and allocation processes, programming and use of evidence-based policies, practices and programs); evaluation; and policy. Assessment findings are prioritized based on their importance to organizational development, as well developmental readiness of the organization for change. Another important element of the assessment prioritization process is identifying key leverage points that not only are conducive to change but also have the capacity to “ripple” positive change throughout the organization. This includes perhaps the most powerful leverage point of all for enhancing organizational performance: changing the collective mindset, norms and beliefs that drive current system behaviors and practices.