This story was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

The Health Improvement Partnership of Maricopa County (HIPMC) is a collaboration of more than 120 public and private organizations working together to improve the health, well-being, and equity of our community. With more than 4,000,000 diverse residents including 5 sovereign Native American nations, Maricopa County is Arizona's most populous county and the 4th most-populous in the nation.  

This is the story of Javier, the hippest javelina in the Southwest! Javier's story mirrors HIPMC's journey to transform into a Community of Solutions. 

Note:  Javier's name and the word javelina are both pronounced with the Spanish letter "J" or "jota which sounds similar to the letter "H" in English.  That's one of the many reasons we love him, because he's cool that way.  To learn more about javelinas in the wild, check out this short video from the Arizona Game and Fish Department or this Javelina Fact Sheet from the Arizona Sonora Desert Museum. 

Leading from Within

Similar to Javier, HIPMC has been on a journey to discover what motivates its partners and how to use that to better interact with the world. Over the past few years HIPMC, has taken time to explore its partners' passions, strengths, and stories in meetings. Activities like completing individual storyboards and sharing personal gifts and stories through an activity called Truth on the Table, helped partners to develop their personal voice and agency.  Watch the videos below to hear the 2019 Steering Committee Co-Chairs tell a bit about their personal journeys. 

The 2012-2017 Community Health Improvement Plan (CHIP) also helped institutions lead from within by asking partners to identify what their organizations were doing to contribute to addressing the current health priorities (at the center of the graphic below).  Click here to see an example of the CHIP Workplan containing this information from July 2017.  

Leading Together

HIPMC has a big vision and lofty goals . The only way to realize the vision and accomplish these lofty long-term goals is to work together. We learned early on through a social network analysis that the HIPMC network had many strengths and there were big opportunities for our partnership.

In 2015, a Steering Committee was formed to distribute the power of leadership, develop the network, and make important strategic decisions. Members generally serve at least 2 years and are selected through an open application process.

From 2012-2017, dramatic growth was seen in the number of HIPMC partners. Progress was also made in documenting what individual organizations were doing to make Maricopa County healthier, as seen in this January 2018 presentation.

Click on the videos below to see HIPMC partners talk about successes and their insights about leading together.

There were growing pains along the way as diverse groups of residents and organizations learned to work together in more effective ways. Although partners collaborating (as illustrated in the above videos) demonstrated HIPMC's value as a network, many attempts at more structured work groups failed between 2012 and 2018. To address this, HIPMC identified Ways of Working Together, which are reviewed at the beginning of each meeting, and used the Touchstones for Collaboration from the 100 Million Healthier Lives initiative to guide intentional discussions about how collaborative work happens.

Building off of lessons learned from previous attempts, HIPMC opted to use the Equity Action Lab framework in 2018 to jump start collaborative work groups for their new Community Health Improvement Plan (CHIP).  This model (visualized below) uses human centered design principles, improvement science techniques, and structured accountability to work towards very short term goals.  These elements helped new work groups succeed at achieving a quick win and to kick off work towards the long-term CHIP goals.

Leading for Outcomes

Much like for Javier, survival depends on working on common goals and developing an ability to refine important skills. HIPMC has learned the importance of using shared goals to align efforts and has made efforts to learn from past mistakes, refine approaches using meaningful measures and improvement science, and to adopt or adapt best practices from others.

At the completion of the 2017 Community Health Assessment (CHA), HIPMC was tasked with prioritizing key issues for focus during the coming 5 years.  While the previous CHIP cycle had focused on things like chronic diseases, the HIPMC Steering Committee decided to shift the focus to the root causes or key drivers that cause poor health outcomes and health disparities in our community.

The HIPMC's priorities were ultimately identified through a prioritization process that included the use of an inter-relationship diagram, prioritization matrices and a series of community forums. 

CHIP Priorities

To set meaningful aims for improvement in these areas, HIPMC created and analyzed driver diagrams before selecting secondary drivers to focus on improving. Subject Matter Experts for each of the priority areas were convened and tasked with recommending SMART goals and prioritizing topics for immediate action. Two 5-year goals were approved by the HIPMC Steering Committee and topics were identified for immediate action.

Leading with and for Equity