The sustainability and long-term viability of social change efforts are hardly ensured by their worthiness. Strategic thinking about finances, business strategy, and capacity are critical to sustaining this kind of work. Our experience has shown that change efforts involving multiple stakeholders in a formal collaborative also benefit from adopting a start-up mentality – where financial, human, and social capital are all considered integral to sparking and sustaining healthy growth and attracting funding.
The National Program Office (NPO) for Aligning Forces for Quality (AF4Q) – the Robert Wood Johnson Foundation’s (RWJF) core initiative to improve the quality of health care that Americans receive – recognized the need for business acumen over the course of the eight-year program. The 16 AF4Q grantees located across the country worked through multi-stakeholder Alliances to lift the overall quality and value of health care, reduce racial and ethnic disparities in care, and provide models for national reform. While building community capacity, knowledge, and skill was an ongoing priority, many Alliances struggled to balance their day-to-day activities with to the need to demonstrate, produce, and articulate tangible value to stakeholders.
The NPO ramped up sustainability efforts during the final two years of the project by engaging Community Wealth Partners to conduct a comprehensive assessment of the Alliances based on its framework outlining the five drivers of sustainability. The results clearly showed that the Alliances struggled the most with three of those drivers: economic viability, focused business strategy, and capacity to deliver, while their social impact and adaptability were better developed.
The following are lessons from these areas that are applicable to other efforts leveraging collective impact strategies.
Economic Viability speaks to a collaborative’s financial health. Sustainable efforts have a surplus or break-even operating model that will carry the work forward in the long term.
- Understanding financial data should be a top priority. Economic viability necessitates the ability to gather, manage, and use financial data to make informed and strategic decisions about how best to manage and use resources.
- Revenue diversification is critical to ensuring that losing any one specific funding stream does not pose a significant financial risk. This can be achieved by identifying potential areas of growth and focusing on improving and monetizing products and services.
- Collaboratives should charge for services as earned income creates a critical inflow of unrestricted dollars and indicates that stakeholders understand and value the services for which they are paying.
Focused Business Strategy is the understanding of what must happen to achieve social goals, which requires continual alignment and a shared understanding of resources, priorities, audiences, strategies, and messages.
- Conduct market research to inform the design of products and services that benefit stakeholders. Without understanding stakeholders’ motivations and barriers, it can be difficult to communicate the benefits of actively engaging with and paying for products and services.
- Consider a new perspective by seeking to understand stakeholder needs and interests prior to developing products and services. It is critical to look at products and services from stakeholders’ perspectives.
- Clearly articulate unique value. A value proposition concretely states the specific benefit a stakeholder receives from using programs, services, or products.
Capacity to Deliver is having the talent, infrastructure, and processes needed to execute a business strategy and deliver social impact. This can be difficult within the collaborative context if accountability and ownership are unclear.
- Prioritize and align talent. Leaders must have a strong vision, a clear understanding of the impact needed in the community, and the team with the right skills and competencies to support valuable programs and services.
- Have a succession plan in place well in advance of transitions. The impact of losing a resource that holds mission-critical knowledge, whether technology, partnerships, or leadership, cannot be underestimated.
- Create a culture of shared ownership from the start. There is a key difference between stakeholder engagement and stakeholder ownership.
- Intentionally engage and effectively manage the board. The most effective board members are often those who have the opportunity to engage in specific projects or committees, partner with staff, and connect with other board members.
Although starting this process earlier in the program would have provided greater benefit to communities, these lessons were valuable for the AF4Q NPO in providing direction and support as the grantees worked to transform health care. All collective impact efforts can gain significant value from looking to the mindset and urgency adopted by start-up ventures in developing their business models and working to ensure long-term viability.
Interested in talking to someone about our framework for assessing sustainability? Email Renee Baiorunos.