What it Takes to Innovate: Learnings from Innovators in Public Health

In summer 2017, PHNCI awarded $1.55 million to nine agencies implementing cross-sector innovations in health equity, data collection and analytics, health in all policies, systems redesign, and access to services. Over the course of 18 months, these agencies tested their innovations, received training from PHNCI, and met together to share and learn from one another. Additionally, PHNCI provided funding for two grantees, Garrett County Health Department and the Minnesota Department of Health, to replicate their innovations in additional communities. PHNCI has been learning from these agencies to test our definition of public health innovation, provide the right amount of support to foster innovation, and to learn what it takes for a public health innovation to be replicable.

To assess the implementation and outcomes of the PHNCI innovation grants, PHNCI contracted with NORC at the University of Chicago to evaluate the initial grantee cohort and one of the two replication cohorts. Five additional health departments were selected to implement the Universal Community Planning Tool with mentorship from Garrett County Health Department, and the Minnesota Department of Health expanded their original learning community to include additional local health departments. What follows below are highlights from the lessons learned from both that evaluation and PHNCI’s observation of the grantees over the last two years.

While each grantee had a different focus, from working with the sheriff’s office, to utilizing GIS technology to map community resources, to implementing participatory budgeting with middle schoolers, moving through the process of innovation yielded learnings that can be applied broadly to any innovation initiative. Grantees’ greatest successes in this period included improved and more enthusiastic relationships with community members and partners, shifts in culture and language, and changes in organizational practices. We know that cross-sector partnerships are crucial for innovation, and by the conclusion of the grant, most grantees reported increased communication, collaboration and trust with their partners, leading to increased awareness about one another’s work, elevation of the health department’s status as a leader in community discussions, and an increased commitment to partnerships. Grantees also stressed that authentic community engagement is essential to identify the issues that matter to community members and to co-produce the right solutions, paving the way for successful implementation and community benefit.

As public health departments increase their focus on addressing health equity, we need to find ways to prepare the workforce to think differently about public health programs and policies and how agencies can work upstream to impact disparities. To that end, grantees reported changes in organizational culture including a shift to using an equity lens to address community needs by establishing new policies or committees, revising data collection procedures, and using data to address inequalities. Grantees also reported a shift in their organizations’ approach to fostering innovation. As agencies progressed through their projects, staff gained a greater understanding of the meaning of innovation, exhibited more open-mindedness in problem-solving, and addressed innovation in the agencies’ strategic plans.

Grantees highlighted the importance of buy-in from leadership, decision-makers, and partners for the sustainability of innovations in public health. Grantees also provided strategies to contribute to sustainability including disseminating information about the innovation itself and also about the process, including:

• leveraging relationships with partners,
• pursuing financial strategies that relate to both bringing in additional grant funds but also to demonstrating the possible cost savings of an innovation,
• piloting or replicating innovations elsewhere, integrating all or part of an innovation into existing plans and programs,
• and pursuing long-term policy changes.

From both the initial innovation sites and replication sites, we learned that many of these strategies also relate to replicating an innovation in another community:

• leadership buy-in,
• community and partner engagement,
• community need,
• and the ability to learn from others who have implemented a similar project.

To that end, PHNCI is excited to release the first six in a series of nine case studies (with the final three to be released soon). These case studies describe each agencies’ work, the steps they took to implement their innovation, challenges faced, successes, lessons learned, and considerations for replication.

*indicates grantees who received additional funds for replication