Convening the Conversations
A top priority for the Reaching for Excellence effort was to capture the full range of community perspectives and priorities for health care in Western New York.
Toward this end, the project team traveled across the eight-county region between January 2008 and March 2009 to convene more than 100 community conversations with over 1,700 Western New Yorkers. Forums, primarily small groups, included block clubs, church groups, health centers, employers, schools, senior centers and community and advocacy groups.
Reaching Out to the Community
The effort's outreach strategy employed a range of tactics, from media to press announcements to grassroots networking to highly coordinated logistics.
Community partnerships helped the effort connect with targeted populations in the region, including the communities with the greatest health needs. The Reaching for Excellence team welcomed all Western New Yorkers to host a conversation for their own community or organization. At each community conversation, participants were encouraged to host their own conversation or recommend additional audiences or contacts. Stacks of customizable conversation invitations were available to all participants at each event.
The project's Web site featured the stories in narrative and audio format, listed upcoming conversations and provided information to those interested in hosting a conversation, including logistical details, customizable conversation invitations. Spanish-language conversation materials helped to engage the region's Hispanic population. Reaching for Excellence staff provided assistance to community members in scheduling conversations and arranging venues.
As the project progressed, participant demographics were periodically evaluated to determine gaps in representation; outreach efforts were redirected accordingly. Targeted outreach to specific demographics included low-income communities, churches, organized labor and men's health groups.
Structuring the Conversations
The conversations were designed to initiate a community-oriented dialogue about health care, accessible to people of every age, race, income, education level and geography. To ensure community members were engaged in a consistent manner, a standard format was developed for the community conversations. This also enabled the project team to reliably distill a set of community priorities to monitor regional performance and drive health care reform.
Each conversation was managed by a team of two trained facilitators, one to manage and focus the discussion and another to record audience feedback and document the profile of the audience and the quality of the conversation. Overall, One Friday: Four Futures recruited and trained 30 health sector leaders from all corners of the eight-county region to coordinate the conversations. The team included two bilingual facilitators, proficient in both English and Spanish, to facilitate the engagement of Spanish-speaking communities in the region.
Planned as 90-minute sessions, each conversation began with an open discussion of participants' most positive encounters with the health system. The core of the conversation consisted of an audio presentation of the four stories, to which audience members could follow along with a storybook. Audience members were asked to respond to each story individually, considering:
- What fits with what you want?
- Who will benefit in this scenario? Who will not do well?
- How would you and your family do in this future?
A broader discussion of the region's health care futures was guided by the following questions:
- What do we, the community, want from our health care system?
- If the health care system is successful at meeting our needs, what will it look like in 2018?
- What are our top health care priorities?
- How do we feel about various tradeoffs and choices?
- What might we want that decision makers are unprepared to hear?
In addition to the group discussion, audience members were offered additional forums to submit their feedback. Surveys administered at the close of the forum asked audience members specific questions about how the stories portray the region's current status and where it is headed, and presented an opportunity to share in writing priorities for the region's health care future. Participants were also asked to complete an anonymous demographic survey (to help the project team monitor the diversity of its participant base), while they could join the project's mailing list to remain engaged in the effort over the long-term. Conversation participants were also encouraged to host their own conversation or recommend additional audiences or contacts; support materials such as customizable conversation invitations were available to all participants at each event.