From Paper to Practice: Bringing Your Health Program to Life

In this episode of the Community Health Management Design Podcast, Dr. Tami Moser guides listeners through the crucial process of implementing a community health program. Using the fictional HealthyKids Millbrook obesity prevention program as an example, the episode covers three key areas of program implementation:

1. **Developing a Detailed Implementation Timeline**
   - Breaking the program into phases
   - Creating specific task lists with durations and responsible parties
   - Using project management tools like Gantt charts

2. **Identifying Key Milestones and Potential Challenges**
   - Setting and celebrating significant program milestones
   - Anticipating common challenges in health programs
   - Developing contingency plans

3. **Structuring an Effective Team and Defining Roles**
   - Identifying key roles needed for the program
   - Creating clear job descriptions
   - Using a RACI matrix for role clarity
   - Aligning team structure with program goals and values

The episode provides practical tips, including the use of a RACI (Responsible, Accountable, Consulted, Informed) matrix for team management, and discusses when to skip using RACI. Dr. Chen emphasizes the importance of thorough planning and strong team building in turning health program concepts into impactful realities.

Listeners are encouraged to apply these strategies to their own health programs, with a teaser for the next episode on using the implementation plan for program launch and early operations.

Tami Moser [00:00:00]: Welcome to the community health management design podcast. I'm doctor Tami Moser. And today, we're diving into the crucial process of turning your health program from a concept into reality. Our topic from paper to practice, bringing your health program to life, is designed to help your brilliant community health program. But now comes the challenging part, implementation, where the rubber hits the road, so to speak. Today, we'll walk through developing a detailed implementation timeline, identifying key milestones and potential challenges, and structuring an effective team. So let's get started. 1st step, developing a detailed implementation timeline.

Tami Moser [00:00:39]: This isn't just about setting a start date and hoping for the best. A well crafted timeline is your roadmap to success. Start by breaking your program into phases. For example, let's consider our healthy kids Millbrook obesity prevention program. We might have phases like pre launch preparation, 3 months, pilot program, 6 months. Evaluation and adjustment, 1 month. Full program launch ongoing. Within each phase, list out every task that needs to be completed.

Tami Moser [00:01:11]: Be specific here. For prelaunch preparation, tasks might include hire and train staff, 6 weeks, secure program locations, 4 weeks, develop educational materials, 8 weeks, and set up data collection systems, 3 weeks. Assign each task a duration and a responsible party. And the responsible party is important because this is what connects to accountability. Use project management tools like Gantt charts, Kanban boards to visualize your timeline. This level of detail might seem excessive, but it's crucial for keeping your program on track and ensuring nothing falls through the cracks. Now let's talk about identifying key milestones and potential challenges. Milestones are significant points in your program's development.

Tami Moser [00:01:59]: For Healthy Good Kids Millbrook, milestones might include completion of staff training, 1st family enrolled in the program, 100th family enrolled, 1st set of outcome data collected. These milestones are up to you to decide what's most important, but these to me are also places where you can celebrate. Celebrating these milestones keeps your team motivated and provides natural points for progress evaluation. So setting those early and understanding why you prefer those particular milestones is important. And I always think of them as, where are we gonna stop and pat ourselves on the back and say, we're doing a good job? I don't necessarily need that as an individual employee, but some employees absolutely thrive on that. And it becomes really important for you to recognize that and to give people a chance to breathe. Say, okay. You know, this mad dash we've been doing on this program, we've got our 1st family enrolled.

Tami Moser [00:03:01]: Now we're really getting started. We've done all this hard work, and it's starting to pay off. Right? And those are the points you wanna give yourself and your staff. As for challenges, anticipate them now to prevent them from derailing you later. Common challenges in health programs include recruitment difficulties, staff turnover, technology issues, funding delays, and this list could go on. But that gives you 4 broad categories that challenges can fall into. For each potential challenge, develop a contingency plan. For example, if you anticipate recruitment difficulties, your plan might include partnering with additional community organizations or adjusting your marketing strategy.

Tami Moser [00:03:46]: Finally, let's discuss structuring an effective team and defining roles. Your team is the engine that will drive your program forward. Is your team up for the task? One of the most crucial conditions of your success is the team you have put together. If you want to commit, convince administrators or funders of the potential for the program, you need to show them that you've identified the right team. So answer this, who is your team? What do they know? What can they do and how motivated are they to work within this program? You need to convince decision makers that each member of your team adds to the collective potential of your program. Focus on their backgrounds, achievements, roles in the program, skills, motivation, commitment, and any other information that's relevant for your program. Start by identifying the key roles you'll roles you'll need. For Healthy Kids Millbrook, this might include a program director, nutritionist, exercise physiologists, community health workers, a data analyst, a marketing coordinator.

Tami Moser [00:04:49]: For each role, create a clear job description outlining responsibilities, required skills, and how the role contributes to program goals. This clarity prevents confusion and ensures all aspects of your program are covered and someone is accountable for that part of the program. Keep in mind that if you're having trouble developing strong job descriptions, you can go to onetdot org and look up most types of roles and will get a wide range of elements that would go on a job description for that person in that role. And so it's a great place to start. You do need to edit what you find there. In other words, not everything is gonna match with your program in that role. But having that starting point makes it a little bit easier because you're not just staring staring at a blank page, which is probably one of the things that delays most of us. Consider the structure of your team.

Tami Moser [00:05:50]: Will you have a hierarchical structure or a more flat collaborative approach? In other words, who's in charge? Do you want one person to be in charge, or is this more of a collaborative team environment where everybody comes together and makes it a decision together? And does it have to be unanimous, or is it majority rules? How are you gonna set up what I call, you know, the rules of your team? And then you've gotta decide how will you communicate flow between the team members. So how you know, communication is both a process and an interpersonal skill set. So let's set the interpersonal skill aside of the people you hire for the roles. Now let's talk about the process of how communication is gonna move between team members. Do you have a technology platform, a software that's gonna allow them to have collaboration and to have everything in writing and to transfer, you know, the next whatever needs to be done by the next person to them to work on. And there's many options for, basically, project management is what we're talking about here. And on a side note, I will say you really need to know how to manage a project to put one of these things together. You can plan and have a great plan, but if you know how to implement and manage the day to day operations of that project to check things off and make sure nothing falls through the cracks, you more than likely will have some problems.

Tami Moser [00:07:15]: So start with that communication. Is it verbal? Is it written? Is it in person? Is it over telehealth in person? Is it all through email? How are you going to maintain HIPAA compliance with your communication process? The interpersonal component of it is a different animal. And so as you're thinking about the people on your team and each role, let's start there, the roles that need to be filled, think about their part in the communication process and what level of skill they will need in both written and or verbal communication. It's not just about communication with the patient, which is very important. Don't get me wrong, but that's also a separate issue than what we're talking about here. In that respect, let me step back to job description. There is a tendency sometimes when you're designing any internal project or plan that you think about, okay, this person is who I'm gonna put in this role. Therefore, I'm gonna write the job description to fit what this person can do or knows how to do, not necessarily what I would write for the role if I didn't have this person.

Tami Moser [00:08:22]: You need to separate out who you think you're gonna fill the roles with first and think about what roles, are you gonna fill the roles with first and think about what roles actually need to be filled and what you truly need each person within that role to do. Then some of that is gonna be preferred. In other words, they don't all have to have it, but you would prefer them to have it. And then you've got required. In other words, if they do not have this, they are not going to be a part of your program. So when you think about this part, really start to think about defining the roles clearly and accurately first, and then decide on how you will put the teams together. So this gives you a good way to start the process. Okay? Now here's a pro tip.

Tami Moser [00:09:18]: Create a RACI matrix for your program. This stands for responsible, accountable, consulted, and informed. This tool clarifies who's doing what, who has decision making power, who needs to be kept in the loop, and who should be consulted on decisions. And I have an Excel workbook that is on your overview and welcome page and on this page for module 3. And so pull that out and you can fill it in and that will help you. The difference between being responsible and accountable in an RACI matrix is that responsible refers to the person or team completing the work, while accountable refers to the person who is ultimately accountable for the outcome and must report on and sign off on the deliverable. The same person can hold both roles, but they are distinct responsibilities and should be listed as such. And they could be different people as well.

Tami Moser [00:10:20]: Skip the RACI if the team communicates really well already. All individuals stay on top of their own work. You don't have to look over anybody's shoulder for them to get their work done. The project is small enough that it would be a time waster going through the steps outlined in the r a c I matrix template. For example, designing a career page, which may only involve 2 departments with fewer stakeholders required for approval. The project team uses an agile framework like scrum. So if you've got a team set up for something like that, you don't need the RACI. That agile framework like scrum will actually kinda take the place of that.

Tami Moser [00:10:59]: The benefits of using RACI charts include clarity. It clearly defines who is responsible for what tasks and decisions, reducing confusions and misunderstandings. Accountability. It assigns accountability for specific tasks and decisions, making it easier to hold people accountable for their actions. Improve communication. It facilitates communication by clearly identifying who needs to be consulted and informed about specific tasks and decisions. Better decision making. It helps ensure that the right people are involved in making decisions leading to better outcomes.

Tami Moser [00:11:36]: Increased efficiency. It can help streamline processes by identifying and eliminating unnecessary steps or duplicated efforts. And last but not least, better coordination. It helps coordinate the work of different teams and individuals reducing the risk of delays or missed deadlines. Remember, your team structure should align with your program goals and values. If community engagement is a key part of your program, ensure your team includes strong community representatives. Implementing a health program is complex, but with careful planning and the right team, you can turn your vision into reality. Your implementation timeline keeps you on track.

Tami Moser [00:12:15]: Anticipating challenges helps you stay agile, and a well structured team ensures you have the right people in the right roles to drive your program forward. Now it's your turn. Take your community health program concept and start building your implementation plan. Begin by outlining your program phases and listing tasks for each. Identify at least 5 key milestones and 3 potential challenges. Then create a list of key roles you'll need on your team. In our next episode, we'll discuss how to use your implementation plan to guide your program's launch and early operations. You'll see how this foundational work sets the stage for a smooth and successful program rollout.

Tami Moser [00:12:57]: Remembering community health management, thorough planning, and a strong team are your best tools for turning great ideas into impactful programs. Keep planning, keep anticipating, and keep building teams that can bring your vision to life. Until next time, this is Doctor Tami Moser signing off.