Model for Improvement - Forming Teams and Writing The Charter

Writing the Collaborative Charter

To form the team, draft a Collaborative Charter to be refined by the team. A Collaborative Charter is used to describe and to launch a collaborative roadmap for the work, including:

  • What needs improvement; reasons for wanting improvement; mission, vision, costs and benefits of improving and not improving
  • Specific goals to improve outcomes, reduce costs
  • Expectations for participants and faculty/support structure

The New York State Pilot Healthy People 2020 State Action Collaborative Charter included the New York State obesity goals, took into account that the three teams in three counties had the option of choosing either a physical activity or nutrition focus, and that all groups were using the Breakthrough Series Collaborative Learning Methodology for the first time in a non-healthcare environment.

Forming Teams

Effective teams include members representing three kinds of expertise within the organization: system leadership, program expertise, and "day-to-day" leadership. There may be one or more individuals on the team with each kind of expertise, or one individual may have expertise in more than one area, but all three areas should be represented to drive improvement successfully.

  • System Leadership: Teams need someone with enough authority in the organization to institute a suggested change and to overcome barriers that arise. The team's system leader understands the implications of the proposed change for various parts of the system and the more remote consequences such a change might trigger. It is important that this person have authority in all areas affected by the change, including the authority to allocate the team's time and resources to achieve its aim.
  • Program Expertise: A program expert knows the subject intimately and understands the processes of mobilizing communities. An expert on improvement methods can provide additional technical support by helping the team determine what to measure, assisting in design of simple, effective measurement tools, and providing guidance on collection, interpretation and display of data.
  • Day-to-Day Leadership: A day-to-day leader drives the project, assuring that tests are implemented and overseeing data collection. It is important that this person understands not only the details of the system, but also the various effects of change(s) in the system. This person also needs to be able to work effectively with the organizational champion(s).

These instructions have been adapted from Improvement Methods: Forming the Team, Institute of Healthcare Improvement.

Example: Healthy People 2020 State Action Teams

County Schools Improvement being sought Roles and Team members
Clinton Beekmantown Middle School: Grades 6-8, Peru Intermediate School: Grades 3-5, Plattsburgh High School: Grades 9-12 Plattsburgh High School: Increased sales of fresh fruit

Beekmantown Middle School: Increased sales of new healthier entree items

Peru Intermediate School: Increased sales of vegetable-based items

For specific improvement statements, see the aim statements.		 Planning Team: Plattsburgh High School Cafeteria Manager, Beekmantown Middle School Cafeteria Manager, Peru Intermediate School Cafeteria Manager, Clinton County Health Department Nutrition Coordinator

Food tasting and food naming: Students at Beekmantown Middle School

Advisors: Cornell Food and Brand Lab staff, New York State Department of Health, Quality Improvement Consultant
Franklin Petrova School in the Saranac Lake School District: Grades K-5 Increased sales of school lunches and healthier menu items. For specific improvement statements, see the aim statements. Planning Team: Saranac Lake District Food Service Manager, Franklin County Public Health Educator, Program Coordinator of Eat Well Play Hard (a non-profit program)

Students from health class: participated in food tastings

Advisors: Cornell Food and Brand Lab staff, New York State Department of Health, Quality Improvement Consultant
Schenectady Martin Luther King Elementary School: Grades K-8 Increase physical activity levels among students in one grade. For specific improvement statements, see the aim statements Planning Team: Martin Luther King Elementary School Principal and teachers, Schenectady County Public Health Services, Cornell Cooperative Extension, Schenectady County

Advisors: Yale-Griffin Prevention Resource Center, New York State Department of Health, Quality Improvement Consultant