Over the past 10 years, the Rippel Foundation has focused on bringing the most pioneering ideas and successes of social movements and other sectors to health. This approach has grown out of our goal to invest in change-making that is transformative in nature and in which others may not typically invest. By shifting perspectives, relationships, and processes, our goal is to uncover ground-breaking solutions that challenge the status quo and improve health, health care, costs, equity, and productivity.
We are proud to have seeded numerous innovations that today catalyze the rethinking of how health and health care is organized and thought about in the United States.
Learn more about our impact:
- Bringing the Lessons of Industrial Pipe Repair to Health and Health Care
- Can a Grape Boycott and Presidential Election Help Fix the U.S. Health System?
Bringing the Lessons of Industrial Pipe Repair to Health and Health Care
For years, John Sterman, head of MIT’s System Dynamics Lab, had been working with industrial and business leaders, as well as with members of the energy sustainability movement. As a system dynamics modeler, he developed board games and computer simulations that helped leaders see the consequences of their actions – intended and unintended – in complex systems like factories or climate change. For John, fixing health and health care in the US was no more complicated than the decision of whether or not to defer maintenance on pumps and pipes in a major manufacturing facility. How do leaders – the bosses who run the facility – decide to invest their resources? Their choices are simple – invest in routine maintenance or defer main maintenance until there is an imminent need for a repair. With competing demands for resources within the company and pressure to produce bottom line results, deferring maintenance often seems like an attractive option. But system dynamics models trace the impact of that decision over time. Deferring maintenance actually drives significantly higher costs and results in greater down time over the long term. The parallels to health and health care are clear. Moving health upstream, focusing on social determinants and prevention, and strengthening our communities can reduce costs and demand on the health care system. Yet lack of system insight and failure to understand the true consequences often lead to poor decisions and the misallocation of resources.
The Foundation seeded an experiment to see if the lessons and tools of system dynamics could be brought to regional health systems – ones that involve all major stakeholders to focus on both health and health care. There were other health models in existence that focused on national policies, specific diseases, and targeted interventions, but none looked at regional health systems, and none allowed the critical stakeholders in a region to play out their own “what if…?” scenarios for system redesign. An award-winning team of MIT-trained system modelers, including Dr. Sterman, developed what has now become the ReThink Health Dynamics Model. First piloted in Pueblo, Colorado in 2010, it has been refined over the years through work with numerous regional health collaboratives and educational institutions. Today, the Model is used by communities and colleges across the country to rethink the definition, design, and approach to investing in a new health system – one that embraces routine maintenance and health as much as repairs and health care. Learn more about the ReThink Health Dynamics Model.
Can a Grape Boycott and Presidential Election Help Fix the U.S. Health System?
Marshall Ganz, now a Harvard professor, had been a Harvard drop out in the 1960’s when he began working with the Civil Rights Movement and with the United Farm Workers in their notorious grape boycott CHECK. He brought decades of experience in these and other social movements to numerous change efforts, including advising the successful 2008 grass roots campaign of President Barack Obama. In all of these, he was able to mobilize millions of Americans in successful campaigns for change. If he could do that, could his work also change the health care system? Marshall’s powerful and proven approach to engagement, mobilization, visioning, and successful strategies for change – mostly in the form of targeted campaigns – provided a model and a challenge. Could these tools and approaches work in the complex, multi-dimensional, and multi-sector environment of health and health care, and could they be adapted to work to move beyond a focused campaign. The Rippel Foundation set out to answer these questions.
Seeding an experiment in Columbia, South Carolina, a team of Marshall’s protégé’s worked closely with the Hospital Association to bring together stakeholders from health, health care, public health, academia, and most importantly the residents and leaders of zip code 29203—one of the poorest and most disease ridden in the country—to improve health and health care. Two years of effort brought together the community players in collaborative relationships that have led to Healthy Columbia and the Healthy South Carolina movements – all using Marshall’s approaches adapted to health. New services are available in the community, and a covenant has engaged thousands of residents in healthier behaviors. Read the Columbia, SC case study.
This approach to community engagement, now a part of the ReThink Health portfolio, was integrated into work with Quality Improvement Organizations (QIOs) in a demonstration project of the Colorado Foundation for Medical Care (now Telligen), funded by CMS. The effort brought new ways of thinking and led to radically different use of resources and improved organizational actions in several communities and QIO’s. Based on the success of that project, Telligen was recently selected to be the national coordinator for the Quality Improvement Network, using ReThink Health as a key engagement provider to foster change in communities across the country. Read the QIO case study.