High-Performance Partnerships - National Academy of Public ...

The PODER Project was a six-year
initiative.The first three years
focused on capacity building and the
last three on implementation. The
biggest challenge was to create a resident-driven
advisory council that
included all stakeholders. Initially,
there was a great deal of conflict
concerning which resident would
control the council. This prolonged
the time frame and created difficulties
with existing and potential funders.
During this period, the real
leadership emerged to develop the
capacity of the council.
PODER/PATCH Project (Denver)
4. Demonstrate that high-performance partnerships
produce.
Nothing generates support like success.
Partners, stakeholders, and the community at
large are more likely to back a winner than a
partnership that has yet to produce. Widely
communicating the partnership’s results is one
way to encourage future support.
STRUCTURING A PARTNERSHIP TO
ACHIEVE RESULTS
The Challenge
An effective governance structure is critical for
a high-performance partnership. There must
be a mechanism to make decisions, allocate
resources, and resolve conflicts. Yet it is difficult
to implement one that accommodates
both collective and individual needs. It is possible
for a detached party to participate in the
governance structure, but it generally has
“stakeholders.” Stakeholders have an interest
in the partnership’s enterprise and usually are
an investor or beneficiary.
Investors are individuals or organizations that
contribute resources. Investors ultimately have
the power to make decisions because they control
the resources to act. They can make things
happen or even veto the use of their resources
if the partnership moves in a contrary direction.
Investors are not necessarily involved in
the partnership’s day-to-day activities, but provide
the wherewithal for the activities to occur.
Smart investors listen to and value the client’s
input, but not necessarily include it in the
decision-making structure. This does not
mean that an investor-controlled partnership
is ineffective in meeting customer expectations
or service needs. At the same time, the
approach runs the risk of appearing exclusionary
or insensitive to some stakeholder interests.
Beneficiaries are the subset of stakeholders that
the partnership’s results affect. They can be
direct customers or indirect beneficiaries, such
as the community at large. They can influence
the partnership’s decisions, but not independently
control them. Certainly, a high-performance
partnership must be customer-focused
and routinely seek input and feedback.
However, a customer service orientation is not
synonymous with partnership governance.
A partnership’s decision-making structure can
be composed solely of investors or a combination
of investors and other stakeholders. The
former can facilitate action and results because
key decision-makers and resource providers
are in charge. But, an investor-only model
must guard against disenfranchisement and
lost support from other stakeholders.
The federally-mandated Advisory Panel on
Medicare Education is a governance structure that
relies primarily on the stakeholder model. While
CMS is the investor, the stakeholders make decisions
and recommendations to guide the agency.
The panel’s chair is from the stakeholder body.
CMS is represented at the table but the panel
works independently as a group, offering critical
guidance to the agency.
Lovell Brigham, Centers for
Medicare and Medicaid Services
113 Powering the Future: High-Performance Partnerships