PROVIDENCE – The punch line at many a community organizing event is to talk about how difficult it is to work together by saying: collaboration is an unnatural activity between consenting adults. It usually draws lots of laughs and guffaws.

But collaboration, much like quality improvement before it, has become the new watchword of community agencies and nonprofits and corporations alike: the idea that success requires a way to bring different, often competing voices to the table and engaging with them in conversation.

The Rhode Island Foundation recently recognized five different nonprofits with its 2017 Best Practices Awards, with a focus on collaboration, communications, innovation, leadership and volunteer engagement.

The winners each received a $1,000 grant and a promotional video highlighting their work – another sign that videos have become an important and valuable messaging component of community engagement: the medium enhances the message.

The sponsor of the Best Practices awards was Blue Cross and Blue Shield of Rhode Island.

The winners included:

• Day One of Providence, which received the Collaboration award for initiating the Uniform Response Protocol, which improves the state’s approach addressing the commercial sexual exploitation of children.

• Foster Forward of East Providence, which received the Innovation award for Works Wonders, which is a comprehensive, trauma-informed, individualized and developmentally appropriate career-readiness program for youth in or who have aged out of foster care.

• Clinica Esperanza of Providence, which received the Volunteer Engagement award for recruiting physicians, nurses, nurse practitioners, medical students, pharmacy students and others to provide more than 7,000 volunteer hours of service.

• Hattie Ide Chaffee Home of East Providence, which received the Communications award for its “Discharge to Community Program,” which has cut hospital emergency room admission rates for clients who were discharged after short-term stays by more than 60 percent.

• Trinity Repertory Company of Providence, which received the Leadership award for developing a successful short-term financial turnaround and long-range planning process designed to maximize stakeholder buy-in and address critical financial and strategic issues facing the theater.

“In a world were human contact is no longer the norm and automation is ascendant, we are reaching out, pitching in and extending a hand to help our neighbors,” said Dr. Annie De Groot, volunteer medical director at Clinica Esperanza and CEO and CSO at EpiVax, in the news release accompanying the award announcement, talking about the ethos of a volunteer-run medical clinic.

Beyond the accolades
Beyond the accolades and the awards, there are some deeper, harder-to-answer questions around the art of collaboration in a community or corporate setting. Such as:

• Who has a seat at the decision-making table?

• How does the collaboration reflect the diversity of the community?

• Whose voice gets heard in the conversation?

• How does collaboration become part of training around decision-making?

Another concern, not often voiced, were the consequences of what happened if someone spoke up and asked questions or offered criticisms.

ConvergenceRI reached out to a number of the award winners in an attempt to drill down on the nature of collaboration and explore how the concept played out in the different organizations, in their own words. Here are their responses:

Clinica Esperanza
The answers were prepared by Dr. Annie De Groot, volunteer medical director at Clinica Esperanza and CEO and CSO at EpiVax, and Steven Vessella, senior business development associate at EpiVax.

ConvergenceRI: In your opinion, what is the value proposition for collaboration and community engagement at Clinica Esperanza?
DE GROOT AND VESSELLA: Clinica Esperanza is all about leveraging altruism to improve health – in other words, neighbors helping neighbors.

We provide the venue for that connection to happen. Thus, for a simple investment of time, or of funding support, our proposition is to provide a return on that investment that is substantial.

We lower emergency room costs in our population by $500,000 per year, and we provide healthcare valued in quality-adjusted life years at more than $3 million per year.

ConvergenceRI: How do you leverage collaboration in the effort to improve outcomes and participation?
DE GROOT AND VESSELLA: One of the key features of our volunteer program is “job satisfaction.” We engage and challenge volunteers. We are volunteers ourselves, so we know what makes us happy. And there is nothing better than walking out of clinic after a volunteer shift knowing that you have improved someone’s life.

That satisfaction is what drives our volunteers to maximize the clinic's ability to deliver on its promise – to be a place to be healthy for patients, staff and volunteers.

The success of Clinica Esperanza would also not be possible without the collaboration we have with the Warren Alpert Medical School of Brown University. Eager, young, bright, motivated student doctors, mentored by volunteer physicians, learn to care for underserved patients and deepen their skills in cultural and linguistic competence. It is a unique and value-added complement of the medical school curriculum.

Also, culturally competent and linguistically appropriate care is key to our model. Our patients build trusting relationships with their care providers when they are able to connect via common language or culture, often improving patient outcome and participation.

ConvergenceRI: How does the value proposition of collaboration play out as part of the culture at EpiVax?
DE GROOT AND VESSELLA: At EpiVax, diversity and inclusion have always been a focus because we recognize that the best ideas and strongest collaborations result when you have a diverse talent pool from which to source ideas.

We are proud to say EpiVax has equal gender representation and our cultural diversity has never been stronger. Our business is thriving. Do you think there is a correlation here? We do. The same concept rings true at Clinica Esperanza.

ConvergenceRI: Why do you think that collaboration is such hard work, at times?
DE GROOT AND VESSELLA: Collaboration relies on patience and listening, and adaptability. We have to adapt our program to the skill sets of our volunteers, and find the projects that suit their skills. This can be a big problem when you have as many volunteers as we do. So, maintaining communication is a key aspect of our volunteer program. We practice the same model at EpiVax on a smaller scale.

Collaboration also requires empathy: to try to understand someone else’s perspective; the ability to keep an open mind. That’s fundamental to our success at Clinica Esperanza and we apply the same principles to our work at EpiVax.

Foster Forward
The responses were prepared by Lisa Guillette, executive director of Foster Forward.

ConvergenceRI: What is your organization's value proposition around collaboration? How is it leveraged and communicated?
GUILLETTE: Our organization’s value proposition on collaboration as a focus of innovation is that innovation is all about finding creative new ways to approach problems and improve efficiencies and results [that are] very difficult to achieve that without collaboration.

Inevitably, new approaches come from shared learning with others, from identifying and reducing duplication and in leveraging resources and contributions towards collective impact.

ConvergenceRI: Do you engage in specific training with employees around collaboration or consensus decision-making?
GUILLETTE: Our training for staff has been more around effective engagement [primarily with the youth and families we serve] but also with each other and community partners in the work. We do incorporate team exercises into our training that require consensus decision-making.

Just two weeks ago, at an all-staff training, we did the NASA exercise on prioritizing 15 items that would help survival if we crash-landed on the moon.

First we completed the exercise individually, and then we were combined into groups where we had to come to a group consensus on prioritizing the items.

Interestingly, while most folks felt strongly about their rankings, they bent a bit to achieve group consensus and, for almost everyone, our group analysis [according to NASA] would have given us a higher probability of survival than our individual assessment.

It does speak to the proverb: If you want to go fast, go alone; if you want to go far, go together. So, it appears to me that making time is an important factor if you value consensus decision-making.

ConvergenceRI: How do you leverage collaboration in your interactions with other agencies and with clients? Does it require you to learn to listen in different ways?
GUILLETTE: The above-mentioned training we recently completed is a Families Thrive framework. It is essentially an approach to guide our work with youth and families [and each other], and it is rooted in really understanding where others are coming from [which requires a lot of listening but also some fundamental background in early childhood and adolescent brain development].

For us, we are at our best collaborating with other agencies when we have a solid understanding of whom each other are, beyond just mission. [We need to answer some important questions: What are our shared values and beliefs? What are our core competencies? In what ways do our programs/services complement each other? What areas are overlapping and potentially creating duplication or redundancies? What would it look like to share resources? How do we start with the easy stuff like shared training opportunities and then build into more comprehensive partnerships involving shared programming, space, data, funding, etc? Are there things one party should take on and another party should give up?

One example I’m proud of is that at Foster Forward we have an amazing financial capability program for current/former foster youth called ASPIRE. We do basic financial literacy training, help young people open IDA bank accounts and then match their savings $1 for $1 up to $1,000 per year.

But, we were starting to see that many of our participants struggled with poor credit scores and needed ongoing assistance making better financial decision so they could get to a place of savings and matching.

We were encouraged by a national funder to implement a new service component of one-on-one financial coaching with our participants. Rather than hire staff and build out that work in house, we formed a collaboration with the Capital Good Fund and we refer our young people to them for financial coaching and we pay the Capital Good Fund directly for those services.

ConvergenceRI: What is the greatest resistance to collaboration that you have encountered, both internally and externally?
GUILLETTE: People often fear what they lose in collaboration. Will they lose control? Will they still get credit? Will they lose strategic advantage in what is undeniably a competitive marketplace?

We try to ask ourselves the old Special K commercial question: What will we gain when we lose? It’s wonderful when funders see and reward nonprofits that intentionally collaborate and then hold them up as examples of innovation.

The challenges we face in our sector are huge - and we spend a lot of money on pilots and interventions that if not connected effectively with other efforts will never bring us to the type of population level impact we are striving to achieve.

So, internally we need to ask ourselves: can we really do this thing we are doing alone and fully impact the population we propose to serve? If not, who are the people and groups externally we need to be talking to and working with to get to that level of effectiveness?

The solutions lie not only in different models of partnerships and funding but also in identifying and addressing systemic policies and practices that are promoting or impeding our efforts.

Day One
The responses were prepared by John Canole, director of Communications, Marketing and Policy at Day One.

ConvergenceRI: What does Day One view as the value proposition for collaboration? How do you leverage it in the work that you do?
CANOLE: Recognizing the need for a more formal approach to dealing with the rising issue of sex trafficking in the state, Day One has convened a task force to develop best practices and make recommendations.

The value of the task force is to ensure a coordinated multidisciplinary team approach to best serve and act in the best interest for all victims and promote safety, treatment, and favorable prosecution outcomes.

Together, we are more effective and have improved communication and working relationships between disciplines.

Having a unified goal and objective brings everyone together for the betterment of our children and community. Together, we have achieved meaningful and measurable outcomes with the release of the CSEC Uniform Response Protocol in 2016. This protocol outlines the appropriate steps for those suspecting possible commercial sexual exploitation of a child or children.

ConvergenceRI: Does the coalition engage in any training activities around collaboration and consensus-decision making?
CANOLE: The task force engages in training activities on an ongoing basis. Having a multidisciplinary team allows experts in different disciplines to share their expertise and educate the group.

The task force has also utilized outside agencies for educational purposes, including My Life My Choice in Boston for cross-discipline education as well as SEEN, who came to consult during the development of our uniform response protocols to ensure we stayed on track throughout the process.

ConvergenceRI: How effective is collaboration in breaking down existing silos, particularly when interacting with government agencies and for-profit entities?
CANOLE: Sex trafficking is a statewide issue, and we know we can’t fight it alone. The task force provides a forum for us to collaborate with all the right stakeholders to determine the best approach.

Working as a task force allowed individuals to come together to release the protocols. The team, which includes representatives from federal, state and local law enforcement, the Department of Children Youth and Families, health care providers and more, develops goals and divides efforts among strategic subcommittees focused on victim services, education and training, and best practices for investigating and prosecuting these cases.

The ongoing task force utilizes these working subcommittees to focus on their areas of expertise. The task force subcommittees include: data, education, policy/legislation, provider, clinical, and runaways.

In working on such an important issue, team members were aware that the goal is more important than any one individual person. When members come together to meet, all baggage and egos are checked at the door and the full focus is in the child.

ConvergenceRI: What do you see as the most difficult barriers to overcome when attempting to collaborate with other folks?
CANOLE: The most difficult barrier to overcome when collaborating with others has been the process of continuously educating the community, task force members, and providers on the uniform response protocol and ensure everyone is on the same page and is educated in knowing what to do.

Blue Cross
As the corporate sponsor for the 2017 Best Practices awards for nonprofits in Rhode Island, ConvergenceRI also asked Blue Cross and Blue Shield of Rhode Island, to respond to a series of questions around collaboration.

The questions asked included:

• In Blue Cross’s opinion, what is the value proposition for collaboration?

• Although the awards focus on nonprofits, is collaboration a process that needs to be nurtured within the for-profit world?

• How is Blue Cross investing in collaboration within its own internal employer-employee relationships? Can you provide an example or two?

• What is the role in leveraging collaboration to breaking down existing silos and improving communication efforts?

Here are their responses, prepared by Jill Flaxington and Gail Carvelli.

Collaboration is one of our four core corporate values at Blue Cross & Blue Shield of Rhode Island. It is a vital part of every interaction we have with our colleagues, members and stakeholders.

The specific pillars of our commitment to demonstrate collaboration include:
• Bringing problems, issues, and solutions to the table together. Thinking about the entire company and our customers.

• Proactively breaking down unproductive silos and sharing information and expertise to achieve a desired result. Sharing information and resources to empower others to do their jobs more effectively.

• Seeking opportunities to work cross functionally for the good of the company.

• Seeking opportunities to work together with our customers, providers and community partners in pursuit of our corporate goals and strategies.

• Putting the needs of stakeholders and partners before our own.

Community investment
The largest example of BCBSRI’s commitment to collaboration, one of the five award categories recognized by the Rhode Island Foundation, is our community investment. As a local nonprofit with deep roots in the Rhode Island community, we are proud to partner with local nonprofits that are doing important work for individuals and families in our state.

For nearly 80 years, BCBSRI has been dedicated to improving the health of all Rhode Islanders. Through our BlueAngel Community Investment Program, we support nonprofits and programs that address the most critical health issues facing Rhode Islanders, from childhood obesity to health literacy to quality care for the uninsured.

We strive to improve the quality of life of every Rhode Islander through improved health and by contributing to the success of a vibrant business community. We often say: “It takes a team” at BCBSRI. That spirit of collaboration extends far beyond our doors, as we partnered with 202 nonprofit organizations in 2016 alone.