PCL_Color_Logo_250Change is hard. It takes leadership to drive change. Robert Jarvik—a former John A. Hartford Foundation grantee and inventor of the artificial heart—once said, “Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them.”

Today’s successful leaders need that same vision, but they also require a set of skills that go far beyond their clinical training and experience. They need strategies to address policy and payment methodology. They need to engage stakeholders. And they need to measure what matters in terms of cost and quality.

In order to develop this new kind of leadership, people capable of driving health care redesign for vulnerable elders, the Hartford Foundation funds—in partnership with The Atlantic Philanthropies—the Practice Change Leaders Program.

The Practice Change Leaders Program—under the leadership of Eric Coleman, MD, MPH, at the University of Colorado—will develop a total of 30 leaders over a three-year period. The program aims for two levels of sustained impact. The first goal is to develop effective leaders who champion high-quality care and promote a prominent role for older adults in defining the type, intensity, and setting of care they choose to receive. The second goal is the resulting improvement in the organization and delivery of health care to older adults.

In order to develop a cadre of change leaders, the Hartford Foundation, in partnership with The Atlantic Philanthropies, funded the original Practice Change Fellows Program in 2007. Led by Dr. Coleman, the goal of this program was to equip emerging leaders with the unique skills and knowledge needed to transform the health care delivery system.

The Practice Change Fellows Program was an opportunity for nurses, physicians, and social workers to develop leadership skills, content expertise, and relationships that enabled them to positively influence care for older adults, not only in their own organizations but also throughout the health care system. Fellows completed a project that integrated or expanded a new geriatric program or service line within their organization, allowing them to remain at their full-time jobs throughout the program.

Five years and 38 fellows later, the Practice Change Fellows Program achieved remarkable outcomes. Fellows successfully implemented cutting-edge approaches for dementia care, primary care, care transitions, congestive heart failure management, delirium, and more.

Today, a new cohort of Practice Change Leaders is addressing critical systems issues that can markedly improve cost and quality for our aging population. The program’s name change from “Fellows” to “Leaders” reflects Hartford’s focus on the investment in change leaders as a means to improve the health of older adults in communities around the United States.

Change begins with the recognition that the bolus of high-cost and low-quality care—with poor health outcomes—is attributed to older adults with multiple chronic conditions and poor function.

Our nation’s most vulnerable older adults are in desperate need of health care redesign. Clinicians need to understand geriatric syndromes and polypharmacy. There must be better care coordination, prevention and chronic disease self-management. In order to help those at risk remain at home, we must focus on optimization of physical function, palliative care, advance care planning, and attend to the needs of family caregivers.

The Practice Change Leaders have vision and fearlessness in spades. The program is designed to arm them with the critical skills to realize that vision.