Amplifying Stewardship Together

There is a growing group of people and organizations who understand the need for action that is grounded in what we are calling stewardship—action that enables all people to prosper and reach their full potential. We call these people and organizations stewards.

Every steward has an area of focus as it relates to improving well-being. Each of us has carved out our role in these respective areas, making up part of an ecosystem. Rippel’s is health. Other stewards focus on democracy, equity, the environment, placemaking, the economy, education, or some combination.

We’ve done a lot of hard work, and we’ve had many breakthroughs. Yet despite our significant investments in time and money, we haven’t made enough progress
toward well-being in the United States. A lot of us have been reflecting and many are asking: what can we do differently?

Stewards are people or organizations that are developing their ability to:

Take responsibility for forming working relationships with others to transform well-being across a region.
Serve as natural boundary spanners because they are informed by place-based, interdisciplinary, multisector, and multicultural perspectives.
Understand that purpose must be larger than oneself and one’s organization, power must be built and distributed with others, and wealth must be invested to create long-term value as well as address short-term urgent needs.

Through our work in the Amplifying Stewardship Together project, we are exploring two big questions that stewards are encountering every day:

The BIG Questions

How can we acknowledge our limitations, amplify our strengths, and expand our horizons?

Could we better achieve our goals if we work more cohesively and with a greater level of accountability to one another?

These are good questions because they challenge us to face our dominant patterns of thinking and acting that weaken our collective ability to succeed.

They open us up to other important questions, which we are also working to clarify through the project:

How can we avoid pursuing narrow solutions when we know that barriers to well-being are complex and often can’t be “solved” by one sector or organization alone?
How do we resist “quick fix” temptations when we know success depends on taking a long-term approach to problem-solving?
How do we collaborate in ways that include all the people, organizations, and ideas that would strengthen our practice? In ways that recognize we can humbly learn from some marginalized cultures that have been encouraging us to work more cooperatively all along?
How do we recognize one another’s strengths and see the potential of what we could do with greater alignment instead of magnifying our differences?
How do we stop writing off those who might one day be effective stewards by wrongly assuming their intentions?

Amplifying Stewardship Together is about working as a group to openly learn from our independent and collective successes and failures, and seeing our differences as assets, so we can adapt our thinking and practices for a more inclusive, cohesive, and effective future. Because we work in such a complex and massive ecosystem that makes up well-being in the United States, we don’t assume it’s possible, or helpful, to create a giant infrastructure and set of processes to help us all work together. But we can lift up shared principles and practices to use as we each go about our own area of focus.

When we amplify these shared principles and practices in our daily work, we will naturally set the conditions that steward well-being across the country. Through this commitment we will create a shared identity and thus the opportunity to claim broader scope and power as part of a visible movement that is stewarding equitable ecosystems for well-being.

Getting Started

Who’s Involved

ReThink Health is working with leaders who act as stewards.

They are:

A mix of local and national leaders
Working in different domains affecting regional well-being: health, economy, environment, democracy, placemaking, education, and more
Well-networked individuals working in well-networked organizations
Successful for different reasons, so they can learn from one another’s strengths
Diverse in race, ethnicity, gender, and age

Since our work is interdependent (whether or not we recognize it as such), we must show up in the world with greater context and understanding about what “stewardship” is today—who we are, what we are doing individually and together, what is at stake, and for whom.

Our activities in Amplifying Stewardship Together will focus on learning, adapting, and amplifying stewardship principles and practices so we can strengthen the foundation from which leaders can continue their efforts to steward well-being.

Learning
Our efforts must be grounded in reality (as opposed to our hunches) about what amplifies and weakens stewardship of well-being. We’ll conduct two nationwide studies to (1) examine long-term, nationwide trends that affect stewardship, and (2) learn the extent to which stewardship mindsets and practices have spread and are aligned in regions across the United States.

Adapting
We must adapt based on what we learn together. We’ll convene to deepen our stewardship practice by understanding and confronting the dominant patterns of thinking and sticky issues that hold us back in our efforts.

Amplifying
We must amplify stewardship principles and practices. Together we’ll shine a light on the broad scope of stewardship and the power we can have when each of us approaches our work with a shared set of principles and practices. We’ll share this common identity with other leaders—via their conferences, advisory groups, publications, and beyond—to invite them to work more cohesively and with greater levels of accountability to others who share their goals.

Meet Our Project Team

Jane Erickson

Project Director

Tami Gouveia

Senior Project Consultant

Bobby Milstein

Director of System Strategy

Sarah Rial

Program Coordinator

Iueh Soh

Project Manager

Resources

External Resource

Stewardship and Public Service: A Discussion Paper

From the Field

03/31/1997

This discussion paper prepared for the Public Service Commission of Canada presents stewardship as a bridge between purely market-based approaches and broader public sector responsibilities. While market-based reforms have shown many possible outcomes, they are not robust enough to embrace the full range of public sector activities, such as governance and guarding the public interest.

External Resource

The Concept of Stewardship in Health Policy

From the Field

01/01/2000

This World Health Organization Bulletin traces the history of stewardship and explores its potential as an avenue for public policy to effectively and efficiently improve health and well-being.

External Resource

The World Health Report 2000: Health Systems: Improving Performance

From the Field

01/01/2000

This report from the World Health Organization dives deep into resource allocation and performance quality in the health care system circa the year 2000. It’s notable for its emphasis on stewardship as a critical part of improving that system.

External Resource

Health Stewardship: The Responsible Path to a Healthier Nation

From the Field

01/01/2009

The Aspen Institute published this paper explaining the value of health stewardship and making a case for its importance for successfully navigating the challenges facing the system that produces health and well-being.

External Resource

What Help is a Steward? Stewardship, Political Theory, and Public Health Law and Ethics

From the Field

12/20/2011

As part of The Northern Ireland Legal Quarterly journal’s special issue on ‘super-stewardship’ and the related work of Roger Brownsword, this paper critically examines stewardship in public health.

External Resource

Achieving Accountability for Health and Health Care Minneapolis, MN

From the Field

11/01/2012

This article in Minnesota Medicine proposes Accountable Health Communities (AHCs) as a way to establish health system stewardship. They would to review local data against the Triple Aim, create shared goals and investments, and involve citizens in reform and stewardship.

External Resource

Stewardship: Choosing Service Over Self-Interest

From the Field

01/01/2013

In this book, Peter Block asserts that a fundamental shift in how we distribute power, privilege, and the control of money—away from self-interest and toward stewardship—can transform every part of an organization for the better, and he examines the nitty-gritty of implementing these reforms.

External Resource

An Introduction to Network Weaving

From the Field

06/01/2013

Building effective networks is one of the key tasks for a steward. This practical guide by June Holley teaches basic skills for doing just that.

External Resource

The Three Horizons: The Patterning of Hope

From the Field

09/13/2013

Bill Sharpe wrote this introduction to the Three Horizon’s framework, which can offer stewards a way to manage innovation and transformational change along the short, medium, and long term.

External Resource

Core Attributes of Stewardship; Foundation of Sound Health System

From the Field

03/01/2014

This International Journal of Health Policy and Management Perspective offers one way to look at stewardship, positing that it has five core attributes: responsible management, political will, a “normative dimension” (equity), balanced interventions, and components of good governance.

External Resource

Promoting Population Health Through Financial Stewardship

From the Field

04/03/2014

This Perspective in the New England Journal of Medicine argues that physicians have an ethical responsibility to act as stewards to promote their patients’ health and well-being.

Publication

2016 Pulse Check Survey Findings

ReThink Health

03/15/2017

These results shaped the development of ReThink Health’s Pathway and Essential Practices by illuminating the characteristics of regional multisector partnerships. The survey explored the following questions: What is the nature of the work stewards do in these partnerships? How does stewards’ multisector partnership work develop over time? How do they advance their work? What barriers to advancement do they face? How do stewards finance their multisector partnership work?

External Resource

Public Involvement and Health Research System Governance: a Qualitative Study

From the Field

08/30/2018

This article in Health Research Policy and Systems describes an exploratory, qualitative study of specific active stewardship efforts in two countries: England and Canada. It illustrates some of the benefits of stewardship while identifying three sets of common issues across both locations.

ReThinkers’ Blog

Regional Stewards: Nudging Systems Toward Health and Well-Being

Stacy Becker, Vice President, Programs

12/11/2018

Stewards can’t control outcomes in a complex adaptive system, but they can nudge them in the right direction. Using the ReThink Health Pathway, stewards can contribute to shifting mental models away from health care alone and toward the full range of factors that produce health and well-being.

External Resource

World Health Organization: Stewardship Resources

From the Field

01/01/2019

The World Health Organization has collected resources related to stewardship, with an emphasis on the health care sector.

ReThink Health’s Amplifying Stewardship Together project is an initiative of The Rippel Foundation, conducted with support from the Robert Wood Johnson Foundation (RWJF). The views expressed here do not necessarily reflect the views of RWJF.