Leadership in Volunteer Multistakeholder Groups Tackling Complex Problems

This chapter explores distributed leadership in volunteer multistakeholder groups tackling complex problems, focusing on community organizing practices to bridge the gap between health and health care in Columbia, South Carolina. Columbia faces increasing chronic disease, high rates of uninsured, unequal access to healthcare services, and rising costs. Regional leaders periodically tackled these problems together but faced challenges common to multistakeholder groups. In 2010, leaders from Columbia partnered with the authors in a learning enterprise to find new, more sustainable ways to address these challenges. Together we adapted a community organizing approach to develop distributed leadership skills necessary to overcome the challenges of volunteer multistakeholder groups and transform the health system in a local area. In the first year, teams provided health screenings to over 1,000 residents; over 3,000 residents exercised leadership to improve community health; over 5,000 residents pledged to improve their health. Clinic hours were extended; new health coaches focused on primary care and wellness programs. Providers and payers committed to reinvesting a share of savings in the community, which has a voice in their use. We show that developing distributed leadership via community organizing offers an approach to solving seemingly intractable community problems.