Medical errors both in the U.S. and worldwide occur at alarming rates. In the U.S. medical errors were the third leading cause of death. Southwick experienced the consequences of preventable medical errors firsthand. As a physician and a professor, he researched and wrote about the causes and solutions for medical errors over the years. Southwick also launched pilot programs applying different quality improvement frameworks from other fields to medicine. Although the results were positive, he encountered resistance from many physicians. To build more skills, Southwick became an Advanced Leadership Fellow in 2010 and a Senior Advanced Leadership Fellow in 2011. He used his time at Harvard to develop solutions that would address the root causes of medical errors. The complexities in healthcare and the entrenched cultural norms presented strong barriers to creating change. The case explores Southwick's efforts in getting medical professionals to work collaboratively, communicate effectively, and create a new sustainable culture that improves healthcare outcomes. Southwick's experience raises the question of how one person can best make a difference in a large, complex, entrenched system.
Across the world, education remains the most powerful tool for improving the lives of women and girls. Important advances have been made in gender and education equality in the last several decades, but millions of girls continue to live without access to quality education and opportunities to develop personal agency. The United Nation's 2015 Sustainable Development Goals enshrine inclusive, equitable, and quality education and the empowerment of women and girls as a global focus for the next ten years. Facing this challenge, the 2016 Advanced Leadership Initiative Deep Dive on Education and Gender Equality at Harvard University identified both key strategies and outstanding challenges in the global fight for gender empowerment in education.
With Brazil's crisis as the backdrop, the 2016 ALI Fellows, Partners, and guests, traveled throughout São Paulo in June of 2016 and were exposed to social innovations in Heliopolis (the largest favela), the transformation of Vila Madalena (neighborhood), cultural inclusion efforts in Sala São Paulo and Pinacoteca (downtown), and highly respected social change leaders and thinkers throughout the trip. The participants were able to engage with a wide array of projects and understand the challenges on the ground more clearly.
Former law firm chairman/CEO Harvey Freishtat was actively involved in the formation of The Conversation Project, a national public engagement campaign to promote earlier end-of-life care discussions among loved ones and then with providers to ensure that end-of-life care wishes were both expressed and respected. The Conversation Project's media campaign and three-pronged strategy of targeting people where they live, work, and pray, was beginning to yield results. However, questions still remained. Would the health care industry create the mechanisms needed to follow people's end-of-life wishes? Was The Conversation Project taking the right steps to fulfill its mission of culture change?
Alberto Mora's time as General Counsel of the Navy from 2001 - 2006 greatly influenced his mission to illuminate the policy consequences of torture. Mora's drive to restore the nation's awareness and conscience against torture was gaining traction. Prominent stakeholders, including leaders in the military, government, NGOs and academia, supported his project. Moving forward, Mora knew that he still faced a number of critical challenges. What vehicles could he use to increase the project's reach and restore the nation's understanding of the costs and consequences of torture? How could he ensure that his project would survive the fluidity of public opinion? Perhaps most challenging, he had to collect meaningful data, which meant soliciting politically sensitive information.
Former Trader Joe's President Doug Rauch developed an innovative idea to address the challenge of food insecurity, food waste, and nutrition. His concept was a new retail grocery model, offering nutritious affordable food to a food insecure population in the inner city using excess inventory. His path was not an easy one, but by April 2015, Rauch was celebrating the upcoming launch of his Boston pilot and flagship store, Daily Table. Daily Table would be able to test its operating model and impact, better understand its customer base, and establish community partnerships. After further expansion to other sites in Boston, Daily Table planned to expand nationally. But there were questions about whether acceptance by one community would transfer to others and what could Rauch do to prepare himself and his team.
After a successful career as a superintendent of some of the nation's largest urban school districts, Carol Johnson elected to complete a Fellowship at Harvard's Advanced Leadership Initiative (2014). There, she hoped to gain perspective and knowledge surrounding how new superintendents of urban school districts could be better trained and supported in this challenging and dynamic role. Following her ALI Fellowship, Johnson created the Leadership for America's Urban Schools (LAUS), a proposed program that would provide mentorship, training, and networking for new urban school leaders.
As a veteran international development specialist, Vivian Lowery Derryck spent 35 years trying to influence governments in Africa by working with State Department and United States Agency for International Development (USAID) officials, African heads of state, and non-profit leaders across the continent. She believed the right outside pressure and expert collaboration could meaningfully shape U.S. foreign policy toward Africa and improve democracy in African governance. Derryck left her tenure as Senior Vice President and Director of Public-Private Partnerships at the former Academy for Educational Development (AED) and joined the inaugural Advanced Leadership Initiative Fellowship program at Harvard University. She thought it would be an ideal opportunity to build on a long-standing desire to start an institute to build African democracy and strengthen good governance on the continent. She launched the Bridges Institute to promote civil society as a pivotal actor in bringing about more inclusive and effective policy dialogue in Africa. This case follows her journey and raises important questions about how to achieve such large scale change.