Appreciative Inquiry

Utilizing Appreciative Inquiry in Health Care
​By: Caroline Carter, Chief Transformation Officer, HC


As Chief Transformation Officer at the Healthcare Collaborative of Greater Columbus, exploring change management approaches for organizational growth and development is a crucial part of the job. One of my preferred approaches to change management at the organizational level is Appreciative Inquiry (AI). My affinity to AI is the focus on positive psychology and strengths, and the intentional engagement of diverse people/roles/stakeholders’ contributions. The AI philosophy is that in every organization something works, and change can be managed through the identification of what works, and the visioning of where the organization wants to be - its preferred state. Participants walk away from an AI experience with a sense of commitment, confidence, and affirmation that they have been successful. They know how to make more moments of success.

This past summer, I was invited to be a guest speaker for Dr. Laura Santurri’s (Ph.D., MPH, CPH) doctoral level students, in their course on Management in Healthcare at the University of Indianapolis. I was able to discuss and share my experience designing and facilitating AI Summits.

I engaged in rich dialogue with the students, discussing the benefits of using AI as a change management technique. I shared stories and examples of my experiences using AI, particularly in health care settings. The traditional approach to change looks for the problem, and then attempts to find a solution. When we look for the problem, we find it and amplify it. We have little mental energy to focus on creativity and innovation. No judgement here, we are taught this approach from a very young age. And to be honest, it is sometimes the right approach - but not always. AI differs from the traditional change model in that it is future focused, and strengths based. AI starts where you are, that is your baseline, and identifies where you want to get to, and you work towards that goal, so you end up far beyond your baseline where you started.

After receiving my Certificate in Appreciative Inquiry from Case Western Reserve University in Cleveland, Ohio, I continued facilitating AI trainings and workshops across a variety of industries, including; healthcare, education, manufacturing, and innovation and technology. In 2007 I was published in the peer-reviewed journal Quality Management in Health Care, writing ‘An Appreciative Inquiry Approach to Practice Improvement and Transformative Change in Health Care Settings. I continue to use AI because it works well for system level change for organization transformation, and engages a myriad of voices and contributions.

AI assesses the assets and strengths that have been successful so far, and focuses on how an organization can continue to utilize those strengths to maximize success. This approach helps to envision results by capturing and portraying attractive images of the ideal and preferred future, which allows the team to then identify and create actionable steps to move the practice toward that ideal image. After the action plans have been implemented, the team can share their best practices and celebrate success.

I’ve had the opportunity to perform AI with HCGC both at the board and community level. In Spring of 2019, I was honored to lead a group of about 100 participatory stakeholders in an HCGC regional learning session through the AI process. The question explored was: “What is the ideal state of health and healthcare in the Central Ohio region?” - a question of possibilities. Visualizations were created in breakout groups, and the full group came back together to share their images of the ‘preferred state’ and discuss what it would take to create real change based on their visions of the future. The most inspiring thing happened when the room full of stakeholders from different (some competing) health systems, payors, and consumer backgrounds came to a uniform realization: we must, as a region of diverse stakeholders, share our data to improve the health and healthcare experience for all people in the Columbus region. These conversations spurred new and exciting partnerships and collaborations that have, in part, contributed to the culture of data sharing, utilization, and visualization to make informed and equitable decisions to contribute to the healthcare landscape in the region. HCGC feels strongly that going on an AI journey at that place and time contributed to our ability to be impactful partners in the COVID-19 pandemic response in central Ohio, as well as other important public health initiatives. Providing a safe, neutral space for stakeholders to come together and co-create the possibilities fostered an environment of inclusivity and collaboration that is still positively impacting our work today.

We will continue to find AI opportunities as we work to strengthen our organization at the staff, board, and community level. We look forward to continuing to engage partners in the community.

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