The 2018 cohort of Sciana: The Health Leaders Network taking a group photo. Photo by Salzburg Global Seminar/Katrin Kerschbaumer

The Sciana Challenge - Planning the next steps forward


Eighteen health leaders from across Europe have outlined the building blocks of a new challenge that will set the groundwork for their activities over the next two years.

Members of the 2018 Sciana cohort have worked together to produce a Sciana Challenge, a statement which outlines priority areas for the cohort to explore.

The document is split up into four areas: context and purpose; the core - leadership; priority challenges to explore; and impact and politics.

The context and purpose, which will be regularly reviewed at future meetings, states: “What are the dimensions and indicators of a sustainable and resilient health system in a complex, ageing, and increasingly diverse society?”

Meanwhile, at the core level, members are asked to consider: How can we as leaders accelerate purposeful improvement in complex systems?

Upon receiving feedback from members, three priority challenges were identified. A strong focus on community, people, places, and co-production emerged. The three challenges are:

1. How do we build capacity for health and well-being for people and places, considering the specificity of urban and rural settings?

2.How does the interaction between digital transformation and human factor change the health system and affect well-being?

3. How do we develop and implement service delivery models based on co-production with full involvement of communities?

During the meeting, members raised questions about the role of the politicians when implementing change and innovation in health and health care. To reflect this in the Sciana Challenge, the question is posed: How do we implement change and innovation in view of the diverse and often competing interests in the political arena through relationships and engagement of many stakeholders and influencers?

The final revisions to the Challenge were revealed on Tuesday morning after members of the second cohort took part in a knowledge exchange event. The purpose of this exercise was to enable each member to offer a skill or service to others and ask for help to achieve their own objectives.

Members offered advice such as how to lead directors with limited knowledge of business, experience regarding incentives, and expertise in relationship-based models of care. Others, meanwhile, offered their experience in policymaking at a European Union level or their experience in education and workforce development.

A mix of questions was put forward by members who sought assistance to achieve their individual objectives. One member was seeking a better understanding of issues in environmental and refugee health, while another asked how health care professionals could receive more support from artificial intelligence and virtual reality tools.

Before the arrival of the 2017 Sciana cohort, the 2018 recruits discussed their next steps and the resources necessary to support the development of projects between meetings.

One working group revealed they had identified two population groups to focus on. One group includes families, children and young people. The other focuses on those lonely and socially isolated. Members looked at the issue through three lenses: How do we organise people? How do we organise structure, particularly at an urban level? How do we organise so that we have successful policy implementation?

Members discussed first collecting positive and negative examples of practice before moving into fieldwork. Another working group asked whether members of the cohort could launch pilot projects on transformation within their own organisations.

To bring others on board, a story might have to be devised. One member described how important it was to communicate Sciana and the work taking place to others within their systems. This could be a useful way to expand collaboration and raise awareness of the issues being discussed.

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