Our progress

Creating A Learning Culture

The Process of Inquiry

A learning culture prioritizes the process of inquiry. Palm Health Foundation seeks to understand the influences impacting change rather than focusing solely on the measurable change itself. This process of inquiry is woven throughout the day-to-day practices and incorporates the Healthier Together communities, Palm Health Foundation staff, community investment committee and board of trustees as they evaluate success in the context of the social determinants of health.

Twice a year, project directors, foundation staff and members of the community investment committee, most of whom are trustees, come together for learning and reflection. Gatherings are grounded by shared purpose, transparency and exploration, which is made possible by the trust among the various people where power dynamics are addressed directly, and where the group models the participatory engagement principles mirrored in community settings.

Through these gatherings, a collective understanding about the changes this initiative is influencing, and can potentially influence, are identified. Underlying this understanding is a recognition that the Healthier Together work is complex adaptive work, and that the smallest adjustments, or “wins,” can be highly impactful shifts leading to major outcomes.

The measures weren’t so much moving the needle on diabetes, but having the organizations support each other so that all the social determinants of heath were improved for the most vulnerable in our community.


Throughout the Healthier Together initiative – from the early years to the middle years and beyond—the foundation recognized that the slightest shifts can have an important role in moving the work forward. These signals have been framed as “wins.”

There are three types of wins:

Outcome Wins
Outcome wins are actual results. The results can be related to leveraged funding or pinpointed by answering the question, “Who is better off?” at an individual or community level. Outcomes can be process or health-related outcomes.

Insight Wins
Insight wins include key learning, sometimes from failure, sometimes from research, and often times from day-to-day experiences from which patterns and signals may emerge. Insight wins help to clarify important issues.

Capability Wins
Capability wins are new skills or capacities that are developed among individuals and a group, and can include system or process enhancements as well.

What is the threshold for a win? It depends.

Examples of Healthier Together Wins

Outcome Wins

Palm Health Foundation secured a $240K grant from Florida Blue Foundation to train resident leaders to become certified Mental Health First Aid trainers. The funding has created long-term, self-sustaining impact by certifying trainers in each Healthier Togethercommunity to provide ongoing multi-lingual mental health education and provides for delivering the program to 2,000 residents.  Learn about how we made an impact in mental health in Palm Beach County’s Haitian communities.

Insight Wins

Two early adopters of the Healthier Lake Worth Beach initiative both decided at separate points to step away from the work. They were instrumental and highly effective in establishing the organizing infrastructure and found the reality of this messy, non-linear work to be outside their comfort zones. As they moved away from the work, it allowed emerging leaders who were comfortable with this phase of the work to step into new roles and provide leadership.

Capability Wins

Healthier Jupiter’s establishment of the mini-grants process and awarding eight recipients selected by the residents of the community enabled residents to pursue activities to improve the health and wellness of their neighborhoods. Read more about this win here.

Wins Questions to Consider

What accomplishments have been achieved to support the goals of your local initiative and the project overall? 

What specific progress has been made in areas that have been identified as strategic priorities? 

What specific progress has been made in areas that have been identified as challenges or barriers? 

What are significant milestones that have been reached demonstrating progress towards goals? 

How will these wins result in or help support positive outcomes for the initiative?

What are the significant results of the activities and processes conducted as they relate to the goals of the initiative, locally and on a larger scale? 

What significant milestones have been achieved as a result of these outcomes? 

How did the observed/experienced outcomes align with intended outcomes? 

What are significant unintended or unexpected outcomes that were a result of specific processes or activities? 

What are significant relevant outcomes that were not a result of specific processes or activities of the initiative?  

What significant lessons were learned, either by observation or experience, as project activities were carried out?

What significant lessons were learned, either by observation or experience, from the outcomes of those activities?

What was learned in particular from those outcomes which were either unintended or unexpected?

What was learned from outcomes that was not a result of a particular project activity or process?

How will these “wins” result in or help support positive outcomes for the initiative?

In what way(s) did a particular activity or process support skill-building?

In what way(s) did a particular activity or process support capacity building?

How did any changes in process support efficiency?

How does the development of this capacity and skill support the goals of the initiative locally and on a larger scale?

How will these “Wins” result in or help support positive outcomes for the initiative?

Reporting in a Learning Culture

Every six months, Healthier Together project directors submit community impact reports highlighting their wins over the half year and describing the changes they are seeing in their communities. Guiding their reports are results-based accountability questions which ask:

How much did we do? (Process Outcome)
How well did we do it? (Process Outcome)
Is anyone better off? (Outcome)

As Healthier Together aims to influence the conditions which hold health disparities in place, results-based accountability prioritizes the communities’ aspirational goals while providing a framework to structure the means to achieve the ends or to “turn the curve,” an indication that change is occurring.

Archived impact reports can be found on the Our Communities pages.

Utilizing Storytelling in a Learning Culture

In addition to a quarterly project-focused assessment using the Cynefin framework, the Healthier Together initiative is utilizing the storytelling platform SenseMaker®, an online storytelling collection tool with robust analytics where storytellers assign meaning to their own stories, and the community is invited to make sense of a collection of stories. With SenseMaker® we are able to see broadly, visualizing patterns across the narratives of wide and diverse populations, and at the same time gain intimate local insight from the individual experiences that people share in their contexts. The stories allow us to continually make adjustments in order to fan the themes and patterns the community would like to see more of and to dampen and minimize the themes and threads they would like to see less of. The foundation used SenseMaker® during the COVID-19 pandemic to aid in providing relief to those with urgent needs and as a data collection tool for current and future community health planning.

Learning is a Highly Dynamic Approach

Early in the initiative, we worked closely with a number of consultants to think through how to structure and develop our learning and evaluation approaches. Their insights and expertise ranged from highly participatory evaluation techniques to traditional impact data measures to systems level evaluation approaches. With each iteration—and as we continued to search for the most meaningful tools to guide our understanding of Healthier Together—our learning and evaluation has developed into a highly dynamic methodology honoring emergence over a goal-orientated, outcomes-driven data collection approach.