6Creating a Sense of Ownership
 

Creating	a	sense	of	ownership	is	essential	 

to	building	and	sustaining	productive	TB	 

partnerships.	This	chapter	describes	three	steps	that	 

can	help	you	create	a	sense	of	ownership	among	 

partners;	these	steps	also	help	you	ensure	that	the	 

partnership	is	productive	and	enjoyable. 

Three Steps for Creating 

Partner Ownership 

1. Creating your partnership’s culture 

2. Consistently sharing information 

3. Creating a common vision 

		 

Step 1: Create Your Partnership’s Culture 

You	can	create	a	culture	of	trust	and	respect	that	all	partners	work	to	maintain.	 

Research Suggests 

Partnerships	are	more	successful	when	 

partners	create	a	culture	that	encourages	 

open	communication,	mutual	respect,	 

and	concern	for	the	interests	of	others.	 

The	ability	to	develop	this	culture	 

appears	dependent	upon	partners	 

establishing	standards	of	conduct.		 

These	standards	help	partners	to: 

•	 Openly	share	information	 

•	 Surface	and	explore	diverse	 

perspectives 

•	 Develop	trust	and	cooperation	 

•	 Work	through	differences	 

•	 Increase	perceptions	that	the	 

partnership	is	enjoyable	and	 

productive	 

Examples	of	standards	of	conduct	 

include: 

Establishing Standards of Conduct— 

The Process is Key 

The process for identifying standards of 

conduct (ground rules) is as important as the 

standards themselves. 

• Introduce the concept at a meeting by 

discussing the potential benefits to partners 

and the work of the group. 

• Inform partners well in advance of the 

proposed discussion date. Prior notice 

increases comfort level, allows partners time 

to develop proposals, and permits them 

to gather suggestions from others in their 

organizations and/or communities. 

• Consider the adage “people support 

what they help to create.” Have members 

brainstorm and generate their own list 

of ideas. After brainstorming, the group 

can review the standards of conduct and 

determine which ones to adopt. 

•	 Open	and	honest	communication	and	information	sharing	 

•	 Valuing	the	views	and	perspectives	of	others 

•	 Understanding	and	respecting	cultural	differences		 

•	 Seeking	win-win	solutions	when	differences	arise 

•	 Using	open	and	fair	decisionmaking	processes 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 4 

Chapter : Creating a Sense of Ownership 
Tips and Strategies 

•	 When	partnerships	include	diverse	members,	it	is	important	to	understand	 

and	honor	cultural	differences	associated	with	identifying	and	implementing	 

standards	of	conduct.	For	instance,	in	some	cultures	respectful	communication	 

requires	expressing	differences	directly	in	a	one-on-one	setting,	rather	than	in	a	 

group	setting.	 

•	 Existing	partnerships	may	have	informally	established	their	ground	rules	or	 

standards	of	conduct	over	time.	In	these	instances,	identifying	and	formalizing	 

these	standards	can	help	to	ensure	they	are	incorporated	into	your	partnership	 

recruiting	process.	 

•	 Have	partners	establish	ground	rules	or	standards	of	conduct	early	in	the	
 

partnership.
 

•	 When	partners	do	not	have	a	history	of	trust	and	positive	working	relationships,	 

it	is	helpful	to	make	“Establishing	Ground	Rules”	an	agenda	item	at	your	first	 

partnership	meeting.	When	all	partners	participate	in	creating	and	adopting	 

these	principles,	they	are	more	likely	to	own	them	throughout	the	life	of	the	 

partnership.	This	sense	of	ownership	ensures	that	when	differences	arise	in	the	 

partnership,	they	are	handled	in	ways	that	do	not	damage	the	spirit	or	the	work	 

of	the	partnership.	 

•	 When	recruiting	new	partners,	include	a	discussion	of	the	partnership’s	culture	 

and	ground	rules	in	the	orientation	process.	 

•	 It	is	often	helpful	to	review	the	standards	of	conduct	at	least	annually	to	ensure	 

they	are	being	honored	and	to	amend	them	as	appropriate. 

Step 2: Consistently Share Information 

After	you	have	established	a	commitment	to	openness	and	respect,	the	partnership	 

can	begin	to	create	a	common	understanding	of	the	TB	issues	they	are	charged	with	 

addressing.	 

Research Suggests 

High-performance	partnerships	conduct	extensive,	honest,	and	ongoing	information	 

sharing.	Leaders	use	information	sharing	as	a	tool	to	develop	a	common	 

understanding	of	the	complex	health-related	issues	the	partnership	is	charged	with	 

addressing,	as	well	as	to	identify	the	assets	and	barriers	that	can	impact	their	efforts.	 

This	common	understanding	is	a	significant	precursor	to	multisector	partnerships	 

working	effectively.	 

4 Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 

Chapter : Creating a Sense of Ownership 
Some	of	the	benefits	of	extensive	and	ongoing	information	sharing	can	be	categorized	 

as	follows:	 

•	 Reduction	in	conflicts	and	disagreements	caused	by	unrealistic	expectations,	 

inaccurate	information,	and	lack	of	trust	 

•	 Increased	ability	to	focus	on	issues	and	actions	that	will	significantly	improve	TB	 

prevention	and	control	outcomes	 

Tips and Strategies 

It	is	important	to	acknowledge	your	TB	program’s	current	limitations	and	service	 

gaps.	When	you	share	the	challenges	your	TB	program	faces,	partners	are	more	likely	 

to	take	responsibility	for	working	with	you	to	solve	these	problems.	 

The	TB	information	that	seems	to	be	the	most	important	for	all	partners	to	 

understand	can	be	categorized	as	follows: 

Transmission	and	pathogenesis	of	TB 

•	 Epidemiology	of	TB	in	your	program	area	 

•	 Stigma,	language,	and	cultural	issues	that	impact	TB	prevention	and	control	 

•	 State	rules	and	regulations	governing	TB	prevention	and	control	efforts	and	how	 

they	were	established 

•	 Comparison	of	your	TB	program	objectives	and	outcomes	to	national	TB	 

objectives	and	priorities 

•	 Current	TB	prevention	and	control	strategies	and	practices,	as	well	as	how	and	 

why	they	were	chosen		 

•	 Resources	currently	designated	for	TB	prevention	and	control	in	your	area 

•	 Potential	impact	of	strengthened	TB	prevention	and	control	activities	on	TB	 

stakeholders 

Things to Keep in Mind 

•	 Having	a	common	understanding	is	not	the	same	as	agreeing	on	individual	issues;	 

instead,	it	is	a	shared	awareness	of	the	variety	of	perspectives,	concerns,	and	 

factors	impacting	the	situation.	 

•	 If	partners	make	critical	comments	about	your	TB	program	or	its	past	efforts,	 

try	not	to	take	the	comments	personally.	Instead,	you	might	respond	with	a	 

comment	that	TB	programs	and	services	need	to	improve	and	that	it	will	take	the	 

commitment	of	all	partners	to	make	this	happen.	 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 4 

Chapter : Creating a Sense of Ownership 
•	 Before	tackling	difficult	issues,	set	a	cooperative	tone	by	acknowledging	the: 

-	 Partnership’s	ground	rules	or	standards	of	conduct 

-	 Complexity	of	the	issue(s)	being	addressed	 

-	 Importance	of	every	partner	to	the	success	of	the	partnership 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 

Chapter : Creating a Sense of Ownership 

44 
 Two Approaches to Information Sharing in Partnerships 

Tell and Sell 

Description	 This communication style emphasizes a perceived expert sharing a limited set of 

predetermined messages on a given topic or issue, followed by selling listeners on 

the importance of the information and perspectives presented. Little time is allotted 

for dialogue or feedback. 

Risks	 This style has limited success in partnerships with diverse members. Partners may 

feel that their views and perspectives are not valued, which may lead to cynicism 

and a decline in their commitment to the partnership. In turn, partners may fail to 

believe or value the information presented. 

Benefits	 The Tell and Sell approach can be useful when addressing issues of minimal 

importance to all partners and thus do not merit an in depth discussion. 

Source: Clampitt, P. G., R. J. DeKoch, and T. A. Cashman. 2000. A strategy for communicating 

about uncertainty. Academy of Management Executives 14:4. 

Communicate and Explore 

Description	 This communication style emphasizes participation. Partners provide feedback 

on the type and scope of information they would like to receive on a given topic 

or issue. Partners’ expertise on various aspects of the topic is identified. At the 

following partnership meeting, several partners provide information on the topic 

to the group. Presenters agree in advance to share information as objectively as 

possible, without expressing their opinions. A facilitator then encourages 

discussion that explores and clarifies the varying perspectives and perceptions, 

placing special emphasis on differences that are likely to impact the partnership’s 

future work. These perspectives are categorized into common themes and 

partners determine whether additional information and exploration is appropriate. 

The goal of this communication style is to surface, respectfully explore, and 

more fully understand the factors impacting complex TB problems. This style is 

particularly helpful when TB partners are from diverse sectors and cultures. 

Risks	 For this communication style to be effective, partners must communicate openly 

and without defensiveness. In the absence of a qualified facilitator, this may not 

be possible. In addition, poor facilitation may cause information to be inaccurately 

summarized and opportunities to create a common understanding of complex 

issues may be missed. This approach has limited success when partners with 

valuable insights are not comfortable expressing themselves in a group setting. 

Thus, it is important to speak individually with partners to assess their comfort 

level and to design additional information-sharing channels as needed. Creating 

these channels may be as simple as developing trust with these partners and 

contacting them personally to gain their insights and perspectives. These partners 

can then work with you to determine how best to incorporate their perspectives 

into the group discussion. Conducting anonymous surveys of partners and 

exploring the resulting information at a meeting have also proven useful. 

Benefits	 The Communicate and Explore approach promotes the sharing of a wide variety 

of ideas and perspectives in a short period of time. This approach allows partners 

to develop a more thorough understanding of complex issues. 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 4 

Chapter : Creating a Sense of Ownership
Step 3: Create a Common Vision 

Information	sharing	helps	partners	create	a	common	understanding	of	“where	we	 

are	right	now.”	The	process	of	creating	a	common	vision	helps	partners	commit	to	a	 

common	understanding	of	“where	we	would	like	to	be.”	This	shared	vision	of	a	desired	 

future	will	help	partners	to	stay	focused,	productive,	and	inspired,	even	in	the	toughest	 

of	times.	 

Research Suggests 

Reflections from a TB Partner A	compelling,	shared	vision	 “When I joined, people were sharing what they serves	as	a	unifying	force	 were doing, but there was no real coordination when	partners	recruit	and	 amongst the partners. We needed to define a common 

orient	new	members,	speak	in	 vision--the reason we were all inspired and willing to 

expend our time, energy and resources. Not everyone public,	undertake	short-	and	 was excited about this. We took a novel approach to long-term	planning	processes,	 get energized by watching a short video, ‘The Deep 

make	decisions,	and	address	 Dive’ from an ABC Nightline segment. It demonstrated 

differences	that	arise	among	 what can be accomplished when people from diverse

backgrounds bring their skills and perspectives to partners.	A	compelling	vision	 the table. The video is all about how to create truly 

is	not	the	same	as	a	mission	 novel solutions and integrate the best ones into a final 

statement,	which	describes	the	 extraordinary product. 

“We used this approach to develop our own vision purpose	of	the	partnership.	 to eliminate tuberculosis. Our vision has given us a Rather,	it	is	a	vivid	and	inspiring	 sense of ownership and unity of purpose. Now we 

description	of	a	desired	future.	 are all moving in the same direction, but with different 

people working on different components. Once we 

had the vision, we had a whole lot more commitment A	compelling	vision and excitement. People didn’t feel like they were 

•	 Is	easy	to	understand	and	 floundering.”
 

remember
 

•	 Is	tangible	and	executable,	yet	stretches	far	beyond	what	is	currently	being	done	 

•	 Has	a	time	limit,	usually	5	to	10	years	into	the	future 

A	compelling	vision	will	help 

•	 Illuminate	the	most	direct	path	from	where	your	TB	prevention	and	control	 

efforts	are	today	to	where	you	would	like	them	to	be	 

•	 Inspire	partners	to	focus	on	activities	that	cause	the	greatest	strides	in	TB	
 

prevention	and	control	
 

•	 Serve	as	a	catalyst	for	team	spirit,	inspiring	enthusiasm	and	commitment	among	 

members	 

•	 Enhance	partners’	desire	to	solve	problems	associated	with	realizing	the	vision 

•	 Minimize	the	conflicts	that	arise	among	partners	 

4 Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 

Chapter : Creating a Sense of Ownership 
In	addition	(see	Chapter	3:	What Successful Health-Related Community Partnerships 

Have in Common),	effective	partnership	visions	encompass	all	four	of	the	following	 

principles:	 

•	 Active	involvement	of	multiple	and	diverse	stakeholders	in	the	identification,	 

prioritization,	and	implementation	of	partnership	goals,	objectives,	and	activities;	 

•	 A	focus	on	community	health,	not	just	the	treatment	of	individual	patients; 

•	 Implementation	mechanisms	that	facilitate	and	coordinate	service	delivery	to	 

the	most	appropriate	recipients,	at	the	most	appropriate	times,	and	in	the	most	 

appropriate	settings;	and 

•	 Effective	use	of	limited	resources	by	providing	the	most	efficient	services	possible. 

Not	observing	these	four	principles	will	severely	limit	partnership	productivity.	42 

Tips and Strategies 

•	 The	visioning	process	is	most	beneficial	to	partnerships	when	all	partners	 

participate. 

•	 Your	visioning	process	needs	to	acknowledge	and	address	the	stigma,	language,	 

and	cultural	issues	impacting	TB	prevention	and	control. 

•	 Use	a	clearly	defined	process	to	develop	the	vision,	such	as	the	one	below: 

Creating a common vision among partners—a sample approach 

1.	 Review the purpose of the partnership and remind all partners that their perspectives 

and input are essential for this purpose to be achieved. 

2.	 Have partners brainstorm about the limitations and barriers that exist to realizing this 

purpose. 

3.	 With the group, categorize the barriers into three to five common themes or areas, 

such as: 

- Screening, diagnosis, and treatment 

- Patient care 

- Education and outreach 


- Funding and resources
 

4.	 Review the themes to determine whether any significant categories or barriers have 

been omitted. 

5.	 Brainstorm what you would like each category to look like in 5 to 10 years, being as 

specific as possible. 

6.	 Write a summary of the resulting vision for review and adoption by the group. 

42Shortell	et	al.,	3.;	Israel	et	al.,	186. 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 4 

Chapter : Creating a Sense of Ownership 
The Vision: A Guide for Effective Action 

A	shared	vision	tends	to	inspire	partners	to	focus	on	identifying	the	goals,	strategies,	 

objectives,	projects,	and	activities	most	likely	to	accomplish	their	vision.	 

A	number	of	organizational	theorists	believe	that	it	is	important	for	action	planning	 

processes	to	build	upon	current	successes	and	available	resources.43	Following	is	one	such	 

approach	for	moving	from	vision	to	effective	action.44 

For	each	category	identified	in	Step	3	of	the	sample	process	above,	ask	the	following	 

questions,	encouraging	input,	discussion,	and	feedback	from	all	partners	as	you	go: 

•	 What	specifically	 Moving from Overall Goals to Effective Action are	we	already	doing	 

well	that	is	moving	 Goals describe the overall mission of the partnership. They 

are broad, general statements that clearly portray general us	toward	our	vision?	 improvements you wish to make. 

What	specifically	 Sample Goal: Increase TB awareness among physicians 

makes	it	work?	 treating high-risk populations. 

Strategies are the approaches you will use to accomplish your Skills?	Resources?	 

goals. Attitudes?	Structures?	 Sample Strategy: Work with associations of physicians Approaches? (such as hospital emergency department physicians), 

medical directors of communities serving high-risk •	 How	and	where	can	 populations, and respected leaders of these same

we	do	more	of	this?	 populations to develop a TB training session. 

What	added	skills	and	 Objectives state the expected result. They are the specific, 

measurable, attainable, realistic, and time-framed (SMART) resources	could	help	 outcomes that are partial accomplishments of the goal. (See the us	accomplish	more?	 Planning With Partners Worksheet in the Toolkit). 

Where	and	how	can	we	 Sample of a SMART Objective: Upon completion of the 

access	them?	 2-hour training session, participants will be able to identify 

three TB stigmas common to their high-risk populations and 

•	 What	can	we	do	better	 three strategies for minimizing these stigmas. 

or	differently?	What	 Activities are specific actions or procedures that are expected to 

occur in order to meet the objectives. skills	and	resources	do	 

Sample Activity: Leaders of high-risk populations will be we	have	to	accomplish	 identified to attend the training session. 

this?	What	added	skills	
 

and	resources	do	we	need?	Where	and	how	can	we	access	them?	
 

Answering	each	of	the	above	questions	helps	the	partnership	identify	the	work	that	needs	 

to	be	done.	At	this	stage,	it	is	helpful	for	the	partnership	to:	 

•	 Review	the	answers	to	the	above	questions	to	identify	potential	partnership	goals,	 

strategies,	objectives,	projects,	and	activities.	 

43Oakley	E,	Krug	D.	1991.	Enlightened leadership: Getting to the Heart of Change, 96–121.	New	York:	Simon	and	Schuster. 44Ibid. 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 

Chapter : Creating a Sense of Ownership 

48 
 

•	 Discuss,	write,	and	prioritize	the	goals,	strategies,	objectives,	and	activities	that	are	 

likely	to	have	the	most	impact	on	your	vision.	(See Chapter	16: Toolkit, “How to 

Write SMART Objectives Checklist” to	help	you	in	writing	SMART	objectives.)	 

•	 Explore	partnership	structures	and	decisionmaking	styles	that	will	help	you	 

determine	next	steps,	which	partners	are	willing	to	work	on	these	steps,	when	the	 

steps	will	be	undertaken,	and	how	information	will	be	shared	with	the	group.	(See	 

Chapter	7:	Making Progress and Making Decisions.)	 

Things to Keep in Mind 

•	 The	vision	is	not	merely	a	document;	it	is	the	guiding	force	that	partnership	 

leaders	consistently	use	to	motivate,	unify,	and	inspire	partners	throughout	the	 

life	of	the	partnership.	 

•	 Effective	leaders	ensure	partners	discuss	priorities,	possible	projects,	and	decisions	 

in	terms	of	their	impact	on	the	vision.	 

•	 When	brainstorming,	make	sure	you	put	all	ideas	on	the	table,	especially	the	 

untried,	unique,	and	novel	ones. 

•	 Be	alert	to	partnership	discussions	or	disagreements	that	become	“either/or”	 

focused.	See	if	a	“both/and”	approach	might	solve	the	problem.	For	instance,	 

if	half	the	group	wants	to	work	on	one	project	and	the	other	half	on	another,	 

perhaps	partners	can	commit	to	undertaking	both	projects. 

By	following	the	steps	outlined	in	this	chapter,	partnership	leaders	can	create	an	 

environment	that	fosters	cooperation	and	productivity. 

Related Resources 

•	 TB-Educate	 

This	is	an	e-mail	listserv	through	which	hundreds	of	health	professionals	from	across	 

the	country	and	around	the	world	exchange	information,	share	experiences,	and	ask	 

TB	education	and	training	questions.	Subscribe	to	the	listserv	at		 

www.cdcnpin.org/scripts/subscribe.asp#tb.	 

•	 TB Notes Newsletter 

This	CDC	quarterly	newsletter	contains	news	about	the	CDC’s	Division	of	 

Tuberculosis	Elimination	activities	and	highlights	from	state	and	local	TB	programs	 

across	the	country.	It	also	contains	a	calendar	of	events	describing	meetings,	 

conferences,	and	other	educational	activities	of	potential	interest	to	those	working	in	 

TB.	Access	the	newsletter	at	www.cdc.gov/tb/notes/notes.htm. 

Forging Partnerships to Eliminate Tuberculosis: A Guide and Toolkit 4 

Chapter : Creating a Sense of Ownership