Overview / Executive Summary

Client Name & Industry: Community Health Centers – Burlington (CHC-Burlington), Community Health / Federally Qualified Health Centers (FQHCs)

Engagement Focus: Strategic Planning, Culture Building, Leadership Development

Location: Burlington, VT

Third River Certifications/Tools Used

• Appreciative Inquiry Facilitation

• Strategic Plan Execution Design

• Positive Creativity Model

Timeframe

2023 - 2024

Top-Level Results or Transformation

• A 4-month process start to launch

• 80+ employees, 14 community partners, and 9 board members engaged

• 5 pillar-based implementation teams launchedwith tracking, timelines, and reporting

• Stronger buy-in and early momentumcompared to past planning efforts

• Greater cross-functional collaborationand leadership development

• Cultural lift: more trust, optimism, and agency across the organization

Client Background

Community Health Centers–Burlington (CHC) is Vermont’s first and largest Federally Qualified Health Center. Since 1977, CHC has delivered primary care, dental, mental health, and substance use disorder services to residents regardless of income, insurance, or housing status.

CHC’s service model integrates trauma-informed care, whole-person healing, and social determinants of health. In 2024, the organization served over 35,000 patients across 165,000 visits through a team of nearly 350 staff members at nine locations.

With a diverse payer mix and participation in Vermont’s All-Payer ACO, CHC operates in a fast-changing healthcare environment. The organization’s leaders knew they needed a fresh planning approach. One that wouldn’t just check strategic boxes, but would bring people together across roles and spark a collective sense of agency and excitement.

The Challenge

Like many mission-driven organizations, Community Health Centers–Burlington had a long history of strategic planning. But previous efforts often followed a familiar, top-down pattern: leadership would shape the goals, draft the plan, and cascade it out to the rest of the organization. The outcome? Plans that felt disconnected from the day-to-day realities of front-line teams, uneven implementation, and little long-term engagement.

Staff and board members alike had started to associate strategic planning with significant time commitments, limited influence, and unclear benefits. Leaders described earlier processes as well-meaning but exhausting, leaving people more drained than energized.

At the same time, the stakes were rising. CHC was growing in size and complexity, operating in an evolving regulatory environment, and participating in state-level health transformation initiatives. Without a clear and actionable strategic plan, the organization risked:

• Fragmentation across clinical and operational departments

• Duplication of effort and missed opportunities for synergy

• Overwhelm from competing initiatives and unclear priorities

• Burnout among leaders asked to deliver on “too many top goals” with too few resources

Adding to the complexity, the board had requested a new three-year strategic plan to be completed within just four months. This meant that any planning process would need to be swift, inclusive, and actionable, without exacerbating the existing sense of fatigue.

CHC leadership understood that this wasn’t just about producing a plan on deadline. It was about designing a process that would build trust, strengthen relationships, and energize the organization, while still delivering a disciplined, accountable strategy.

They needed a model that could deliver alignment with velocity—and do it in a way that felt like a cultural win, not a political or operational burden.

Our Approach

To meet its ambitious timeline and cultural aspirations, CHC engaged a cross-functional facilitation team that brought together deep expertise in healthcare transformation, strategic planning, and change leadership. Led by Kim Marie McKernan (Inspired Outcomes Now), Terry Fulcher, and Mike McCormick (Third River Partners), the team introduced a distinctive methodology called Positive Creativity – i.e., a model designed to move organizations from burnout and bureaucracy to clarity, alignment, and energy. The Positive Creativity model blends three critical elements:

1. Appreciative Inquiry (AI) as the Operating System

Rather than focusing on problems to be solved, AI focuses on the strengths, stories, and aspirations already alive in the organization. Through appreciative interviews, inquiry prompts, and collaborative design sessions, teams explored questions like:

• “When are we at our best?”

• “What do we want to preserve as we grow?”

• “What would success look like if we got this right, together?”

These questions grounded the process in hope, agency, and respect, helping CHC shift from a reactive mindset to a generative one.

2. Creativity Tools as the Applications

To complement the strength-based lens of AI, the facilitation team introduced accessible, energizing tools from creativity science. These included:

• “Problem to Opportunity Trees”, which reframed frustrations into future-forward possibilities

• Success Zone Mapping, which helped identify where CHC was already making progress and where gaps remained

• Play-based ideation, including visual metaphors and low-stakes collaboration exercises to lower hierarchy and increase innovation

These tools brought fun, speed, and cross-functional insight to what is often a stiff, linear process.

3. Strategic Planning Best Practices

To ensure structure and discipline, the team employed the SOAR framework (Strengths, Opportunities, Aspirations, Results), in place of traditional SWOT analysis. This kept the focus on what CHC could leverage and build, not what it feared or lacked.

The team also introduced planning rigor through the use of templates, decision filters, and layered facilitation. Third River Partners acted as the strategic integrator, ensuring that insights from numerous sessions were translated into a coherent and focused strategic architecture.

Stakeholder Engagement at Every Level

A critical feature of the approach was its intentionally broad and distributed engagement strategy, including:

• A 12-member internal planning core team, trained and empowered to conduct small-group sessions across departments, sites, and roles

• One-on-one interviews with 14 external community and system partners

• Board and executive visioning sessions, ensuring governance input was embedded early and often

• A culminating two-day off-site retreat, where more than 40 staff, board, and community representatives collaboratively drafted the plan’s strategic framework

In all, more than 120 people across the ecosystem directly shaped the strategic direction, not just in theory, but in concrete actions and priorities.

Visual Communication and Knowledge Transfer

Throughout the process, the team emphasized visual thinking and strategic storytelling. Instead of dense documents, participants were engaged with:

• Colorful graphic templates

• Metaphorical planning wheels and filters

• Large-format idea walls and decision boards

• Summary maps that captured the emerging plan in intuitive, accessible formats

These tools made complex ideas feel usable and ensured that teams didn’t just understand the plan but saw themselves in it.

Third River’s Role in Alignment and Execution Design

As the strategy co-lead, Third River Partners provided the critical connective tissue between creative insight and implementation architecture. This included:

• Designing the five strategic pillars and assigning ownership

• Creating templates for implementation tracking, sponsor reporting, and initiative filtering

• Coaching CHC’s executive and HR leaders on embedding the plan into regular rhythms and reviews

• Ensuring each strategic element translated into workable structures, decision rights, and accountability tools

The end result was a plan that was not only co-created but also co-owned, with a clear pathway for momentum, measurement, and cultural reinforcement.

Implementation

At the conclusion of the planning retreat, Community Health Centers–Burlington emerged with a shared vision, but leaders knew that the real test would be implementation. The difference this time: the strategy wasn’t handed off to a separate “planning office” or stored in a binder. Instead, it was structured to live in the day-to-day operations of the organization, with clarity, ownership, and accountability baked in from the beginning.

Five Strategic Pillars anchored the plan, each linked to a central area of CHC’s long-term success. These pillars were not abstract themes. They were chosen and defined through staff and partner input and translated into a concrete set of near-term actions and future-focused aspirations.

1. Sponsorship and Team Formation

Each pillar was assigned a senior leader sponsor, responsible for activating and stewarding progress. These sponsors:

• Recruited diverse cross-functional implementation teams, including emerging leaders and frontline staff

• Convened regular planning huddles or working groups, weekly in the early phases, shifting to bi-weekly as efforts stabilized

• Ensured alignment with ongoing projects and initiatives, reducing redundancy and respecting capacity

• Partnered with HR and executive leadership to surface roadblocks, clarify decision rights, and celebrate early wins

Rather than creating new layers of bureaucracy, implementation teams were designed to build on existing momentum and integrate seamlessly with current workflows.

2. Rhythms of Accountability

To prevent the plan from losing energy over time (a common challenge in nonprofit environments), CHC and Third River co-designed an accountability rhythm that was lightweight but consistent:

• Monthly sponsor reports to the executive leadership team and board, focused on progress, risks, and next steps

• Quarterly pillar team reviews, which served as learning loops to adjust timelines, reallocate resources, or pivot strategies as needed

• A strategic plan dashboard, accessible internally, tracking initiatives against milestones

This rhythm helped reinforce that the strategic plan was not a side project. It was how CHC did its work, week by week.

3. Tools to Reinforce Focus and Clarity

Recognizing that CHC operates in a fast-moving healthcare environment, the facilitation team introduced a simple but powerful Strategic Alignment Filter. This decision-making tool gave teams a quick way to assess:

• Does this new idea align with one of our five pillars?

• Is it supported by data or community voice?

• Are the capacity and sponsorship in place to act on it?

This filter reduced ambiguity and helped CHC leaders say “no” to low-impact distractions, without creating bureaucratic hurdles.

Additionally, each implementation team used a shared set of planning templates and reporting tools, created in collaboration with Third River, to ensure clarity, consistency, and visibility across pillars.

4. Communication and Cultural Visibility

One of the most significant implementation wins was the visibility of the plan inside the organization. Many CHC staff reported that, for the first time, a strategic plan felt present in their daily work.

To support this cultural visibility, CHC leveraged:

• Town hall events and team huddles, where leaders shared updates and invited reflection

• Visually designed pillar posters and metaphors, hung in common spaces across sites

• Strategic storytelling during leadership meetings, highlighting team contributions and lessons learned

• Simple language in internal memos and materials, ensuring the plan was understandable and relatable, not corporate jargon

The cultural tone of implementation mirrored the planning process: human-centered, hopeful, and built on mutual trust.

5. Third River’s Role in Sustaining Momentum

Beyond facilitation, Third River Partners remained engaged during early implementation to coach sponsors, troubleshoot bottlenecks, and reinforce habits of disciplined follow-through. Their contributions included:

• Facilitation of sponsor strategy sessions

• Alignment support between pillars and operational planning cycles

• Mid-course evaluations to recalibrate timelines and clarify KPIs

• Equipping HR and OD leads to embedding the plan into performance conversations and onboarding

This “embedded strategic partnership” ensured that implementation wasn’t just about checking boxes. It was about building muscle memory for future adaptive planning.

The Results

CHC–Burlington didn’t just finish a strategic plan. They changed the way planning and alignment happened across the organization. What once felt like a burdensome, top-down process became a source of pride, energy, and shared ownership. From planning through early implementation, results were measurable, meaningful, and widely felt.

Staff at all levels used the same words to describe the experience: “energizing,” “clear,” “efficient,” and “hopeful.” The outcomes went far beyond paper deliverables. There was visible momentum in how leaders engaged, how teams aligned, and how strategy turned into coordinated action.

Quantitative Results:

• 120+ people engaged across roles, including over 80 staff, 14 community partners, and 9 board members – One of the most inclusive planning processes in CHC’s history

• Strategic plan completed in 4 months, from kickoff to board approval – Met a bold timeline without sacrificing participation or quality

• 100% of pillar sponsors identified and launched implementation teams within the first 30 days – Ensured immediate traction and accountability

• 20% reduction in planning hours compared to previous cycles – Designed for efficiency while increasing depth

• Monthly updates initiated to the board and executive team through simplified dashboards and templates – Built a culture of learning and transparent decision-making

• Multiple emerging leaders were placed into implementation roles – Created opportunities for talent development and future succession planning

Qualitative Outcomes:

The true transformation was cultural. Staff who had previously been skeptical of strategic planning now reported renewed confidence and enthusiasm about the organization's direction. Teams no longer felt overwhelmed by disconnected initiatives. Instead, they recognized how their work contributed to a shared strategic vision.

• Deepened cross-functional trust: By bringing staff from different departments and sites together during both planning and implementation, relationships were strengthened, and silos began to dissolve.

• Stronger sense of shared leadership: Because pillar teams were built with input from across the organization—not just executives—more people saw themselves as part of the leadership fabric.

• Clarity in the midst of complexity: Staff gained tools and a language to talk about priorities, trade-offs, and how to say “no” to distractions.

• Increased hope and agency: The appreciative and creative tone of the process lifted morale at a time when fatigue and burnout were real risks.

• Culture of follow-through: Unlike previous planning efforts that lost steam, the early wins and clear structures ensured sustained engagement.

Anecdotal Signals of Change

The shift in tone was also evident in how people talked about the experience:

• “It actually felt fun and hopeful.”

• “We didn’t just list problems. We got to dream—and then build something real.”

• “This wasn’t another initiative. It’s how we’re doing things now.”

Leaders shared that, for the first time, implementation wasn’t something “the board would check in on.” It was a living part of how teams worked, decided, and communicated every day.

Impact

The success of the strategic planning process at CHC–Burlington wasn’t just evident in the on-time delivery or the level of participation. It was visible in the transformation of culture, leadership dynamics, and how strategy shows up in daily operations. The real impact went beyond deliverables: it rewired how the organization thinks, collaborates, and leads.

What began as a time-limited strategic engagement quickly evolved into a catalyst for broader institutional alignment. Leaders describe this shift as both pragmatic and deeply personal.

1. Culture of Trust and Shared Leadership

One of the most significant outcomes was the strengthening of internal trust. By utilizing Appreciative Inquiry and engaging people from all levels of the organization, the planning process served as an immediate trust-building mechanism. Individuals who had previously felt disconnected or unheard were now actively participating in shaping decisions, setting priorities, and taking ownership of outcomes.

• Staff spoke of feeling “seen and valued,” especially those in operational and support roles who were often excluded from past planning cycles.

• The core team structure elevated emerging leaders, giving them experience and exposure that created ripple effects across departments.

• Board and executive leaders adopted a posture of humble inquiry, leading to greater alignment between governance and operations.

“It helped all levels of the organization apply a solution-finding rather than a problem-oriented mentality.” — Eric Kratochvil, Board President

2. A Strategic Plan That Drives Real Decisions

Unlike previous plans that were referenced occasionally or shelved entirely, the new strategic plan became a daily tool for alignment, prioritization, and focus.

• Pillar teams used the strategic filter to make difficult resource allocation choices.

• Department heads referenced the plan in budget planning, hiring decisions, and partnership evaluations.

• HR began exploring how to embed plan elements into job descriptions, onboarding, and internal communications.

This was a shift from a static document to a living framework for decision-making, flexible enough to respond to change, but clear enough to provide structure.

“We asked less of our folks’ time commitment during this process than in previous processes, and the results were actually better.” — Jeffrey McKee, CEO

3. Resilience in a Shifting Policy and Care Environment

As a Federally Qualified Health Center operating in Vermont’s All-Payer Model, CHC must continuously navigate regulatory shifts, reimbursement complexity, and evolving community needs. The process helped the organization build a stronger foundation for adaptive leadership.

• The plan’s flexible design made it easier to integrate new policy mandates and patient priorities without losing momentum.

• Cross-team collaboration positioned CHC to respond quickly to staffing or programmatic shifts.

• The shared language of “strategic pillars” created coherence across sites and roles, even amid external uncertainty.

This impact, strategic resilience paired with cultural alignment, sets the stage for CHC to lead not just reactively, but proactively in its community health ecosystem.

4. A Replicable Model for the Future

Perhaps most notably, the success of this engagement created a new organizational playbook for how CHC approaches change. The Positive Creativity methodology isn’t being retired. It’s being repeated and adapted.

• Several pillar teams are now using the same inquiry-based tools to shape team-level goals.

• The core planning team is being reconvened to apply the approach to other cross-functional projects.

• Leaders across departments are asking: “How can we keep using these methods to build culture while solving problems?”

This embedding of mindset, not just method, is the true long-term value.

Key Takeaways / Lessons Learned

The CHC–Burlington engagement offers a roadmap for how values-driven organizations can approach strategy not just as a deliverable, but as a catalyst for cultural alignment, distributed leadership, and lasting change. The following five takeaways summarize what made this process successful and why it can be replicated elsewhere.

1. Strategy Works Better When Everyone Sees Themselves in It

Too often, strategic plans are written by a small group and shared with many. At CHC, the process flipped that script: broad input shaped the vision, and broad ownership carried it forward. The result? Staff, board, and partners didn’t just understand the plan. They believed in it and felt responsible for its success.

Lesson Learned: When planning becomes participatory, strategy becomes personal.

2. Appreciative Inquiry Builds Trust and Momentum at the Same Time

By grounding the process in Appreciative Inquiry, CHC focused on what’s working, what’s possible, and who’s ready to lead. This changed the tone from problem-fixing to possibility-seeking and allowed the planning process itself to act as a cultural intervention.

Lesson Learned: Strengths-based design isn’t just a feel-good philosophy. It’s a high-trust, high-yield strategy.

3. Simplicity + Structure = Implementation That Sticks

The engagement succeeded not just because it was creative and inclusive, but because it was structured, time-bound, and implementation-ready. Tools like the five-pillar framework, strategic filters, and simple reporting dashboards made it easy to move from idea to action.

Lesson Learned: Clear roles and lightweight rhythms make execution sustainable, even in busy, stretched environments.

4. Strategy Can Be a Leadership Development Engine

CHC used this planning process to identify and develop emerging leaders, not merely to fill the room, but to empower them to carry the work forward. Providing team members with visibility and meaningful responsibility enhanced leadership capacity throughout the organization.

Lesson Learned: The best plans don’t just set direction. They grow the people who will get you there.

5. Culture Shift Is Both the Means and the End

Perhaps the most powerful lesson is this: the process is the product. Because the strategy was built through relationships, inquiry, and shared decision-making, it naturally reflected and reinforced the values CHC aimed to embody in the long term.

Lesson Learned: When people feel connected to the process, they stay committed to the outcomes.

About Third River Partners

Third River Partners equips mission-driven organizations and their leaders to align teams, accelerate impact, and grow sustainably. Through leadership certification programs, team alignment strategies, and fractional support, we help leaders serve well and scale wisely.