The Role of the Chief Nursing Officer in Bridging Gaps Among Health Systems and Communities to Improve Population Health

Jan 8, 2015, 9:56 AM

Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

Since my doctoral work in public health, I have thought a great deal about the relationship of public health theory and practice and my acute care background. With more than 30 years of progressive leadership experience in a variety of for-profit/non-profit, inpatient and outpatient positions, I am trying to generate dialogue and discern a purposeful plan regarding the role of a Chief Nursing Officer in an academic medical center and the health of the populations we serve in our communities.

Based on earlier work in the 1990s and early 2000s, in 2007 the Health Research and Education Trust (HRET) engaged national experts to address the following question: How can hospitals engage their communities to improve the health of everyone? The report provides a framework and encourages hospital leaders and community members to envision health care in communities beyond the medical services offered by providers; it notes that the production of health is not only medical care, but also our environment, individual behavior, and genetic make-up.

This report reminded me of theoretical models of health behavior change. There are a wide variety of models formulated to understand and promote health behavior change in relation to individual health behavior, interpersonal health behavior, as well as community and group models (DiClemente, Salazar & Corsby, 2013; Glanz, Rimer & Viswanath, 2008). Ecological models of health behavior are gaining popularity because they consider the connections between individuals and their environments. Can hospital leaders conceptualize the broader context of health behavior change as integral to their financial success in population health strategies? According to HRET: 1) medical care contributes only 10 percent to the production of health; 2) 75 percent of U.S. health care spending goes to preventable diseases; and 3) 10 percent of the population accounts for more than 60 percent of health care spending.

For those of us who are most familiar with acute, inpatient care, we have a transformational shift on our hands!  

Key steps in the process include community-based needs assessments, using the best evidence to consider high-impact strategies, clear systems to measure progress on selected indicators, and a clear commitment to mutual collaboration across a variety of community sectors and stakeholders.

So what will the Chief Nursing Officer, within an academic medical center, do to help guide the health system toward renewed focus on population health? Look around and get involved!

I should join my colleague, Mary Howard, DNP, RN, NEA-BC, Administrator for Patient Care Services and the Chief Nursing Officer for University Hospital East, in support of the recent U.S. Department of Housing and Urban Development (HUD) grant—a $30 million grant to Columbus Metropolitan Housing Authority (CMHA) and Partners Achieving Community Transformation (PACT) to help improve and revitalize the Near East Side neighborhood around University Hospital East. PACT is a partnership between The Ohio State University, the City of Columbus and the CMHA. This federal Choice Neighborhoods Initiative Grant will allow PACT to redevelop and improve housing, empower people with workforce training and wellness programs, and grow this community by attracting new businesses.

Just this week, I learned about ENCompass! An undergraduate student organization at the Ohio State University dedicated to bridging the gap between medical and social care, its mission is to empower individuals and improve the health of those living in the Columbus community by connecting them with resources that address social determinants of health.

So the first thing this Chief Nursing Officer can do is look beyond the walls of the hospital itself, and realize that what fills hospital beds today is, in part, the lack of what is needed in our quest for a Culture of Health: sustainable communities built to promote and support healthy lifestyles. Perhaps this is my 2015 New Year’s Resolution!

 

References

DiClemente, R.J., Salazar, L.F., & Crosby, R.A. (2013). Health behavior theory for public health. . Burlington, MA: Jones & Bartlett.

Glanz, K., Rimer, B.K., & Viswanath, K. (2008). Health behavior and health education. Jossey-Bass: San Francisco, CA.

Health Research and Educational Trust (2007). Where Do We Go From Here? The Hospital Leader’s Role in Community Engagement, Retrieved December 23, 2014, http://www.nonprofithealthcare.org/resources/where_do_we_go_from_here.pdf

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.