Across the country, there is growing awareness that restraining the increase in health costs and improving the health outcomes will require approaches that address the full array of factors that affect health. Greater attention and resources must be devoted to promoting a safer environment, healthy lifestyles, prevention of illnesses and injuries, and early detection and treatment of health problems, as well as dealing with the underlying determinants of health. Improving access to outpatient and inpatient medical services and the quality of those services, while vitally important, are not enough.
To effectively design, implement, and sustain a comprehensive approach to promoting the overall health of communities, we need meaningful collaboration among healthcare delivery organizations, governmental public health departments, and other community stakeholders. Unfortunately, while there is evidence of some increase in recent years, decades of limited communications, lack of mutual understanding, and incongruent goals have inhibited collaboration among these groups across the country. The University of Kentucky College of Public Health recently conducted a study intended to accelerate change, encourage collaboration, and contribute to building a Culture of Health in America. The purpose of the study is to identify successful partnerships involving hospitals, public health departments, and other stakeholders in improving the health of communities they serve and elevate key lessons learned.
The 12 partnerships in the study have involved hundreds of public and private organizations and thousands of community volunteers from various corners of the country. From New Orleans, Louisiana to New Ulm, Minnesota, these efforts have successfully informed broad cross-sections of their communities around the determinants of health, local issues that need to be addressed, and the long-term value of improving the overall health of their communities. Through engaging community organizations and citizens in their programs and activities, these partnerships are generating collective interest and action, building community spirit and social capital, and helping to build a Culture of Health within the communities they serve.
Formal partnerships involving hospitals and/or health systems, public health departments, and other stakeholders who share a commitment to improving the health of the community they serve have an important social role. These partnerships can serve as effective vehicles for collective action. But this is difficult work with substantial challenges, so our team formulated eleven recommendations for community leaders and policy makers to consider when developing effective and durable partnerships:
- To have enduring impact, partnerships focused on improving community health should include hospitals and public health departments as core partners but, over time, engage a broad range of other parties from the private and public sectors.
- Whenever possible, partnerships should be built on a foundation of pre-existing, trust-based relationships among some, if not all, of the principal founding partners. Other partners can and should be added as the organization becomes operational, but building and maintaining trust among all members is essential.
- In the context of their particular community’s health needs, the capabilities of existing organizations, and resource constraints, those who decide to establish a new partnership devoted to improving community health should adopt a statement of mission and goals that focuses on clearly-defined, high priority needs and will inspire community-wide interest, engagement, and support.
- For long-term success, partnerships need to have one or more “anchor institutions” with deep dedication to the partnership’s mission and commitment to provide on-going financial support.
- Partnerships focused on improving community health should have a designated body with a clearly-defined charter that is empowered by the principal partners to set policy and provide strategic leadership for the partnership.
- Partnership leaders should strive to build a clear, mutual understanding of “population health” concepts, definitions, and principles among the partners, participants, and, in so far as possible, the community at large.
- To enable evidence-based evaluation of a partnership’s progress in achieving its mission and goals and fulfill its accountability to key stakeholders, the partnership’s leadership must specify the community health measures they want to address, the particular objectives and targets they intend to achieve, and the metrics they will use to track and monitor progress.
- All partnerships focused on improving community health should place priority on developing and disseminating “impact statements” that present an evidence-based picture of the effects the partnership’s efforts are having in relation to the direct and indirect costs it is incurring.
- To enhance sustainability, all partnerships focused on community health improvement should develop a deliberate strategy for broadening and diversifying their sources of funding support.
- If they have not already done so, the governing boards of nonprofit hospitals and health systems and the boards of local health departments should establish standing committees with oversight responsibility for their organization’s engagement in examining community health needs, establishing priorities, and developing strategies for addressing them including multi-sector collaboration focused on community health improvement.
- If they have not already done so, local, state, and federal agencies with responsibilities related to population health improvement and hospital and public health associations should adopt policy positions that promote the development of collaborative partnerships involving hospitals, public health departments, and other stakeholders focused on assessing and improving the health of the communities they serve.
We think a paradigm shift is occurring in America: there is growing realization that controlling the increase in health expenditures and improving the health of our nation’s population will require major changes in traditional policies, practices, and organizational models. These partnerships are bold pioneers and, we hope, as harbingers of a new era of innovation and multi-sector collaboration focused on building a robust Culture of Health throughout America.
Have you built effective health partnerships? Share your story in the comments below.