Keeping people well requires hospitals to move much of the job from within the walls of the organization where acute care is delivered to outside the hospital into the community where prevention and early intervention and treatment are based.
It’s a major sea change, but hospitals don’t have to go it alone. There are many organizations in each community whose mission can align with that of the hospital and will benefit from such a partnership. Working with other providers such as allied professionals and satellite community-based settings can create innovation that utilizes a wide range of resources and can more effectively support patient self-management and family-centered care.
Who will be your most important collaborators and how do you begin to build a strong partnership with them?
The following five steps will help you get started.
1. Find partners providing services that advance the organization’s mission and broaden its role as an essential healthcare leader. Identify the intersection of the hospital’s mission, expertise and goals for growth with community needs. Bring on partners whose work enhances the hospital’s resources in the areas in which it wants to grow (i.e., physicians’ groups, residency programs, public health entities, community-based health organizations) and with specialties in areas of that intersection. Initiating the collaboration that addresses community needs will enhance the hospital’s role as a leader. Integrate collaboration with community providers into the plans for growth in all areas.
2. Community partners should include organizations that address the health issues represented by emergency department visits and readmissions. To begin, mine the data that will tell you where your charity dollars are being spent and what those dollars are buying. What are the emergency department patients coming in for, and what are the complaints that are bringing patients back over and over again? Bring in partners that address those problems in an outpatient setting before they become acute and those that can support patients in following through with their post-acute care plans. For example, if substance abuse is a primary source of ED high utilization, begin discussions with organizations that provide substance abuse treatment and mental health and homelessness services to find common goals and collaborate to provide patient services in community-based settings.
3. Look to partners that can address the social determinants of health: those factors in community residents’ lives that influence their behaviors and have an impact on their health. The goal is to create a continuum of care from prevention to acute care. Begin with those partners that have direct interest and engagement in health and wellness (i.e., YMCA, mental health providers, community-based clinics) and expand from there to those working on the built environment, transportation, access to healthy foods, schools, affordable housing, employment and interpersonal and community violence.
4. Select leaders who can move the work forward. The working group of individuals who make up the decision-making body of the collaboration should be leaders who can speak on behalf of their organization. Only with participants who have the authority to act on their organization’s behalf can the partnership progress at an efficient pace. This may require creating a position that is focused outward (i.e., community health vice president or director of community health) or engaging a consultant who represents the hospital to community providers.
The decision-making group must also have meaningful representation of the target population. Community residents who are consumers of the services to be provided need to be at the table with decision-making power and be given a leadership role. These are the people who are engaged through their relationships with the community-based partner agency (i.e., the affordable housing organization or the local school parent association). They will ensure viability of the plans made and will act as conduits to those the hospital and its partners want to engage.
5. Include evaluation metrics from the get go. Healthcare organizations across the country are searching for effective solutions to community health challenges. Establishing evaluation measures will allow you and your partners to demonstrate most successful practices, improve or redesign those that are inefficient and build a case for funding and policy change. Doing so will mean investing in IT that will provide the necessary data.
Joan Dentler is president and chief executive officer of Avanza Healthcare Strategies, which provides healthcare organizations with strategic guidance, with a focus on outpatient services and community collaborations. For more than 25 years Ms. Dentler has been consulting on, developing or operating hospital outpatient services, ambulatory surgery centers and community health initiatives.
Ellen Sanchez is director of community health strategies for Avanza Healthcare Strategies. With 25 years experience in community outreach, education and health promotion, Ms. Sanchez has designed and implemented many successful programs from the ground up and turned existing programs into models of innovation.
