Hospitals Look Outside Their Four Walls to Improve Community Health

Aug 9, 2016 1:15 PM ET

Hospitals Look Outside Their Four Walls to Improve Community Health

There’s a transformation occurring in how care is being delivered across communities. Acting as an anchor, hospitals and health systems are expanding beyond their physical campus by establishing partnerships with government agencies, non-profits and other organizations in their community to proactively and more fundamentally advance community health. As shown by the Blue Ribbon Panel initiated by the Baxter International Foundation and American Hospital Association’s Center for Healthcare Governance, these partnerships are yielding creative, sustainable solutions to serious community health issues like obesity, domestic violence and drug abuse.

The panel was established as part of the 30th anniversary of the Baxter International Foundation’s Foster G. McGaw Prize for Excellence in Community Service, one of the most esteemed community service honors in healthcare. First awarded in 1986, the prize recognizes and inspires hospitals and health systems to significantly improve their communities.

Seven prize recipients sat on the panel to share their insights on executing this new model of care delivery and emerging governance practices. The panelists recognized that the magnitude and complexity of social problems defy not only single solutions, but also the ability to determine at the outset of an initiative what potential solutions might succeed.

“Hospitals and health systems continue to forge strong ties to their communities as they improve wellness, expand services and increase access to even better quality care,” Debra Stock, AHA vice president, member relations, said. “Through hospital-convened community partnerships, profound changes that advance the health of individuals and communities can occur.”

Addressing the underlying causes of ill health, hospitals and health systems accept a holistic definition of health that encompasses both medical conditions and social determinants. One panelist noted that if the goal is to improve the healthcare in communities, it’s important to remember that healthcare is only 20 percent of that equation and, therefore, the remainder consists of lifestyle, behavior and social conditions. 

Collaborative governance – a model that unites organizations with common interests and missions in integrated thinking, planning and doing – was found to be the governance model most embraced by hospitals, health systems and their partners to improve community health. This includes the need for multi-sector collaboration to achieve the level of impact necessary for improved community health; in addition to the key role the hospitals and health systems have as key players.

For example, the 2015 Foster G, McGaw Prize winner, Massachusetts General Hospital (MGH), recently celebrated the 20th anniversary of its Center for Community Health Improvement (CCHI), which was founded to collaborate with underserved communities to address social and economic determinants of health, reduce barriers to care for vulnerable populations and promote health equity. The new clinic initiative, which built upon long-standing community-based prevention work, became the leading clinical priority of the entire hospital’s strategic plan.

As a result, the hospital was able to make a strong case in tackling substance abuse disorders by developing a comprehensive clinical initiative designed to transform care for patients. Known as the Substance Use Disorders (SUD) program, the initiative focused on re-designing care at all levels, such as enlisting recovery coaches to provide support and be a consistent member of the patients’ care team, developing new guidelines for safer opioid prescribing, enhancing the utilization and understanding of a validated SUD screening for all inpatients upon admission, and creating a transitional outpatient clinic to provide short-term care for discharged patients.

After conducting a community health needs assessment, which Blue Ribbon panelists noted was a good foundation in determining the focus, priorities and metrics around which hospitals, public health agencies and other community partners can make a difference, MGH found the specific communities in its service area had a pressing health problem with substance abuse. In addition to the SUD program, the hospital has also partnered with communities to change food options and physical environments so that healthy choices for eating and active living are easier to make and conducted refugee health assessments to connect them to primary care within 30 days. 

Every community is different, each with its own set of problems. For instance, one might find housing and poverty to heavily impact public health, whereas another might find tobacco use to be a major influence. By establishing partnerships with other agencies and organizations, more can be achieved to ensure the social determinants are also tackled in addition to basic health needs. Through programs like the Foster G. McGaw Prize and the Blue Ribbon Panel, the Baxter International Foundation continues to recognize and celebrate health organizations that support an integrated approach to better and easily accessible care.

“Two plus two doesn’t equal four anymore – it equals nine when you pool all your resources together and you can do things collaboratively with other organizations,” observed Vince Ford, chief community health officer at Palmetto Health, the 2014 Foster G. McGaw Prize winner, located in Columbia, South Carolina.