This year the Internal Revenue Support mandated that all non-profit hospitals undertake a community health needs assessment (CHNA) that year each 3 years thereafter. Further, these hospitals need to document a written report annually thereafter describing the progress that the community is making towards meeting the indicated needs. This type of examination is a prime example of primary prevention strategy in population health management. Primary prevention strategies give attention to protecting against the occurrence of diseases or strengthen the resistance to diseases by focusing on environmental factors generally.
I believe it is quite fortunate that non-profit clinics are carrying out this activity in their neighborhoods. By assessing the needs of the community and by working with community groups to increase the health of the community great strides can be made in increasing public well-being, a key determinant of their general health. As explained on the Institute for Health-related Improvement’s Blue Shirt Site (CHNAs and Beyond: Private hospitals and Community Health Improvement), “There is growing reputation that the social determinants of health – where we live, work, and play, the meals we eat, the opportunities we must work and exercise and stay in safety – drive health outcomes. Of course, there may be a sizable role for healthcare to play in providing medical care services, but it is indisputable that the foundation of any healthy life lies within the community. To manage true inhabitants health – that is, the health of a community – hospitals and health systems must partner with a broad variety of stakeholders who reveal ownership for increasing health inside our communities. ” We assume that these kind of community engagement can become increasingly important as reimbursement is driven by value.
Historically, healthcare providers have managed the health of individuals and local health departments have maintained the city environment to promote healthy lives. Nowadays, with the IRS necessity, the work of both are beginning to overlap. Included with the recent connection of the two are local coalitions and community organizations, such as religious organizations.
The city in which I live provides a fantastic example of the new interconnections of various organizations to collectively increase the health of the community. In 2014 nine non-profits, including three hospitals, in Kent County, Michigan conducted a CHNA of the state to determine the strong points and weaknesses of health in the county and examine the community’s awareness of the pressing health needs. The assessment determined that the main element areas of focus for bettering the health of the community are:
? Mental health issues
? Poor nutrition and unhealthy weight
? Substance abuse
? Violence and safety
At this time the Kent County Overall health Department has started growing a strategic plan for the city to talk about these issues. A large variety of community groupings have begun meeting regular to form this proper plan. There are four work groups, one for every single of the key areas of focus. I are involved in the Material Abuse workgroup as a representative of one of my clients, Kent More advanced School District. Other people will include a substance abuse avoidance coalition, a Federally experienced health center, a compound abuse treatment center and the local YMCA, and others. The local hospitals are involved in other workgroups. One of the treatment group representatives is a co-chair of our group. The health department would like to be certain that the strategic plan is community driven.
At the first meeting the health division leadership explained that the strategic plan must be community driven. This is so so that the various agencies in the community will buy into the strategic plan and will work cooperatively to provide the most effective elimination and treatment services without overlap. The dollars put in on services will be more effective if the many agencies work to boost each others’ work, to the extent possible.
For this time the Material Abuse work group is examining relevant data from the 2014 CHNA study and from other local resources. The epidemiologist at the department is researching relevant data with the group so that any decisions about the goals of the strategic plan will be data powered. Using data to make decisions is one of the keystones of the group’s operating principles. Every objectives in the ideal plan will be specific, measurable, achievable, realistic and time-bound (SMART).
After the tactical plan is finished, the groups will continue with implementation of the plan, evaluating the outcomes of the implementation and altering the plan as needed in light of analysis. As one can see, the workgroups of the CHNA are following the classic Plan-Do-Check-Act process. This kind of process has been shown time and again in many settings-healthcare, business, making, et al-to produce excellent outcomes when properly adopted.
As noted above I would recommend that healthcare providers get involved with community groupings to use population level health management strategies to increase the overall health of the community. One good area of involvement is the Community Health Needs Evaluation project being implemented through the local health office and non-profit hospitals.